This story originally appeared on Ophelia and was produced and distributed in partnership with Stacker Studio.
Counties where the most opioids are dispensed in Iowa
When Purdue Pharma first began sales of OxyContin in the late 1990s, it was advertised as relief for cancer patients and people with chronic pain. Aggressive marketing fueled the drug's popularity, along with that of other opioid pain management drugs on the market. But as the company touted OxyContin to physicians, it downplayed the drug's addictiveness, according to confidential Justice Department reports obtained by news organizations, leading to widespread use that has fueled an opioid epidemic across the U.S.
More than 645,000 people have died from opioid-related overdoses between 1999 and 2021, according to the Centers for Disease Control and Prevention. Provisional data shows just under 80,000 people died in 2022 alone.
Opioid prescriptions have decreased dramatically over the past decade as physicians and public health officials learned about the dangers of OxyContin and other opioids prescribed for pain management. In 2020, the most recent year with data available, the national opioid dispense rate reached 43.3 per 100 people, the lowest rate ever recorded.
A 2022 study funded by the National Institute on Drug Abuse found that counties with higher dispensing rates had more cases of opioid misuse and dependence. The study suggested that reducing prescriptions at the local level can lower a community's rate of opioid abuse or misuse.
Other studies, however, have suggested that decreasing prescriptions may have fueled a new phase of the opioid epidemic: the rise of synthetics like fentanyl. In 2020, synthetics accounted for 82% of all opioid deaths.
It's also important to note that, as awareness has grown about the dangers of dispensing opioid prescription painkillers, more health care professionals are also prescribing medications like Suboxone–which contains buprenorphine and naloxone—for the treatment of addiction and opioid use disorders. While Suboxone is also an opioid medication, it works differently than typical opioid painkillers, blocking the effects of more powerful and addictive opioids to deter intentional misuse.
Using data from the Centers for Disease Control and Prevention, Ophelia broke down counties in every state with the highest opioid dispense rates. In the case of a tie, the county with the higher population and higher raw number is ranked higher. Data was available for 98% of counties in the United States. Overall in Iowa, the opioid dispensing rate was 40.2 per 100 people, compared to 43.3 nationally.
Read the national story for additional historical context and see where other counties outside of Iowa stand.
#50. Shelby County
- Opioid dispensing rate: 33.1 per 100 people
--- 17.7% lower than state average
--- 23.6% lower than national average
#49. Marshall County
- Opioid dispensing rate: 33.1 per 100 people
--- 17.7% lower than state average
--- 23.6% lower than national average
#48. Jasper County
- Opioid dispensing rate: 33.3 per 100 people
--- 17.2% lower than state average
--- 23.1% lower than national average
#47. Winnebago County
- Opioid dispensing rate: 33.5 per 100 people
--- 16.7% lower than state average
--- 22.6% lower than national average
#46. Linn County
- Opioid dispensing rate: 33.6 per 100 people
--- 16.4% lower than state average
--- 22.4% lower than national average
#45. Grundy County
- Opioid dispensing rate: 33.8 per 100 people
--- 15.9% lower than state average
--- 21.9% lower than national average
#44. Audubon County
- Opioid dispensing rate: 34.5 per 100 people
--- 14.2% lower than state average
--- 20.3% lower than national average
#43. Montgomery County
- Opioid dispensing rate: 34.6 per 100 people
--- 13.9% lower than state average
--- 20.1% lower than national average
#42. Lee County
- Opioid dispensing rate: 34.6 per 100 people
--- 13.9% lower than state average
--- 20.1% lower than national average
#41. Marion County
- Opioid dispensing rate: 34.7 per 100 people
--- 13.7% lower than state average
--- 19.9% lower than national average
#40. Poweshiek County
- Opioid dispensing rate: 35.0 per 100 people
--- 12.9% lower than state average
--- 19.2% lower than national average
#39. Mills County
- Opioid dispensing rate: 35.6 per 100 people
--- 11.4% lower than state average
--- 17.8% lower than national average
#38. Hardin County
- Opioid dispensing rate: 35.8 per 100 people
--- 10.9% lower than state average
--- 17.3% lower than national average
#37. Davis County
- Opioid dispensing rate: 35.9 per 100 people
--- 10.7% lower than state average
--- 17.1% lower than national average
#36. Ida County
- Opioid dispensing rate: 36.1 per 100 people
--- 10.2% lower than state average
--- 16.6% lower than national average
#35. Dubuque County
- Opioid dispensing rate: 36.1 per 100 people
--- 10.2% lower than state average
--- 16.6% lower than national average
#34. Guthrie County
- Opioid dispensing rate: 36.4 per 100 people
--- 9.5% lower than state average
--- 15.9% lower than national average
#33. Harrison County
- Opioid dispensing rate: 36.6 per 100 people
--- 9.0% lower than state average
--- 15.5% lower than national average
#32. Clinton County
- Opioid dispensing rate: 36.6 per 100 people
--- 9.0% lower than state average
--- 15.5% lower than national average
#31. Jefferson County
- Opioid dispensing rate: 37.6 per 100 people
--- 6.5% lower than state average
--- 13.2% lower than national average
#30. Van Buren County
- Opioid dispensing rate: 37.7 per 100 people
--- 6.2% lower than state average
--- 12.9% lower than national average
#29. Wapello County
- Opioid dispensing rate: 37.7 per 100 people
--- 6.2% lower than state average
--- 12.9% lower than national average
#28. Monona County
- Opioid dispensing rate: 37.9 per 100 people
--- 5.7% lower than state average
--- 12.5% lower than national average
#27. Floyd County
- Opioid dispensing rate: 38.3 per 100 people
--- 4.7% lower than state average
--- 11.5% lower than national average
#26. Appanoose County
- Opioid dispensing rate: 40.1 per 100 people
--- 0.2% lower than state average
--- 7.4% lower than national average
#25. Pottawattamie County
- Opioid dispensing rate: 40.3 per 100 people
--- 0.2% higher than state average
--- 6.9% lower than national average
#24. Lucas County
- Opioid dispensing rate: 40.9 per 100 people
--- 1.7% higher than state average
--- 5.5% lower than national average
#23. Mahaska County
- Opioid dispensing rate: 40.9 per 100 people
--- 1.7% higher than state average
--- 5.5% lower than national average
#22. Obrien County
- Opioid dispensing rate: 41.2 per 100 people
--- 2.5% higher than state average
--- 4.8% lower than national average
#21. Cass County
- Opioid dispensing rate: 42.4 per 100 people
--- 5.5% higher than state average
--- 2.1% lower than national average
#20. Greene County
- Opioid dispensing rate: 43.3 per 100 people
--- 7.7% higher than state average
--- 0.0% lower than national average
#19. Woodbury County
- Opioid dispensing rate: 44.3 per 100 people
--- 10.2% higher than state average
--- 2.3% higher than national average
#18. Carroll County
- Opioid dispensing rate: 45.3 per 100 people
--- 12.7% higher than state average
--- 4.6% higher than national average
#17. Ringgold County
- Opioid dispensing rate: 46.9 per 100 people
--- 16.7% higher than state average
--- 8.3% higher than national average
#16. Des Moines County
- Opioid dispensing rate: 47.3 per 100 people
--- 17.7% higher than state average
--- 9.2% higher than national average
#15. Page County
- Opioid dispensing rate: 47.7 per 100 people
--- 18.7% higher than state average
--- 10.2% higher than national average
#14. Decatur County
- Opioid dispensing rate: 49.7 per 100 people
--- 23.6% higher than state average
--- 14.8% higher than national average
#13. Hamilton County
- Opioid dispensing rate: 49.8 per 100 people
--- 23.9% higher than state average
--- 15.0% higher than national average
#12. Webster County
- Opioid dispensing rate: 50.6 per 100 people
--- 25.9% higher than state average
--- 16.9% higher than national average
#11. Calhoun County
- Opioid dispensing rate: 52.0 per 100 people
--- 29.4% higher than state average
--- 20.1% higher than national average
#10. Scott County
- Opioid dispensing rate: 54.4 per 100 people
--- 35.3% higher than state average
--- 25.6% higher than national average
#9. Black Hawk County
- Opioid dispensing rate: 54.7 per 100 people
--- 36.1% higher than state average
--- 26.3% higher than national average
#8. Union County
- Opioid dispensing rate: 54.8 per 100 people
--- 36.3% higher than state average
--- 26.6% higher than national average
#7. Taylor County
- Opioid dispensing rate: 60.2 per 100 people
--- 49.8% higher than state average
--- 39.0% higher than national average
#6. Clay County
- Opioid dispensing rate: 60.2 per 100 people
--- 49.8% higher than state average
--- 39.0% higher than national average
#5. Polk County
- Opioid dispensing rate: 60.2 per 100 people
--- 49.8% higher than state average
--- 39.0% higher than national average
#4. Johnson County
- Opioid dispensing rate: 67.9 per 100 people
--- 68.9% higher than state average
--- 56.8% higher than national average
#3. Cerro Gordo County
- Opioid dispensing rate: 69.5 per 100 people
--- 72.9% higher than state average
--- 60.5% higher than national average
#2. Monroe County
- Opioid dispensing rate: 84.1 per 100 people
--- 109.2% higher than state average
--- 94.2% higher than national average
#1. Wayne County
- Opioid dispensing rate: 95.9 per 100 people
--- 138.6% higher than state average
--- 121.5% higher than national average
