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Nearly one in five Americans admits to taking some sort of drug every day to help relax — most of them in states that rate low on the income and happiness scales, according to a new survey.

West Virginians are by far the most likely to take a prescription or over-the-counter drug to chill out, with 28 percent of those polled saying they do. Alaska appears to be the most naturally laid-back state, with just 13.5 percent saying they use drugs to calm down.

The rates are probably even higher than that, says Dan Witters, research director of the Gallup-Healthways well-being index.

“I think it is reasonable to assume that some respondents may be understating their use just because they are talking to a live human being on the other side of the phone,” Witters told NBC News.

“Those also lowest wellbeing states in the nation.”

The statistics come from Gallup’s ongoing survey with health consultants Healthways. They telephoned more than 176,000 adults —at least 450 in each state — with survey questions.

“They are asked ‘How often do you use drugs or medications, including prescription drugs, which affect your mood and help you relax?’,” said Witters. The survey is not designed to discern the type of drug being used.

Drug use is pretty clearly linked with lower levels of happiness, Witters says.

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“It makes good sense you see a West Virginia or a Kentucky or an Indiana among the highest drug incidence states in the nation,” he said. “Those also lowest wellbeing states in the nation.”

The top 10?

After West Virginia comes Rhode Island, with nearly 26 percent of those surveyed saying they use drugs to help relax almost every day. Kentucky follows with 24.5 percent; Alabama with 24.2 percent; Louisiana at 22.9 percent; South Carolina at 22.8 percent; Mississippi, Missouri and Indiana with 22 percent and Oregon at 21.9 percent.

The 10 states where the fewest people use daily drugs?

Alaska 13.5 percent

Wyoming 15.5 percent

California 15.8 percent

Illinois 16 percent

North Dakota 16.4 percent

New Jersey 16.5 percent

Colorado 16.7 percent

Texas 16.7 percent

Utah 16.8 percent

Maryland 17.3 percent

Drug use is part of the calculation that Gallup and Healthways use in making their “Wellbeing Index”. Low wellbeing affects people’s lives but also their employers, says Witters.

“It manifests itself in lots of ways,” he said. “If you look at missing work due to poor health, unplanned absences, people who are heavier users of drugs are certainly going to be more likely to be missing work in unplanned circumstances,” he said. “They also are going to be performing at lower levels.”

Some of the highest-using states also have higher rates of obesity, Witters said, and people there report they feel less happy about their personal appearance. “Those are all vanguards of drug use,” he said.

"People who are heavier users of drugs are certainly going to be more likely to be missing work in unplanned circumstances."

Some people may be abusing drugs, but not all, says Witters. “If you have a lot of physical pain you are going to be more likely to be a drug user,” he said.

Many of the states are among the states the Centers for Disease Control and Prevention has found have the highest rates for prescribing narcotic painkillers. And they also have more smokers.

What’s not clear is which comes first: the drug use, or the unhappiness.

“One possibility is that taking mood-altering drugs or medication nearly every day contributes to lower well-being,” Gallup says in a statement.

“But a more probable explanation is that Americans who already have lower well-being are more likely to use drugs or medication to relax or alter their mood, possibly to help cope with challenges related to their low purpose, social, financial, physical or community well-being.”