Opioids flow most freely freely in these Alabama counties

Published 3:24 pm Friday, September 22, 2023

Counties where the most opioids are dispensed in Alabama

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 Alabama, the opioid dispensing rate was 80.4 per 100 people, compared to 43.3 nationally.

Read the national story for additional historical context and see where other counties outside of Alabama stand.


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#50. Washington County

– Opioid dispensing rate: 29.4 per 100 people
— 63.4% lower than state average
— 32.1% lower than national average

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#49. Dale County

– Opioid dispensing rate: 31.8 per 100 people
— 60.4% lower than state average
— 26.6% lower than national average

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#48. Crenshaw County

– Opioid dispensing rate: 33.4 per 100 people
— 58.5% lower than state average
— 22.9% lower than national average

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#47. Butler County

– Opioid dispensing rate: 35.1 per 100 people
— 56.3% lower than state average
— 18.9% lower than national average

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#46. Lee County

– Opioid dispensing rate: 35.4 per 100 people
— 56.0% lower than state average
— 18.2% lower than national average

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#45. Russell County

– Opioid dispensing rate: 35.9 per 100 people
— 55.3% lower than state average
— 17.1% lower than national average

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#44. Choctaw County

– Opioid dispensing rate: 37.8 per 100 people
— 53.0% lower than state average
— 12.7% lower than national average

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#43. Pike County

– Opioid dispensing rate: 38.5 per 100 people
— 52.1% lower than state average
— 11.1% lower than national average

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#42. Chilton County

– Opioid dispensing rate: 39.3 per 100 people
— 51.1% lower than state average
— 9.2% lower than national average

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#41. Talladega County

– Opioid dispensing rate: 39.7 per 100 people
— 50.6% lower than state average
— 8.3% lower than national average

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#40. Sumter County

– Opioid dispensing rate: 41.9 per 100 people
— 47.9% lower than state average
— 3.2% lower than national average

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#39. Tallapoosa County

– Opioid dispensing rate: 43.4 per 100 people
— 46.0% lower than state average
— 0.2% higher than national average

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#38. Pickens County

– Opioid dispensing rate: 43.7 per 100 people
— 45.6% lower than state average
— 0.9% higher than national average

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#37. Henry County

– Opioid dispensing rate: 46.2 per 100 people
— 42.5% lower than state average
— 6.7% higher than national average

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#36. Randolph County

– Opioid dispensing rate: 47.0 per 100 people
— 41.5% lower than state average
— 8.5% higher than national average

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#35. Cherokee County

– Opioid dispensing rate: 50.6 per 100 people
— 37.1% lower than state average
— 16.9% higher than national average

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#34. Fayette County

– Opioid dispensing rate: 53.6 per 100 people
— 33.3% lower than state average
— 23.8% higher than national average

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#33. Monroe County

– Opioid dispensing rate: 53.7 per 100 people
— 33.2% lower than state average
— 24.0% higher than national average

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#32. Lauderdale County

– Opioid dispensing rate: 57.3 per 100 people
— 28.7% lower than state average
— 32.3% higher than national average

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#31. Marengo County

– Opioid dispensing rate: 58.8 per 100 people
— 26.9% lower than state average
— 35.8% higher than national average

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#30. Chambers County

– Opioid dispensing rate: 60.5 per 100 people
— 24.8% lower than state average
— 39.7% higher than national average

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#29. Dallas County

– Opioid dispensing rate: 62.7 per 100 people
— 22.0% lower than state average
— 44.8% higher than national average

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#28. Saint Clair County

– Opioid dispensing rate: 63.0 per 100 people
— 21.6% lower than state average
— 45.5% higher than national average

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#27. De Kalb County

– Opioid dispensing rate: 64.3 per 100 people
— 20.0% lower than state average
— 48.5% higher than national average

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#26. Shelby County

– Opioid dispensing rate: 64.6 per 100 people
— 19.7% lower than state average
— 49.2% higher than national average

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#25. Winston County

– Opioid dispensing rate: 65.0 per 100 people
— 19.2% lower than state average
— 50.1% higher than national average

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#24. Baldwin County

– Opioid dispensing rate: 65.0 per 100 people
— 19.2% lower than state average
— 50.1% higher than national average

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#23. Clarke County

– Opioid dispensing rate: 65.9 per 100 people
— 18.0% lower than state average
— 52.2% higher than national average

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#22. Morgan County

– Opioid dispensing rate: 67.9 per 100 people
— 15.5% lower than state average
— 56.8% higher than national average

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#21. Jackson County

– Opioid dispensing rate: 71.7 per 100 people
— 10.8% lower than state average
— 65.6% higher than national average

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#20. Coffee County

– Opioid dispensing rate: 74.4 per 100 people
— 7.5% lower than state average
— 71.8% higher than national average

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#19. Cullman County

– Opioid dispensing rate: 81.1 per 100 people
— 0.9% higher than state average
— 87.3% higher than national average

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#18. Escambia County

– Opioid dispensing rate: 81.2 per 100 people
— 1.0% higher than state average
— 87.5% higher than national average

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#17. Clay County

– Opioid dispensing rate: 81.7 per 100 people
— 1.6% higher than state average
— 88.7% higher than national average

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#16. Covington County

– Opioid dispensing rate: 85.3 per 100 people
— 6.1% higher than state average
— 97.0% higher than national average

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#15. Montgomery County

– Opioid dispensing rate: 86.3 per 100 people
— 7.3% higher than state average
— 99.3% higher than national average

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#14. Tuscaloosa County

– Opioid dispensing rate: 86.6 per 100 people
— 7.7% higher than state average
— 100.0% higher than national average

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#13. Madison County

– Opioid dispensing rate: 87.3 per 100 people
— 8.6% higher than state average
— 101.6% higher than national average

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#12. Franklin County

– Opioid dispensing rate: 89.4 per 100 people
— 11.2% higher than state average
— 106.5% higher than national average

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#11. Marshall County

– Opioid dispensing rate: 92.2 per 100 people
— 14.7% higher than state average
— 112.9% higher than national average

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#10. Calhoun County

– Opioid dispensing rate: 97.9 per 100 people
— 21.8% higher than state average
— 126.1% higher than national average

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#9. Mobile County

– Opioid dispensing rate: 98.0 per 100 people
— 21.9% higher than state average
— 126.3% higher than national average

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#8. Autauga County

– Opioid dispensing rate: 98.3 per 100 people
— 22.3% higher than state average
— 127.0% higher than national average

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#7. Etowah County

– Opioid dispensing rate: 102.8 per 100 people
— 27.9% higher than state average
— 137.4% higher than national average

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#6. Marion County

– Opioid dispensing rate: 106.0 per 100 people
— 31.8% higher than state average
— 144.8% higher than national average

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#5. Conecuh County

– Opioid dispensing rate: 113.3 per 100 people
— 40.9% higher than state average
— 161.7% higher than national average

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#4. Walker County

– Opioid dispensing rate: 123.0 per 100 people
— 53.0% higher than state average
— 184.1% higher than national average

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#3. Houston County

– Opioid dispensing rate: 136.5 per 100 people
— 69.8% higher than state average
— 215.2% higher than national average

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#2. Jefferson County

– Opioid dispensing rate: 139.0 per 100 people
— 72.9% higher than state average
— 221.0% higher than national average

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#1. Colbert County

– Opioid dispensing rate: 150.0 per 100 people
— 86.6% higher than state average
— 246.4% higher than national average

This story originally appeared on Ophelia and was produced and
distributed in partnership with Stacker Studio.