Painkiller prescription map. (Centers for Disease Control and Prevention)

The South, it seems, has a painkiller problem. Or maybe it’s just a pain problem. Whatever it is, the region leads the nation in per capita prescriptions, according to a new CDC report.

Alabama, Tennessee, West Virginia, Kentucky and Oklahoma were home to the highest per capita painkiller prescriptions, according to 2012 data. New Jersey, Minnesota, New York, California and Hawaii had the lowest rates. But the South wasn’t alone its regional superiority. Not to be left out, the Northeast claims the states, especially Maine and New Hampshire, with the most per person prescriptions for long-acting, high-dosage painkillers. Health-care providers prescribed the equivalent of a bottle per adult in 2012—a total of 259 million painkiller prescriptions. An average of 46 people die every day due to prescription overdose.

Higher prescription rates are associated with higher overdose rates, the CDC found. And the data suggest that geography influences how health-care providers prescribe.

Painkiller prescription infographic. (Centers for Disease Control and Prevention)

Part of the problem is that providers have differing approaches to writing prescriptions, according to the report. Another cause may be so-called “pill mills,” for-profit clinics that prescribe lots of painkillers, often in large amounts to individuals who don’t need them.

Policy can play a role in addressing the problem, though. The federal government can help states implement their own overdose prevention programs, boost access to mental health and substance abuse treatment and give health-care providers better data and guidance. States can improve prescription monitoring, implement policies to cut back on oversubscribing pain clinics, better evaluate their own data and programs, and boost substance abuse treatment programs.

Some states have already seen big decreases in kinds of painkiller abuse and deaths thanks to such policies, including New York, Florida and Tennessee, which the CDC highlighted below.

Painkiller reduction successes. (Centers for Disease Control and Prevention)