A new study suggests North Carolina is home to four of the top 25 cities for opioid abuse, and the vast majority of cities on the list are located in the South.

The report, published by Castlight Health, found Wilmington to be the number one city in the U.S. for the percentage of people abusing opioids.

Hickory was in the top five. Jacksonville and Fayetteville made the list too.

In fact, the only state with more cities on the list is Alabama.

The report used two criteria to identify abuse: receiving more than a 90-day supply of an opiate and getting prescriptions from more than four doctors in a five-year period.

Typically, those misusing these medications are older, lower income, and tend to live in rural parts of the South.

Broadly speaking, the study found that one-third of all opioid prescriptions are being abused. According to Castlight, prescriptions for the drugs quadrupled between 1999 and 2010, and cost the U.S. economy $56 billion annually.

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