OBJECTIVES The United States (US) is in the midst of a drug epidemic, with some regions disproportionately affected by illicit drug use and dependence. Few studies have explored the relationship between MAT capacity and priority areas of need. The objective of this study was to identify illicit drug dependence priority regions (IDD-PRs) and high need treatment priority-regions (HNT-PRs) within the US. METHODS Data was obtained from the National Survey on Drug Use and Health (NSDUH) and Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Service Locator from 2012 to 2014 were used to identify a set of illicit drug dependence and unmet treatment need priority regions within the US. Geospatial analysis was performed using Local Moran’s I, which is a local indicator spatial autocorrelation to identify IDD-PR and HNT-PR “hot spots.” RESULTS : We identified 32 IDD-PRs in the US that were both illicit drug dependence outliers and “hot spots.” The 32 IDD-PRs are located in states disproportionately affected by the opioid overdose epidemic, including most of the top 10 states for drug poisoning mortality rates in 2015. The HNT-PRs were those IDD-PRs that were also in the top one percentile of people ages 12 and older who needed but did not receive treatment for illicit drug dependence in the past year. This revealed four HNT-PRs, which are located in urban areas in along the Atlantic coast, including Washington D.C., Philadelphia, and Baltimore. CONCLUSIONS The use of mapping and geospatial methods allows for targeted, place-based interventions based on the results. Targeting scarce resources for the treatment of illicit drug dependence in the IDD-PRs and HNT-PRs, may produce the greatest benefit per dollar spent.