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Oklahoma Counties With Worst Drug Problems

by Landmark Recovery

March 12, 2019
A woman looking at a map of Oklahoma

The drug epidemic in the country, fueled by the rise of opioids, has led to tens of thousands of deaths each year across the nation. Data from the Center for Disease Control and Prevention says that there were over 30,000 drug overdoses directly attributed to synthetic opioids. Moreover, studies show that this number may not be dropping any time soon. Despite federal legislative efforts to crack down on prescription drug abuse, there is some evidence that the problem will get worse before it gets better.

Unintentional poisoning deaths have increased dramatically since the late 1990’s, in the United States and Oklahoma. From 2007 to 2012, Oklahoma ranked high for the distribution of many common opioids including oxycodone, hydrocodone, fentanyl, and morphine.

Both illicit and prescription pills have led to the deaths of thousands in the state of Oklahoma, and thousands more are addicted. However, there have been some measures passed by the state, and other activist campaigns, to try and cut down on the abuse of drugs in the state and educate people on the damage that these pills and substances can have on people.


Problem Counties in Oklahoma

A woman looking at a map of Oklahoma

While Oklahoma in general has a problem with drugs, specifically prescription painkillers and methamphetamine, when you examine the issue more closely, you find that there are only a few counties that are the main contributors to the problem.

For example, Pawnee, Creek, and Johnston Counties had the highest prescription rates in the state. The most commonly prescribed opioids are hydrocodone, oxycodone, and morphine. Over 326 million opioid pills were dispensed to Oklahoma residents, enough for every adult in the state to have 110 pills.


Oklahoma County

Oklahoma County is located in the central part of the state and is the most populous county in the state with over 700,000 residents. There were over 730 drug overdose deaths in Oklahoma County between 2012 and 2016. Of those 732 overdose deaths, 470 of them, or 64 percent, were a result of prescription drugs. Prescription drugs are a scourge in the state, and in Oklahoma County specifically oxycodone, hydrocodone, morphine, methadone, and fentanyl reign supreme.

Despite the efforts from the state and federal government, Oklahoma county’s drug overdose numbers have been fairly consistent since 2013. On average, the county sees about 200 drug overdose deaths each year.


Tulsa County

Tulsa County is the second-most populous county in the state of Oklahoma with over 600,000 residents. It is the most densely populated state and is home to the city of Tulsa.

While the death rate for Tulsa County was low for the state, the county still had one of the highest drug overdose death counts in the state with 655 overdose deaths between 2012 and 2016. Synthetic opioids and prescription medication were the most commonly used substances in overdose deaths in Tulsa County. Heroin was also one of the main substances of abuse in the county.


Muskogee County

Muskogee County is located in the central eastern portion of Oklahoma. Muskogee is perhaps one of the most problematic counties in the state. Muskogee has one of the highest rates of death due to drug overdoses in the state and have killed 111 Oklahoman’s from 2012 to 2016. The most common substances involved in overdose deaths in the country are generally synthetic opioids, including oxycodone, hydrocodone, morphine, methadone, and fentanyl.

According to state data,the prescription rate in Muskogee County was 30 percent higher than the state rate.In 2017 there were enough opioids dispensed in the county for every adult to have the equivalent of 215 hydrocodone 10mg tablets. Similarly, 17 percent of Muskogee County adults with an opioids prescription had an overlapping prescription for a benzodiazepine, increasing the risk of fatal overdose.


Sequoyah County

Similar to Muskogee County, Sequoyah County has one of the highest rates of drug overdose in the state while also having a high number of overdose deaths in the state. From 2012 to 2016, there were 50 overdose deaths, 74 percent of which came from prescription drugs.

It should also be noted that, in 2017, the county had a higher than average drug arrest rate. According to data from the Oklahoma state government, over 30 percent of all arrests in the county were related drug related.

Like most other states with prescription drug problems, the low population, generally rural counties have the higher drug overdose rate, but urbanized, highly populated areas seems to have the highest raw numbers of overdose deaths.


Common Drugs of Abuse in Oklahoma

According to the Oklahoma Department of Mental Health and Substance Abuse Services, there are 326,000 Oklahoman’s aged 12 and older are dependent or abuse alcohol or illicit drugs. While illicit drugs are a major issue in the state, especially methamphetamine, prescription drugs remain a threat to the state as it has one of the highest prescription rates in the country.

“Prescription drug abuse is Oklahoma’s fastest growing drug problem and impacts our state in multiple ways…One in twelve Oklahoman’s abuse painkillers, such as hydrocodone and oxycodone. Prescription opioid painkillers are four of the top five medications responsible for unintentional overdose deaths,” said former Governor Mary Fallin in a opioid prevention report.



There are over 250,000 Oklahoman’s who are dependent or abuse alcohol. Similarly, 159,000 Oklahoman’s aged 21 or older reported heavy alcohol use in the past 30 days. Despite the high rate of alcohol consumption in the state, only about 7.6 percent of those in need of alcohol treatment accessed help. Oklahoma overall has the 11th highest rate of alcohol poisoning in the nation and 6th in the nation for alcohol-related mortality.

The report says that excessive drinking results in 1,350 deaths and 41,460 years of potential life lost each year in Oklahoma. According to the Oklahoma Department of Mental Health and Substance Abuse Services, 30 percent of people serving substance abuse treatment through the state, reported alcohol as their primary “drug of choice”.

Tulsa specifically has been shown to have problems with alcohol. Over 20 percent of Tulsa residents aged 18 to 34 reported binge drinking in the past 30 days. Similarly, the County’s DUI rate was 20 percent higher than the state average, a state that already has a higher death rate due to drunk driving than the national rate.



According to the Oklahoma State Department of Health, methamphetamine is the most deadly illicit substance in the state and from 2007 to 2016, meth killed over 1300 Oklahoman’s. Moreover, the amount of deaths from the drug has spiked in recent years. In 2007, just 39 people died from methamphetamine, that number jumped to 278 in 2016, an increase of over 600 percent in less than 10 years.



Of all the prescription pills in the state, oxycodone seems to be the most popular, perhaps due to the aggressive and allegedly deceptive marketing techniques of Purdue Pharma, the manufacturers of OxyContin, the most popular opioid in the country. In fact, Oklahoma Attorney General, Mike Hunter, filed a lawsuit against the company in 2018 alleging that the manufacturer, “executed massive and unprecedented marketing campaigns through which they misrepresented the risks of addiction from their opioids and touted unsubstantiated benefits.”

Overall, oxycodone has proven to be a deadly drug in the state, the opioid killed 1370 Oklahoman’s between 2007 and 2016.


Opioid Abuse and Misuse

Being that Oklahoma has one of the highest prescription rates in the country, there is a fair bit of opioid abuse and misuse. Opioid abuse is when you actively are taking the drug to achieve a certain high. Misuse is a lesser form of this, essentially taking the drug without following prescription guidelines. According to the ODMHSAS, in 2009, Oklahoma ranked first nationally in the non-medical use of pain relievers for all age categories.


What Is Being Done?

A man sitting outside on his computer researching what Oklahoma is doing about substance abuse

There have been a number of state and federal measures to try and cut back on the availability and misuse of drugs in the state. In fact, according to White House data from the Obama administration, in 2012 alone over $115 million was spent on the state to help alleviate some of the problems that the state was facing.


Prescription Monitoring Program

Oklahoma House Bill 1948, which became effective in November 15, established the Prescription Monitoring Program. The goal of the program was to reduce prescription fraud, substance abuse, doctor shopping, and other illegal pharmaceutical activities. The law requires all dispensers of Schedule II, III, IV, and V controlled substances to submit dispensing information.

“The Prescription Drug Monitoring Program is a valuable tool for practitioners, pharmacists, and law enforcement in the prevention and detection of the diversion and abuse of pharmaceutical controlled substances,” Oklahoma Bureau of Narcotics Director John Scully said in the 2018 Oklahoma Drug Threat Assessment.


Methamphetamine Manufacturing

In the early and mid 2000s, the meth problem in Oklahoma was fueled by small time manufacturers throughout the state using pseudoephedrine, a common over-the-counter drug used in some meth-making processes. To cut back on these homemade labs, called “shake and bake”, the state passed a measure that combated the availability of pseudoephedrine, reclassifying it as a Schedule V drug. While the passage of the law had an effect on the number of clandestine methamphetamine laboratories, there is evidence that the use of the drug in the state has not declined. While small-time laboratories in the state once reigned supreme, when new laws passed these declined and Mexican cartels saw an area for high demand for the drug and jumped on the opportunity. Today, a majority of methamphetamine in the state of Oklahoma comes from across the southern border.


Fighting Addiction Through Education

Fighting Addiction Through Education, or FATE, is a nonprofit organization based out of Oklahoma. It’s message is simple: change the culture surrounding substance abuse through drug prevention designed to educate and empower. The program was started by Reggie Whitten, after his 25-year-old son, Brandon, died from his addiction to prescription pills and alcohol. FATE has a number of moving parts, targeting elementary, middle, high schools and even college. FATE also includes “Oklahoma Life of an Athlete”, a free drug prevention program offered throughout Oklahoma schools that uses online training to demonstrate the impact of alcohol and other drugs on athletic performance.


Treatment Programs

There are a number of drug and alcohol treatment programs scattered throughout the state of Oklahoma. Drug and alcohol treatment can be an effective method for helping those with substance use disorders achieve sobriety. Inpatient, or residential, treatment centers will likely help patients safely deal with their withdrawal symptoms through medically supervised detox. Following detox, inpatient care is normally characterized by therapy sessions and group support programs. During these therapy sessions patients will be educated on drugs of abuse and learn about triggers and relapse prevention. Following discharge from an inpatient facility, many patients elect to go through outpatient treatment in which they attend therapy sessions throughout the week while working their way toward independent living.


In Conclusion

Overall, the opioid epidemic has lead to an overabundance of prescriptions throughout the country, and Oklahoma is one state that has been disproportionately affected. There are many problem counties throughout the state of Oklahoma when it comes to drug addiction. A few of the counties include Oklahoma County, Tulsa County, Muskogee County, and more. While there have been efforts from the state to reduce the effects of the drug problem, drug overdose numbers have remained consistent over the past few years, however, the amount of prescription pills available have decreased.

Landmark Recovery is one drug and alcohol treatment center that can help you or your loved one get sober and avoid relapse. Landmark has an inpatient facility in Oklahoma City and an outpatient facility in Tulsa. Landmark utilizes evidence-based treatment methods and a holistic approach to recovery to help our patients on the road to sobriety. If you believe that you or a loved one may need treatment, feel free to make a confidential call to 405-896-8426.