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1 / 50#50. Transylvania County
- Opioid dispensing rate: 39.8 per 100 people
--- 24.6% lower than state average
--- 8.1% lower than national average
Counties where the most opioids are dispensed in North Carolina
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 North Carolina, the opioid dispensing rate was 52.8 per 100 people, compared to 43.3 nationally.
Read the national story for additional historical context and see where other counties outside of North Carolina stand.
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2 / 50#49. Wayne County
- Opioid dispensing rate: 40.5 per 100 people
--- 23.3% lower than state average
--- 6.5% lower than national average
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3 / 50#48. Alleghany County
- Opioid dispensing rate: 41.4 per 100 people
--- 21.6% lower than state average
--- 4.4% lower than national average
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4 / 50#47. Mcdowell County
- Opioid dispensing rate: 42.4 per 100 people
--- 19.7% lower than state average
--- 2.1% lower than national average
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5 / 50#46. Chowan County
- Opioid dispensing rate: 42.6 per 100 people
--- 19.3% lower than state average
--- 1.6% lower than national average
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6 / 50#45. Lenoir County
- Opioid dispensing rate: 42.8 per 100 people
--- 18.9% lower than state average
--- 1.2% lower than national average
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7 / 50#44. Vance County
- Opioid dispensing rate: 43.5 per 100 people
--- 17.6% lower than state average
--- 0.5% higher than national average
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8 / 50#43. Ashe County
- Opioid dispensing rate: 45.2 per 100 people
--- 14.4% lower than state average
--- 4.4% higher than national average
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9 / 50#42. Rutherford County
- Opioid dispensing rate: 45.4 per 100 people
--- 14.0% lower than state average
--- 4.8% higher than national average
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10 / 50#41. Beaufort County
- Opioid dispensing rate: 46.5 per 100 people
--- 11.9% lower than state average
--- 7.4% higher than national average
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11 / 50#40. Onslow County
- Opioid dispensing rate: 46.8 per 100 people
--- 11.4% lower than state average
--- 8.1% higher than national average
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12 / 50#39. Harnett County
- Opioid dispensing rate: 47.3 per 100 people
--- 10.4% lower than state average
--- 9.2% higher than national average
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13 / 50#38. Cabarrus County
- Opioid dispensing rate: 48.7 per 100 people
--- 7.8% lower than state average
--- 12.5% higher than national average
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14 / 50#37. Halifax County
- Opioid dispensing rate: 50.1 per 100 people
--- 5.1% lower than state average
--- 15.7% higher than national average
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15 / 50#36. Mecklenburg County
- Opioid dispensing rate: 51.3 per 100 people
--- 2.8% lower than state average
--- 18.5% higher than national average
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16 / 50#35. Rockingham County
- Opioid dispensing rate: 51.4 per 100 people
--- 2.7% lower than state average
--- 18.7% higher than national average
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17 / 50#34. Caldwell County
- Opioid dispensing rate: 52.4 per 100 people
--- 0.8% lower than state average
--- 21.0% higher than national average
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18 / 50#33. Rowan County
- Opioid dispensing rate: 53.8 per 100 people
--- 1.9% higher than state average
--- 24.2% higher than national average
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19 / 50#32. Watauga County
- Opioid dispensing rate: 54.5 per 100 people
--- 3.2% higher than state average
--- 25.9% higher than national average
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20 / 50#31. Pasquotank County
- Opioid dispensing rate: 55.4 per 100 people
--- 4.9% higher than state average
--- 27.9% higher than national average
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21 / 50#30. Guilford County
- Opioid dispensing rate: 55.9 per 100 people
--- 5.9% higher than state average
--- 29.1% higher than national average
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22 / 50#29. Lee County
- Opioid dispensing rate: 56.1 per 100 people
--- 6.3% higher than state average
--- 29.6% higher than national average
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23 / 50#28. Robeson County
- Opioid dispensing rate: 58.0 per 100 people
--- 9.8% higher than state average
--- 33.9% higher than national average
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24 / 50#27. Hertford County
- Opioid dispensing rate: 59.2 per 100 people
--- 12.1% higher than state average
--- 36.7% higher than national average
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25 / 50#26. Bertie County
- Opioid dispensing rate: 59.5 per 100 people
--- 12.7% higher than state average
--- 37.4% higher than national average
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26 / 50#25. Haywood County
- Opioid dispensing rate: 61.3 per 100 people
--- 16.1% higher than state average
--- 41.6% higher than national average
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27 / 50#24. Burke County
- Opioid dispensing rate: 61.4 per 100 people
--- 16.3% higher than state average
--- 41.8% higher than national average
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28 / 50#23. Carteret County
- Opioid dispensing rate: 62.8 per 100 people
--- 18.9% higher than state average
--- 45.0% higher than national average
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29 / 50#22. Cumberland County
- Opioid dispensing rate: 64.3 per 100 people
--- 21.8% higher than state average
--- 48.5% higher than national average
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30 / 50#21. Gaston County
- Opioid dispensing rate: 65.9 per 100 people
--- 24.8% higher than state average
--- 52.2% higher than national average
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31 / 50#20. Durham County
- Opioid dispensing rate: 68.2 per 100 people
--- 29.2% higher than state average
--- 57.5% higher than national average
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32 / 50#19. Dare County
- Opioid dispensing rate: 68.8 per 100 people
--- 30.3% higher than state average
--- 58.9% higher than national average
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33 / 50#18. Surry County
- Opioid dispensing rate: 68.8 per 100 people
--- 30.3% higher than state average
--- 58.9% higher than national average
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34 / 50#17. Buncombe County
- Opioid dispensing rate: 73.5 per 100 people
--- 39.2% higher than state average
--- 69.7% higher than national average
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35 / 50#16. Columbus County
- Opioid dispensing rate: 73.8 per 100 people
--- 39.8% higher than state average
--- 70.4% higher than national average
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36 / 50#15. Cherokee County
- Opioid dispensing rate: 74.1 per 100 people
--- 40.3% higher than state average
--- 71.1% higher than national average
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37 / 50#14. Iredell County
- Opioid dispensing rate: 74.4 per 100 people
--- 40.9% higher than state average
--- 71.8% higher than national average
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38 / 50#13. Craven County
- Opioid dispensing rate: 75.6 per 100 people
--- 43.2% higher than state average
--- 74.6% higher than national average
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39 / 50#12. Mitchell County
- Opioid dispensing rate: 76.3 per 100 people
--- 44.5% higher than state average
--- 76.2% higher than national average
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40 / 50#11. Nash County
- Opioid dispensing rate: 79.2 per 100 people
--- 50.0% higher than state average
--- 82.9% higher than national average
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41 / 50#10. New Hanover County
- Opioid dispensing rate: 80.5 per 100 people
--- 52.5% higher than state average
--- 85.9% higher than national average
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42 / 50#9. Richmond County
- Opioid dispensing rate: 84.1 per 100 people
--- 59.3% higher than state average
--- 94.2% higher than national average
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43 / 50#8. Orange County
- Opioid dispensing rate: 90.9 per 100 people
--- 72.2% higher than state average
--- 109.9% higher than national average
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44 / 50#7. Scotland County
- Opioid dispensing rate: 95.1 per 100 people
--- 80.1% higher than state average
--- 119.6% higher than national average
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45 / 50#6. Forsyth County
- Opioid dispensing rate: 95.3 per 100 people
--- 80.5% higher than state average
--- 120.1% higher than national average
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46 / 50#5. Swain County
- Opioid dispensing rate: 96.1 per 100 people
--- 82.0% higher than state average
--- 121.9% higher than national average
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47 / 50#4. Pitt County
- Opioid dispensing rate: 102.3 per 100 people
--- 93.8% higher than state average
--- 136.3% higher than national average
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48 / 50#3. Catawba County
- Opioid dispensing rate: 104.6 per 100 people
--- 98.1% higher than state average
--- 141.6% higher than national average
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49 / 50#2. Cleveland County
- Opioid dispensing rate: 112.2 per 100 people
--- 112.5% higher than state average
--- 159.1% higher than national average
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50 / 50#1. Moore County
- Opioid dispensing rate: 124.5 per 100 people
--- 135.8% higher than state average
--- 187.5% higher than national average
