The Most Popular Drugs in America, State by State

Thomas Goetz
Thomas Goetz, MPH, leads the Research team at GoodRx.
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Americans fill a lot of prescriptions – more than 4 billion a year. And it turns out there are some interesting patterns in the state-by-state trends, looking at a representative sample of prescription fill data in the US.

The most frequently prescribed drug in more than half the states is levothyroxine, used to treat thyroid deficiencies. This is followed by an opioid pain medication and two heart disease medications – atorvastatin and lisinopril.

These numbers are based on a representative sample of prescription fills at US pharmacies. They reflect overall US prescriptions, not fills using GoodRx. The data comes from several sources, including pharmacies and insurers, and provides a representative sample of nationwide US prescription drug volume. The data reflects the absolute volume of prescription fills for all forms of a medication, so a 30-day prescription and a 90-day prescription both count as 1 fill. The data is from the past 12 months, March 2017 through February 2018.

Here’s the interactive map, with the Top 10 drugs in each state.

Here’s the rundown of the most-prescribed drug in each of the 50 states.

The Most Popular Drugs in America

Levothyroxine (Synthroid)
#1 in 26 states (AR, AZ, CO, CT, FL, IA, KS, KY, LA, ME, MI, MN, MT, ND, NJ, NV, OR, PA, SD, TX, UT, VT, WA, WI, WV, WY)
Levothyroxine, also known as the brand drug Synthroid, is an important replacement hormone when your body can’t make enough thyroid hormone. More than 120 million prescriptions for levothyroxine are written in the US every year. Fully 15% of Americans over age 55 are taking the medication. It’s widely used to treat “hypothyroidism,” when the thyroid produces low amounts of hormone, resulting in tiredness and lack of energy – despite some controversy over whether those people are being helped by the medicine.

hydrocodone/acetaminophen (Norco, Vicodin)
#1 in 10 states (AK, AL, GA, ID, IL, IN, MS, NC, NE, OK)
There’s been no lack of concern about the high rates of opioid use and abuse in the U.S., with daily headlines about the opioid epidemic. Nonetheless, the drugs are still widely prescribed in all states, much to the alarm of the Centers for Disease Control and Prevention. The drugs are often prescribed following surgery, as well as for chronic pain (more than 11% of Americans report persistent pain). Encouragingly, there is some evidence that growing awareness and tighter restrictions have started to push down the volume of prescriptions for these drugs. The CDC has prescribing guidelines here.

Atorvastatin (Lipitor)
#1 in 5 states (CA, HI, MD, MO, VA)
Lipitor (atorvastatin) is used to treat high cholesterol; it lowers cholesterol levels and is a common first treatment for the more than 70 million Americans with high cholesterol or heart disease – that’s ⅓ of American adults. Statins were breakthrough drugs in the late 1980s and 90s, and are now all available in cheaper generic form.

Lisinopril (Prinivil, Zestril)
#1 in 5 states (MA, NH, NM, OH, RI) 
For the 80 million Americans with high blood pressure, lisinopril is what doctor’s call a first-line therapy, meaning that’s often the first drug used for treatment. It’s also used after heart attacks, as well as to prevent kidney and eye complications in people with diabetes. Relatively cheap and with fairly modest side effects, lisinopril works well for a lot of people, and so is widely prescribed nationwide.

Amphetamine salt combo (Adderall)
#1 in 2 states (DE, SC)
Best known by the brand name Adderall, amphetamine salts are widely prescribed for Attention Deficit Hyperactivity Disorder, a condition marked by inattention, hyperactivity, and impulsivity. As the name says, it’s made of amphetamine, a drug that has a long history of abuse. The CDC has prescription guidelines here. Originally used for children, the drug is increasingly prescribed to adults, especially young adults. Most recently there’s been a surge of prescriptions for young women, leading to concerns from the CDC that the drug is still being misused.

Amlodipine (Norvasc)
#1 in 1 state (NY)
Another widely prescribed drug for high blood pressure, amlodipine has been around since the 1980s. As with lisinopril, the great number of prescriptions is a reflection of the millions of Americans who are at risk for heart disease, a population that will continue to grow as the median age of Americans increases, obesity rates stay high, and so on.

Buprenorphine/Naloxone (Suboxone)
#1 in 1 state (TN)
Tennessee is one of the hardest hit states by the opioid epidemic. Doctors in the state wrote a stunning 1.4 opioid prescriptions for every 1 citizen of Tennessee, the second highest nationwide. Hospitalizations for opioid overdoses has soared in recent years, and overdose deaths in the state climbed by more than 50% between 2012 and 2016, according to a recent report by the Tennessee department of health. The state is fighting back with new legislation, including new restrictions on treatment clinics which often prescribe Suboxone, which is used to treat opioid addiction.

Here the full map to share.

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