South Dakota has less than 1 million residents, and many people in this state struggle with drugs and alcohol. The most prevalent drugs are alcohol, meth, heroin, and prescription opioids, but most people entering treatment cite marijuana as their primary issue. Keep reading to take a closer look at the most used drugs in South Dakota. 

1. Alcohol

Compared to people in other states, South Dakota drivers are the 7th most likely to die in an alcohol-related accident. Every year, alcohol costs the state $598 million in reduced productivity, increased healthcare costs, law enforcement expenses, and motor vehicle damage. 

To get a sense of the harm caused by alcohol in this state, check out these stats:

  • 40% of all South Dakota traffic deaths involve alcohol.
  • 62% of drivers involved in these accidents have a blood alcohol content (BAC) of over double the legal limit.
  • Drivers under 21 are responsible for 31.8% of these accidents.
  • Between 2002 and 2012, 537 people died in crashes related to alcohol. That is over 50 people per year.
  • In South Dakota, 5.7 people per 100,000 die in accidents related to alcohol every year. The national average is just 3.3 per 100,000 people.
  • 2.5% of South Dakotans report that they drive after drinking. Nationwide, only 1.3% of people admit to drunk driving.

2. Meth

In 2019, South Dakota made headlines for its meth campaign. Designed to build awareness about the state’s meth issue, the ads used the tagline “meth, we’re on it” and showed images of people farming, playing sports, or doing other activities. Critics called the campaign tone deaf, but several state officials claimed it filled its purpose of drawing awareness to the issue.

The meth problem is growing in this state. Look at these stats:

  • Between 2014 and 2018, the number of people entering treatment for meth doubled. 
  • In South Dakota, the number of 12 to 17 year olds who have tried meth is double the national average.
  • Meth is involved in 83% of the state court cases focused on controlled substances. 

This state brings a lot of drug charges against residents. Between 1980 and 2019, the prison population increased from 500 to 3,828. Close to a 3rd of prisoners are locked up due to drug convictions — double the national average. Only 5% are charged with distribution, while 18% are in prison for possession and 9% for ingesting controlled substances.

3. Heroin

Although heroin is not as widespread as meth, many South Dakotans still struggle with this highly addictive drug. Sometimes people experiment with heroin after trying other street drugs. In other cases, people develop an addiction to prescription opioids, and then, when they cannot find pills, they turn to heroin.

Both heroin and prescription opioids can be deadly. As fentanyl enters the state, the risk of fatal overdoses increases even more. Tragically, fentanyl is up to 50 times more potent than heroin, and it’s often produced to look like prescription opioids.

Check out these recent news stories about heroin and other opioids in South Dakota:

  • In Minnehaha County, home to the state’s largest city Sioux Falls, there were 21 drug overdoses in 2017. The following year, 23 people died of overdoses. In the first six months of 2019, there were 39 overdose calls and 9 fatalities.
  • After receiving heroin in the mail, a South Dakota woman overdosed and died. The sender received 20-year prison sentence.
  • A man from California was caught sending 100,000 fentanyl pills to people in Chamberlain, Mitchell, and Sioux Falls. He planned to send 2.6 million pills to people around the country, and his entire stash was more than double the largest physical fentanyl seizure ever recorded.

4. Prescription Opioids

The most dispensed drug in this state is hydrocodone. This prescription opioid has a high potential for abuse, and it can be deadly.

To learn more, look at these stats:

  • In 2017, healthcare providers wrote 49 prescriptions for every 100 people in South Dakota. Although that’s nearly one opioid prescription for every other person in the state, the number is still less than the national average of 58.7 prescriptions for every 100 people.
  • 4% of people age 12 to 17 in South Dakota have tried prescription pain relievers.
  • Between 2009 and 2013, 146 babies were born exposed to drugs in South Dakota. That is 36.5 infants per year, and 1 in 4 cases involved opioids. 

5. Marijauna

As noted above, when people enter treatment in South Dakota, the drug they cite most often is marijuana. In Nov 2020, the state is voting on legalizing recreational and medical marijuana, and at the time of writing, South Dakota is one of only three states that bans hemp.  

If you are struggling with these drugs or any other substances, you should reach out for help. Contact a treatment center in your local area today. Do not wait to get your life back on track. 


  1. Daniel J and Owen A. (n.d.). Trends in substance use across the nation and South Dakota
  2. Dimon, L. (2014, February 11). Which drug is your state most addicted to? This map reveals a disturbing trend
  3. Epp, T. (2018, May 11). South Dakota ranks high in DUI deaths
  4. Logan, E. (2019, November 22). South Dakota declared war on meth. But critics say state policies doom any hope of change
  5. National Institute on Drug Abuse. (2019, May 22). South Dakota opioid summary
  6. South Dakota adolescent substance abuse facts. (2019, May 1)
  7. Zaveri, M. (2019, November 19). ‘Meth. We’re on It?: South Dakota’s anti-meth campaign raises eyebrows

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