Last updated : May 12, 2025
Drug use in America is has gone up and down over the years, and while we’re currently in the midst of a national opiate crisis, a handful of cities are especially plagued by a variety of drugs.
According to 2013 research conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), some 68.9% of America’s estimated 22 million drug users are in some kind of full or part-time employment. This means that despite what most employers believe, many of them employ people who use drugs. We know that this has a negative impact on society in general, but the problem is magnified dramatically in the workplace.
Our workplace drug problem
The National Council on Alcoholism and Drug Dependence (NCADD) reports that drug abuse costs American employers over $81 billion every year. These financial losses are caused by:
- high turnover rates
- reductions in productivity
- workplace theft
- higher absenteeism
- more sick time use
- lower quality of work
The problem of workplace drug abuse is far wider than the often extreme and obvious effects of “hard” drugs such as heroin, cocaine, or crystal meth. In fact the misuse of marijuana and prescription opiates is far more prevalent and just as harmful. This is why the Department of Transportation has updated their DOT drug testing regulations in January 2018.
Are you wondering if your city has earned a place on this list? Find out below:
9 Albuquerque, NM
Its location has long placed New Mexico square on the main distribution route for heroin and meth, but Alburquerque also has a significant opiate problem. Recent figures suggest that more than 200 people die each year from drug overdoses.
8 Knoxville, TN
Tennessee is one of the worst affected states in the nation, and Knox County alone saw some 237 overdose deaths in 2016. Recent successes in tackling the opiate epidemic have been offset by an apparent increase in heroin use.
7 Warren, MI
The drug problem in this large Detroit suburb is best exemplified by the sharp rise it has seen in heroin related deaths, which increased more than tenfold between 2014 and 2016. But there is also a significant opioid problem, and across Detroit as a whole, 1,980 drug related deaths were recorded in 2015.
6 Cincinnati, OH
In August 2016, Cincinnatti saw a shocking 174 overdoses in a mere 6 days. This was of course a peak, but rates of 20-25 a day remain the norm. The severity of the problem is blamed on the use of synthetic opioids such as carfentanil and fentanyl which can be hundreds of times stronger than heroin.
5 Birmingham, AL
Opioids are the big problem in Birmingham. Law enforcement officers now routinely carry Narcan, an effective antidote in cases of overdose, and the remedy is also widely available in pharmacies for addicts and their families.
4 New Bedford, MA
In October 2017 the US Federal Drug Enforcement Agency announced that New Bedford would be one of six cities nationwide to which it would be sending teams of investigators to help combat the problem of drug trafficking.
Heroin and the synthetic opioid, fentanyl and its derivatives, are particularly serious issues for the city.
3 Philadelphia, PA
A dramatic surge in overdose deaths in Philadelphia saw the 2016 figure increase to more than 900, a 30% increase on 2015.
The alarming number, largely blamed on opioids, led city Mayor, Jim Kenney, to establish a new 16 person special task force to tackle the crisis.
2 Baltimore, MD
Health and law enforcement professionals in Baltimore also largely blame the use of fentanyl in place of heroin, knowingly or otherwise, for the dramatic rise in overdose deaths in the city.
Compared with the same period in 2015, fentanyl related deaths soared nearly threefold to more than 700 in the first nine months of 2016.
1 Dayton, OH
Montgomery County Sheriff, Phil Plummer, places the blame for Dayton and Montgomery’s status as the overdose capital of the nation squarely on fentanyl and other opioids.
By June 2017, the county was on course to record more than 800 overdose deaths for the year, the highest rate in the country per head of population.
