Its residents also filled prescriptions for oxycodone, hydrocodone and other opioids 18,439 times, the highest per capita rate in California.

Places like West Virginia, Ohio and rural New England have become synonymous with prescription painkiller abuse, a scourge blamed for more than 183,000 deaths from 1999 through 2015.

California, though, is far from a bystander to the crisis. There were 1,925 opioid-linked overdose deaths in California last year, according to recently updated state data, and thousands of emergency room visits.