When it comes to drug use, North Dakota has a better track record than most other states. A decade ago, drug-induced deaths were less than half the national rate. And a 2018 WalletHub study suggested North Dakota had the fifth smallest drug problem in America.

In 2017, there were 9.2 drug overdose deaths per 100,000 people in the Peace Garden State. The majority of these were linked to opioids. While this is lower than the national average, since 2014 there’s been an annual increase. This is a worrying trend.

In a single-day count in 2015, 2,457 individuals were enrolled in substance use treatment in the state. Substance use has affected the local American Indian/Alaska Native communities in particular. 

High Intensity Drug Trafficking Areas include the following counties:

  • Burleigh
  • Cass
  • Grand Forks
  • Morton
  • Ramsey
  • Richland
  • Walsh
  • Ward

Read on to find out the top five most used drugs in North Dakota:

#1 Marijuana

In North Dakota, Marijuana is illegal for recreational use. But it is the substance most often named in primary drug treatment admissions.

  • 2011: two thirds of treatment admissions were for cannabis use.
  • 2014-2015: an annual average of about 3000 adolescents aged 12-17 used marijuana in the past month. That’s an estimated 6.2% of people in this age group. 

#2 Meth

According to DEA agents, the Upper Midwest region is flooded with meth. This is partly due to dealers being able to charge more for the substance in northern areas than in Chicago and Detroit, for example.

Check out these facts:

  • As recently as 2018, the DEA seized about 61.8 pounds of meth in ND, up from three pounds the previous year.
  • Meth is the most popular hard drug in North Dakota, both in rural towns and urban areas. 
  • 2016: the state recorded 1,955 meth-related arrest incidents. 
  • Amphetamines were the second-most cited cause of treatment admissions to state facilities.

#3 Alcohol

Excessive drinking is a problem in North Dakota. Heavy drinking refers to consumption exceeding 8-15 drinks in a week. And binge drinking refers to consuming more than four drinks in a row.

Have a look at these shocking statistics:

  • 2018: North Dakota topped a list comparing alcohol consumption across the U.S. Almost a quarter of adults in the state are binge drinkers and heavy drinkers, the highest share in the country. 
  • Also in 2018, the state had the highest rate of alcohol-related driving deaths in the country. 

Youth consumption is cause for concern too:

  • According to a SAMHSA report in 2014-2015, an annual average of about 6000 adolescents aged 12-17 drank alcohol in the previous month. That’s slightly higher than the national average. 
  • Youth binge drinking was also higher than the national average in 2017. 16% of surveyed high school students reported binge drinking in the month before the study.

#4 Prescription Opioids

Recreational use of pain relievers often leads to addiction. As a result, North Dakota has had an operational prescription drug monitoring program since 2008.

  • 2018: the state had a relatively low opioid pain reliever prescription rate – it placed 45th out of the 50 states.
  • Still, in 2016, 4% of surveyed high school aged children misused pain relievers during the previous year. This is on par with the rest of the country. 
  • In a single-day count in 2015, 84 people received medication-assisted therapy for opioid withdrawal in treatment facilities in North Dakota.

#5 Illicit Opioids

Addiction can lead to illicit drug use when prescriptions become unavailable. Just like every other state, North Dakota has been affected by the opioid epidemic.

  • 2014-2015: an annual average of about 1,000 people over the age of 12 used heroin in the past year in North Dakota.
  • 2016: 22.2% of new HIV cases in the state were as a result of injection drug use.
  • Between 2011 and 2014, the number of newborns with Neonatal Abstinence Syndrome increased. The number of cases went from 1.7 per 1000 hospital births to 4.8.
  • In November 2019, an 8 month old baby overdosed on heroin and fentanyl in Bismarck.
  • Currently, there are five syringe exchange programs in the state.

Get Treatment for Substance Use in North Dakota

If you or someone you know is struggling with addiction, there is hope. We highly recommend seeking treatment. Treatment usually begins with a detox supervised by health professionals. This is the safest way to go through withdrawal and can minimise symptoms.

Treatment also includes therapy which aims to address the root causes of substance use disorders. Counseling equips patients with the know-how to avoid triggers and maintain sobriety. And doctors can prescribe alternative medications for co-occurring disorders where appropriate.

Getting help doesn’t have to be more difficult than getting drugs. Contact a rehab program near you to discuss the best options to suit your needs. It’s the first step towards a more stable, healthy and happy life.


  1. Explore Drug Deaths in North Dakota | 2019 Annual Report. (2019)
  2. Hazzard, A. (2017). Meth still region’s drug of choice — and it’s gaining popularity
  3. Torgerson, R. (2018). North Dakota ranked drunkest state in America, with Minnesota not far behind | Grand Forks Herald
  4. https://www.grandforksherald.com
  5. https://www.drugabuse.gov
  6. https://www.inforum.com
  7. https://obamawhitehouse.archives.gov
  8. https://www.hhs.gov
  9. https://www.ajc.com
  10. https://store.samhsa.gov

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