By Taylor Knopf

A 2016 report found that people who abuse opioids are more likely to live in the rural south than anywhere else in America.

Twenty-two of the 25 top cities for opioid abuse are located in southern states, according to the report by the health care information company Castlight. Wilmington is at the very top of that list, with more than 11.6 percent of the population abusing opiates.

Three other North Carolina cities made the top 25 list: Hickory at 9.9 percent; Jacksonville at 8.2 percent; and Fayetteville at 7.9 percent of residents using opiates.

During the same period, Wilmington, Hickory and Fayetteville also made the top 25 list for number of opioid prescriptions abused. About 50 percent of all opioid prescriptions are abused in those three cities, according to the analysis.

Castlight’s report defined opioid abuse by two criteria: a patient who received more than a 90-day supply of opioids who also received an opioid prescription from four or more physicians between 2011 and 2015.

Other key findings in the Castlight report:

  • graph showing ages of people abusing opioids, with Baby Boomers having the highest rates
    Graphic courtesy Castlight

    People who abuse opioids cost their employers about twice as much each year in medical expenses than those who don’t. On average, they cost $8,597 more than their non-using colleagues in 2015. Castlight estimates that opioid addiction costs American employers about $8 billion a year.

  • Castlight reported that people abuse one out of every three opioid prescriptions. Those who abuse opioids have twice as many pain-related conditions. The top four diagnoses are joint pain, neck pain, abdominal pain and back pain.
  • People older than the age of 50 are four times more likely to abuse opioids than those under 30, Castlight reported. About 7.4 percent of Baby Boomers misuse opioids, while only 2 percent of Millennials do.
  • Income makes a difference. About 6.3 percent of people living in America’s lowest income areas abuse opioids. These are places where the average income is less than $40,000. In areas where residents make an average of $85,000 or more, about 2.7 percent of people abuse their opioid prescriptions.
  • People living in states with marijuana legalization laws are less likely to abuse opioids. About 2.8 percent of people living in these states abuse opioids, compared to the 5.4 percent of people in states without marijuana laws.
  • People diagnosed with a mental illness are three times as likely to abuse opioids. About 8.6 percent of people with mental health issues abuse opioids, while only 3 percent of people without abusing them.

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Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...

One reply on “Four North Carolina Cities Make Top 25 List for Opioid Abuse”

  1. NC has a problem with drug abuse, no arguement . Castlight states at the outset of their study it is a sample of their customers. So of the people that signed up for their health benefit plan, these where the worst cities. That is different from comparing a city with the national incidence of use/abuse/death. The CDC has done this NC ranks 28 in the nation (1 is highest)

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