When it comes to illegal drug use, there are two extremes in South Dakota.

According to BestLife, the Mount Rushmore State's 916.51 drug-related arrests per capita are by far the most in the United States, based on the latest numbers from the Federal Bureau of Investigation (FBI) over a 12-month period.

To give you an idea of just how high that number is, consider that only one other state, Wyoming - has more than 800 arrests (845.78) per 100,000 residents.

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And while more people are being locked up on drug charges in South Dakota, fewer people are dying here from overdoses than almost anywhere else in America.

Figures from the Centers for Disease Control and Prevention (CDC) show that for the number of drug overdose deaths, primarily caused by cocaine and opioids, South Dakota is next to last with 10.29 deaths per 100,000 residents.

Only Nebraska (9.31) had fewer.

As for the number of people that have what the Substance Abuse and Mental Health Services Administration (SAMHSA) refer to as 'illicit drug use disorder' (meaning they are addicted to one or more illicit substances),  the Mount Rushmore State again is one of the best places in the country, with 1,695.57 people per 100,000 residents.

Only Texas and Wyoming fared better.

BestLife combined all of those factors to assign each state with a  'Drug Misuse Index' score. South Dakota's was below the national average (43.27 out of a possible 100) - 29th overall of the places with the biggest drug-related issues.


  1. West Virginia
  2. Delaware
  3. Tennessee
  4. Louisiana
  5. Maryland
  6. Ohio
  7. Kentucky
  8. Pennsylvania
  9. Florida
  10. New Jersey


  1. Kansas
  2. Mississippi
  3. Nebraska
  4. Texas
  5. Georgia
  6. Hawaii
  7. Alabama
  8. Montana
  9. Washington
  10. New York

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