Two congressional districts in Alabama rank among the five highest in the U.S. for the number of opioid prescriptions, a recent Harvard University study found.

Alabama's 4th Congressional District, which includes parts of more than a dozen northern and western counties, has higher prescribing rates of opioids than another other district in the country, the study says.

The study used 2016 prescription data and population information from the 2010 census to identify which areas of the U.S. have the highest prescription rates for fentanyl, hydrocodone, morphine and other opioids.

The study says during 2016 there were 166 prescriptions per 100 people in Alabama's 4th Congressional District. That's more than double the average, which is about 67 prescriptions per 100 people.

The district includes Franklin, Colbert, Marion, Lamar, Fayette, Walker, Winston, Cullman, Lawrence, Marshall, Etowah, and DeKalb counties, plus parts of Jackson, Tuscaloosa and Cherokee counties.

The district with the fifth highest prescription rate is Alabama's 1st Congressional District, which includes Washington, Mobile, Baldwin, Escambia and Monroe counties, plus part of Clarke County in southwest Alabama.

"It is deeply saddening to learn that the 4th Congressional District has such a high opioid prescription rate," said U.S. Rep. Robert Aderholt, the Alabama Republican who represents the district. "I think this crisis, particularly in rural America, corresponds directly to President Trump's popularity in these areas. People here have felt left behind and have seen their jobs and opportunities disappear. Due to the epidemic of depression, some people have turned to prescription drugs to dull the pain.

"However, I believe that President Trump's renewed focus on these areas and increasing jobs has resonated here strongly," the congressman's statement continued.

Trump last year declared the opioid epidemic a "public health emergency." In the past decade, opioid prescriptions and overdoses have quadrupled in the U.S., according to the Harvard study.

In his statement, Aderholt pointed $4 billion worth of funding that was set aside by Congress for fiscal year 2018 to address, prevent and treatment opioid addiction. Aderholt also noted that $130 million was set aside for the Rural Communities Opioid Response program.

Rural areas with mostly white populations are hit particularly hard by the crisis, researchers said. The areas with the highest prescription rates were mostly in the southeast part of the country.

Alabama ranks first in the nation for the number of painkiller prescriptions per capita, according to Attorney General Steve Marshall, who has sued opioid manufacturers and co-chaired the state's Opioid Overdose and Addiction Council.

In the Alabama 1st Congressional District, which includes Mobile, there were about 131 prescriptions per 100 people during 2016, the study found.

"No community in the entire country is immune from the opioid epidemic, including right here in Southwest Alabama," said Rep. Bradley Byrne, the Republican who represents the 1st district. "That's why I have been such a strong advocate for additional funding to address the opioid crisis, as well as a package of over 50 bills dealing with everything from alternative treatment options to best practices for prescribing opioids. We must continue working to ensure everyone receives the care they deserve while ensuring best practices on the prescription of dangerous opioid drugs."

In Mobile last year, a doctor was sentenced to 20 years in a local "pill mill" case. Earlier this year in Fairhope, a doctor was acquitted in the overdose death of a former 3 Doors Down guitarist.

Other districts on the top five for prescriptions are the Kentucky 5th at No. 2, the Tennessee 3rd at No. 3 and the Tennessee 1st at No. 4.

The study by researchers at the Harvard T.H. Chan School of Public Health was published earlier this month in the American Journal of Public Health. It's believed to be the first to examine opioid prescription rates by congressional district, the study says.

"...while I think that while Congress can address the funding, this battle will be won at the state and local level," Aderholt said in his statement. "It will take a targeted approach that can't be done from Washington. With that being said, I will continue to work to make sure that state and local governments and organizations have the resources they need to win this war."

The study's authors said, "By knowing opioid prescribing rates by congressional district, instead of at the state level, which may be very different, representatives may be able to advocate more strongly for federal policy."