Abstract Opioid addiction and related deaths have been called one of the most severe public health crises in our time. The current study focuses on rates of opioid prescribing. We hypothesized that poor adult mental health, affordability of health care, poverty, and number of practicing primary care physicians (per 100,000 persons in the state) would be associated with the number of prescriptions written (per 100 persons in the state). We found that each of these variables was significantly correlated with the number of prescriptions written (poor mental health r = .76, poverty r = .54, affordability r = .53, number of physicians r = − .51). Forward and backward linear multiple regression analyzed the degree to which the independent variables predicted the number of opioid prescriptions written. Results suggest that two predictor variables (poor adult mental health and number of physicians) accounted for a total of 75% of the variance in prescriptions written.