West Virginia is leading the way in drug overdoses with a rate of 41.5 per 100,000.

From Reuters:

The number of deadly heroin overdoses in the United States more than quadrupled from 2010 to 2015, a federal agency said on Friday, as the price of the drug dropped and its potency increased.

There were 12,989 overdose deaths involving heroin in 2015, according to the National Center for Health Statistics, compared with 3,036 such fatalities five years earlier.

In 2010, heroin was involved in 8 percent of U.S. drug overdose deaths, a study by the Atlanta-based center said. By 2015, that proportion had jumped to 25 percent.

The center’s research was based on death certificate data and did not examine the underlying causes. But a 2015 study by the U.S. Centers for Disease Control and Prevention found that the declining price of heroin and its increasing purity might be causing more people to use it.

The latest statistics come as authorities in several parts of the United States grapple with opioid and heroin crises.