America is clearly losing the war on drugs in some states, arguably winning in others

The state with the worst illicit drug problem is also home to the largest percentage of teenage users.

That would be New Mexico, which has been slow to enact policies that could head off problem drug use or treat it once it starts making another addict. 

Examples of measures that might help: employee drug testing laws—New Mexico has none—and effective sobriety programs for marijuana-using Medicaid patients at risk for harder drug use. The “Land of Enchantment” state has the 13th-lowest share of people in these programs. 

Other markers leading to New Mexico’s worst-of-all ranking: It has 

• the highest share of teenagers who report having tried marijuana before age 13, 
   
• the second-highest share of adults who use illicit drugs, and 
   
• the eighth-highest share of children who lived with anyone who had a problem with alcohol or drugs.

Meanwhile New Mexico has a “large number of drug overdose deaths per capita, highlighting the severity of the drug crisis in the state.”

The quote as well as the findings are from the organization behind the rankings, WalletHub. 

Its latest look at drug use by state, posted April 29, should give pause to others in the top 20 of the bottom states (No. 1 = worst):

20. Alabama

19. South Carolina

18. Oregon

17. Michigan

16. Washington

15. Vermont

14. Louisiana

13. Montana

12. Maine

11. Wyoming

10. Mississippi

9. Oklahoma

8. District of Columbia 

7. Colorado

6. West Virginia

5. Missouri

4. Nevada 

3. Alaska

2. Arkansas

1. New Mexico 

The triumphing 10 

At the other end of the scale is the honor roll of 10 states with the least vexing drug problems. In order starting with the very best: 

Utah, Florida, Minnesota, Maryland, Iowa, Virginia, Ohio, Hawaii, Connecticut and Nebraska. 

WalletHub compared and contrasted the 50 states plus the District of Columbia on 20 specific metrics bundled into three categories—drug use & addiction, law enforcement, and drug health issues & rehab.

“Drug abuse has a long and storied history in the United States, and we’ve been ‘at war’ with it for decades,” remarks WalletHub managing editor John Kiernan. “Yet despite the country’s best efforts to fight it, the problem is still prevalent.”

He cites CDC statistics showing there were more than 68,400 drug overdose deaths in the 12-month period ending in October 2025.

“It’s crucial for the government to address this issue and prevent it from getting any worse,” Kiernan writes. “The government must also deal with the changing landscape of drug use, as newer drugs like fentanyl become more widespread.”

For WalletHub’s full findings and analysis, click here.