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Think the deadly opioid epidemic is just raging in the Rust Belt? Think again.

Prosperous and progressive Oregon had a 5.1 percent increase in drug overdose deaths in the 12-month period ending April 3, according to provisional figures from the federal Centers for Disease Control and Prevention.

"Oregon has one of the highest rates of prescription opioid misuse in the nation; more drug poisoning deaths involve prescription opioids than any other type of drug, including alcohol, methamphetamines, heroin and cocaine," the Oregon Health Authority states clearly on its website.

Three Oregonians die every week from prescription opioid overdose, it says.

And while the number of deaths specifically from prescription opioid abuse has been declining, the pattern in Oregon appears to be similar to that in the really hard-hit states, like West Virginia, Ohio and Pennsylvania — addiction to prescription painkillers frequently drives people to heroin (often laced with fentanyl) and, for too many, death.

Tune in all week to see Lester Holt's "Across America" reporting trip on "NBC Nightly News."

In some neighborhoods in north Portland, which is the state’s biggest city, the crunch of needles underfoot has become a sad and not unfamiliar sound. And it’s a plague that doesn’t discriminate between rich and poor.

“Some people have lost everything,” Dr. Rachel Solotaroff of Central City Concern, a nonprofit in Portland dedicated to fighting homelessness that also helps addicts get back on their feet, told NBC Nightly News. “They had jobs, families, master’s degrees.”

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In Clackamas County, which is south of Portland, paramedics like Amy Jo Cook told NBC that they aren’t just waiting for the next drug overdose call.

As one of the region’s first “community paramedics,” Cook actively checks on addicts she has helped. NBC's cameras were rolling when Cook checked on Jackie Robertson, whose life she saved in February with the opioid overdose medication Narcan.

“Even if they get care in the hospital, when they leave that, there’s nowhere for them to go, no one to really reach out to,“ Cook said.

Overdoses from prescription painkillers are more of a rural plague, while heroin overdoses are more common in the big cities like Portland, Salem and Eugene, said Dr. Katrina Hedberg, who is Oregon’s state health officer.

“It really has to do with the distribution pattern,” said Hedberg, who noted that most of the state’s largest cities are located on Interstate 5, which traverses the length of the West Coast.

But just as in other parts of the country, the heroin being sold on the streets is increasingly being laced with fentanyl, making it that much deadlier.

Oregon health officials have responded by taking steps to make safer treatments available to pain patients, making sure anti-overdose remedies are widely and easily available, and by reducing the number of pills in circulation by revamping prescription practices.

"Oregon also has access to legal marijuana," said Lindsey LaSalle, senior staff attorney at the Drug Policy Alliance. "Numerous studies have noted that states with access to marijuana have lower fatal overdose rates. People are using marijuana to manage their pain and it has been shown to be effective for people trying to get over an opioid addiction."

The 513 deaths in Oregon tallied by the CDC in the 12 months ending April 3 were a drop in the bucket compared with hard-hit states like Pennsylvania (5,577 deaths, a 38.4 percent jump), Florida (5,516 deaths, a 28.9 percent increase) and Ohio (5,231, a 30.8 percent boost).

But at the same time, some rural counties in Oregon had some of the highest rates of opioid prescriptions in the nation, raising the risk of addiction.

“Even at low doses, taking an opioid for more than three months raises the risk of addiction by 15 times,” the CDC reported.

And it’s a short jump from prescription painkillers to heroin. Nearly half of the junkies who took part in a Portland needle exchange program reported that they were addicted to opioids before they began shooting up heroin, local rehab outfits reported.

To prevent more deaths, groups like the Portland People’s Outreach Project have, since February 2015, delivered about 5,000 clean syringes a week to local junkies and exchanged them for dirty needles, which they then discard.

And they do it in Portland style — by bicycle.

“We recognize that there is a vital need for clean injection supplies in our community, “ the group states on its website. “In our view, injection drug users are better serviced by compassion and respect than by criticism and punishment."