Each day, at dinner tables and social functions across the country, millions of adults enjoy alcohol responsibly. Moderate drinking — defined as two standard drinks per day for men and one standard drink for women — carries relatively little risk, and may even have some health benefits. However, beyond this threshold, alcohol can only be detrimental.
Excessive drinking — along with tobacco use, inadequate exercise, and poor nutrition — is one of four main risk factors for preventable disease identified by the CDC. In addition to short-term consequences, such as impaired judgement and motor skills, excessive alcohol consumption is associated with liver disease, certain cancers, increased risk of a heart attack or stroke, and poor mental health. Here is a look at 23 ways a drinking habit can harm you.
Each year, alcohol misuse is directly linked to diseases and accidents that kill an estimated 95,000 Americans. Excessive drinking also costs the economy hundreds of billions of dollars annually, mostly in lost productivity.
Using data from County Health Rankings & Roadmaps, a joint program between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, 24/7 Tempo identified the metropolitan areas with the highest excessive drinking rate in each state. Four states — Delaware, New Hampshire, Rhode Island, and Vermont — have only one metro area. As a result, these areas rank on this list by default only.
Excessive drinking can be either binge drinking or heavy drinking. CHR defines binge drinking as consumption of more than four drinks in a single occasion for women and more than five drinks for men. Heavy drinking is defined as more than one drink a day on average for women and more than two drinks a day for men.
Though each of these metro areas has the highest excessive drinking rate in its respective state, the share of adults who report excessive drinking in these areas varies considerably — from as low as 13.6% to over 30%. Nationwide, the excessive drinking rate is 19.2%
It is important to note that alcohol affects everyone differently, and as a general rule, drinking less is better than drinking more. Additionally, the vast majority of Americans who drink excessively — about 90% of them — do not have a severe alcohol use disorder, a chronic disease commonly referred to as alcoholism.
Click here to see the drunkest metro in every state
Click here to see our detailed methodology
Alabama: Daphne-Fairhope-Foley
> Adults binge or heavy drinking: 18.7% (Alabama: 14.9%)
> Driving deaths involving alcohol: 29.6% (Alabama: 26.9%)
> Median household income: $56,439 (Alabama: $51,734)
> Adults reporting poor or fair health: 16.5% (Alabama: 21.4%)
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Alaska: Fairbanks
> Adults binge or heavy drinking: 18.6% (Alaska: 17.6%)
> Driving deaths involving alcohol: 40.9% (Alaska: 37.9%)
> Median household income: $72,065 (Alaska: $75,463)
> Adults reporting poor or fair health: 14.0% (Alaska: 15.6%)
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Arizona: Prescott Valley-Prescott
> Adults binge or heavy drinking: 21.6% (Arizona: 18.1%)
> Driving deaths involving alcohol: 17.3% (Arizona: 24.7%)
> Median household income: $53,816 (Arizona: $62,055)
> Adults reporting poor or fair health: 16.7% (Arizona: 18.6%)
Arkansas: Fayetteville-Springdale-Rogers
> Adults binge or heavy drinking: 18.1% (Arkansas: 17.3%)
> Driving deaths involving alcohol: 23.8% (Arkansas: 26.2%)
> Median household income: $61,674 (Arkansas: $48,952)
> Adults reporting poor or fair health: 21.8% (Arkansas: 23.3%)
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California: San Luis Obispo-Paso Robles
> Adults binge or heavy drinking: 24.4% (California: 18.1%)
> Driving deaths involving alcohol: 40.5% (California: 28.7%)
> Median household income: $77,265 (California: $80,440)
> Adults reporting poor or fair health: 15.2% (California: 17.6%)
Colorado: Fort Collins
> Adults binge or heavy drinking: 23.2% (Colorado: 21.3%)
> Driving deaths involving alcohol: 32.6% (Colorado: 33.7%)
> Median household income: $75,186 (Colorado: $77,127)
> Adults reporting poor or fair health: 11.2% (Colorado: 13.8%)
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Connecticut: Norwich-New London
> Adults binge or heavy drinking: 22.4% (Connecticut: 20.5%)
> Driving deaths involving alcohol: 35.2% (Connecticut: 31.5%)
> Median household income: $75,633 (Connecticut: $78,833)
> Adults reporting poor or fair health: 13.6% (Connecticut: 13.0%)
Delaware: Dover*
> Adults binge or heavy drinking: 19.9% (Delaware: 19.8%)
> Driving deaths involving alcohol: 25.8% (Delaware: 26.0%)
> Median household income: $58,001 (Delaware: $70,176)
> Adults reporting poor or fair health: 21.0% (Delaware: 16.3%)
*Because Dover is the only eligible metro in Delaware, it is the drunkest metro by default.
Florida: North Port-Sarasota-Bradenton
> Adults binge or heavy drinking: 24.4% (Florida: 19.7%)
> Driving deaths involving alcohol: 26.4% (Florida: 22.3%)
> Median household income: $65,526 (Florida: $59,227)
> Adults reporting poor or fair health: 16.8% (Florida: 19.5%)
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Georgia: Savannah
> Adults binge or heavy drinking: 20.2% (Georgia: 16.8%)
> Driving deaths involving alcohol: 22.6% (Georgia: 20.3%)
> Median household income: $60,371 (Georgia: $61,980)
> Adults reporting poor or fair health: 18.5% (Georgia: 18.4%)
Hawaii: Kahului-Wailuku-Lahaina
> Adults binge or heavy drinking: 23.0% (Hawaii: 23.0%)
> Driving deaths involving alcohol: 49.0% (Hawaii: 31.2%)
> Median household income: $80,754 (Hawaii: $83,102)
> Adults reporting poor or fair health: 14.7% (Hawaii: 15.4%)
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Idaho: Pocatello
> Adults binge or heavy drinking: 19.5% (Idaho: 17.1%)
> Driving deaths involving alcohol: 28.6% (Idaho: 31.4%)
> Median household income: $51,612 (Idaho: $60,999)
> Adults reporting poor or fair health: 17.0% (Idaho: 15.1%)
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Illinois: Springfield
> Adults binge or heavy drinking: 22.0% (Illinois: 21.5%)
> Driving deaths involving alcohol: 24.7% (Illinois: 31.1%)
> Median household income: $62,205 (Illinois: $69,187)
> Adults reporting poor or fair health: 16.0% (Illinois: 15.9%)
Indiana: Indianapolis-Carmel-Anderson
> Adults binge or heavy drinking: 18.9% (Indiana: 18.6%)
> Driving deaths involving alcohol: 18.6% (Indiana: 18.8%)
> Median household income: $62,502 (Indiana: $57,603)
> Adults reporting poor or fair health: 18.2% (Indiana: 18.2%)
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Iowa: Dubuque
> Adults binge or heavy drinking: 28.1% (Iowa: 25.8%)
> Driving deaths involving alcohol: 15.6% (Iowa: 26.8%)
> Median household income: $62,178 (Iowa: $61,691)
> Adults reporting poor or fair health: 13.0% (Iowa: 13.5%)
Kansas: Lawrence
> Adults binge or heavy drinking: 19.1% (Kansas: 18.2%)
> Driving deaths involving alcohol: 37.5% (Kansas: 19.9%)
> Median household income: $64,233 (Kansas: $62,087)
> Adults reporting poor or fair health: 14.8% (Kansas: 16.3%)
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Kentucky: Louisville/Jefferson County
> Adults binge or heavy drinking: 18.7% (Kentucky: 17.2%)
> Driving deaths involving alcohol: 22.8% (Kentucky: 25.5%)
> Median household income: $61,172 (Kentucky: $52,295)
> Adults reporting poor or fair health: 20.1% (Kentucky: 21.8%)
Louisiana: New Orleans-Metairie
> Adults binge or heavy drinking: 21.4% (Louisiana: 19.7%)
> Driving deaths involving alcohol: 30.7% (Louisiana: 32.3%)
> Median household income: $55,710 (Louisiana: $51,073)
> Adults reporting poor or fair health: 20.6% (Louisiana: 21.4%)
Maine: Portland-South Portland
> Adults binge or heavy drinking: 24.2% (Maine: 22.0%)
> Driving deaths involving alcohol: 30.4% (Maine: 35.4%)
> Median household income: $71,913 (Maine: $58,924)
> Adults reporting poor or fair health: 13.2% (Maine: 17.1%)
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Maryland: Salisbury
> Adults binge or heavy drinking: 18.9% (Maryland: 15.4%)
> Driving deaths involving alcohol: 29.6% (Maryland: 28.8%)
> Median household income: $61,283 (Maryland: $86,738)
> Adults reporting poor or fair health: 18.6% (Maryland: 15.2%)
Massachusetts: Barnstable Town
> Adults binge or heavy drinking: 26.5% (Massachusetts: 23.5%)
> Driving deaths involving alcohol: 37.3% (Massachusetts: 30.2%)
> Median household income: $85,042 (Massachusetts: $85,843)
> Adults reporting poor or fair health: 12.7% (Massachusetts: 13.5%)
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Michigan: Monroe
> Adults binge or heavy drinking: 22.8% (Michigan: 20.9%)
> Driving deaths involving alcohol: 40.6% (Michigan: 29.3%)
> Median household income: $62,839 (Michigan: $59,584)
> Adults reporting poor or fair health: 17.4% (Michigan: 18.3%)
Minnesota: Duluth
> Adults binge or heavy drinking: 25.2% (Minnesota: 23.2%)
> Driving deaths involving alcohol: 34.5% (Minnesota: 29.7%)
> Median household income: $60,316 (Minnesota: $74,593)
> Adults reporting poor or fair health: 14.3% (Minnesota: 12.9%)
Mississippi: Gulfport-Biloxi
> Adults binge or heavy drinking: 16.6% (Mississippi: 14.8%)
> Driving deaths involving alcohol: 21.4% (Mississippi: 19.6%)
> Median household income: $50,642 (Mississippi: $45,792)
> Adults reporting poor or fair health: 21.3% (Mississippi: 22.1%)
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Missouri: St. Louis
> Adults binge or heavy drinking: 21.6% (Missouri: 20.5%)
> Driving deaths involving alcohol: 30.4% (Missouri: 27.1%)
> Median household income: $66,417 (Missouri: $57,409)
> Adults reporting poor or fair health: 17.1% (Missouri: 19.5%)
Montana: Missoula
> Adults binge or heavy drinking: 23.5% (Montana: 21.9%)
> Driving deaths involving alcohol: 36.2% (Montana: 44.8%)
> Median household income: $57,347 (Montana: $57,153)
> Adults reporting poor or fair health: 13.2% (Montana: 14.1%)
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Nebraska: Lincoln
> Adults binge or heavy drinking: 25.3% (Nebraska: 23.7%)
> Driving deaths involving alcohol: 29.4% (Nebraska: 32.7%)
> Median household income: $61,539 (Nebraska: $63,229)
> Adults reporting poor or fair health: 12.5% (Nebraska: 13.8%)
Nevada: Reno
> Adults binge or heavy drinking: 22.3% (Nevada: 17.9%)
> Driving deaths involving alcohol: 38.9% (Nevada: 29.1%)
> Median household income: $72,132 (Nevada: $63,276)
> Adults reporting poor or fair health: 18.1% (Nevada: 19.1%)
New Hampshire: Manchester-Nashua*
> Adults binge or heavy drinking: 19.1% (New Hampshire: 20.2%)
> Driving deaths involving alcohol: 34.4% (New Hampshire: 31.5%)
> Median household income: $83,626 (New Hampshire: $77,933)
> Adults reporting poor or fair health: 12.2% (New Hampshire: 12.8%)
*Because Manchester-Nashua is the only eligible metro in New Hampshire, it is the drunkest metro by default.
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New Jersey: Ocean City
> Adults binge or heavy drinking: 21.4% (New Jersey: 16.0%)
> Driving deaths involving alcohol: 31.7% (New Jersey: 21.9%)
> Median household income: $69,980 (New Jersey: $85,751)
> Adults reporting poor or fair health: 15.5% (New Jersey: 15.5%)
New Mexico: Santa Fe
> Adults binge or heavy drinking: 18.0% (New Mexico: 16.7%)
> Driving deaths involving alcohol: 28.4% (New Mexico: 29.8%)
> Median household income: $61,298 (New Mexico: $51,945)
> Adults reporting poor or fair health: 17.8% (New Mexico: 20.3%)
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New York: Albany-Schenectady-Troy
> Adults binge or heavy drinking: 22.7% (New York: 19.2%)
> Driving deaths involving alcohol: 24.1% (New York: 20.6%)
> Median household income: $73,398 (New York: $72,108)
> Adults reporting poor or fair health: 14.2% (New York: 16.3%)
North Carolina: Wilmington
> Adults binge or heavy drinking: 19.8% (North Carolina: 17.6%)
> Driving deaths involving alcohol: 23.4% (North Carolina: 27.6%)
> Median household income: $57,667 (North Carolina: $57,341)
> Adults reporting poor or fair health: 16.8% (North Carolina: 18.0%)
North Dakota: Fargo
> Adults binge or heavy drinking: 22.5% (North Dakota: 23.7%)
> Driving deaths involving alcohol: 36.5% (North Dakota: 42.3%)
> Median household income: $62,820 (North Dakota: $64,577)
> Adults reporting poor or fair health: 12.6% (North Dakota: 13.6%)
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Ohio: Cleveland-Elyria
> Adults binge or heavy drinking: 19.4% (Ohio: 18.5%)
> Driving deaths involving alcohol: 40.4% (Ohio: 32.2%)
> Median household income: $57,228 (Ohio: $58,642)
> Adults reporting poor or fair health: 17.9% (Ohio: 17.8%)
Oklahoma: Oklahoma City
> Adults binge or heavy drinking: 15.3% (Oklahoma: 14.9%)
> Driving deaths involving alcohol: 27.1% (Oklahoma: 26.5%)
> Median household income: $60,605 (Oklahoma: $54,449)
> Adults reporting poor or fair health: 19.5% (Oklahoma: 20.9%)
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Oregon: Bend
> Adults binge or heavy drinking: 22.1% (Oregon: 19.5%)
> Driving deaths involving alcohol: 26.6% (Oregon: 31.5%)
> Median household income: $71,643 (Oregon: $67,058)
> Adults reporting poor or fair health: 15.1% (Oregon: 18.2%)
Pennsylvania: Scranton–Wilkes-Barre
> Adults binge or heavy drinking: 22.4% (Pennsylvania: 20.2%)
> Driving deaths involving alcohol: 27.2% (Pennsylvania: 26.2%)
> Median household income: $54,304 (Pennsylvania: $63,463)
> Adults reporting poor or fair health: 19.3% (Pennsylvania: 17.6%)
Rhode Island: Providence-Warwick*
> Adults binge or heavy drinking: 21.5% (Rhode Island: 19.7%)
> Driving deaths involving alcohol: 36.6% (Rhode Island: 41.6%)
> Median household income: $70,967 (Rhode Island: $71,169)
> Adults reporting poor or fair health: 16.8% (Rhode Island: 16.5%)
*Because Providence-Warwick is the only eligible metro in Rhode Island, it is the drunkest metro by default.
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South Carolina: Hilton Head Island-Bluffton
> Adults binge or heavy drinking: 24.1% (South Carolina: 17.8%)
> Driving deaths involving alcohol: 26.7% (South Carolina: 31.8%)
> Median household income: $71,252 (South Carolina: $56,227)
> Adults reporting poor or fair health: 15.7% (South Carolina: 17.8%)
South Dakota: Sioux Falls
> Adults binge or heavy drinking: 23.1% (South Dakota: 24.3%)
> Driving deaths involving alcohol: 27.4% (South Dakota: 35.5%)
> Median household income: $65,566 (South Dakota: $59,533)
> Adults reporting poor or fair health: 12.3% (South Dakota: 13.4%)
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Tennessee: Knoxville
> Adults binge or heavy drinking: 18.1% (Tennessee: 17.1%)
> Driving deaths involving alcohol: 25.4% (Tennessee: 24.6%)
> Median household income: $56,623 (Tennessee: $56,071)
> Adults reporting poor or fair health: 20.5% (Tennessee: 21.2%)
Texas: Austin-Round Rock-Georgetown
> Adults binge or heavy drinking: 21.1% (Texas: 19.0%)
> Driving deaths involving alcohol: 26.4% (Texas: 25.7%)
> Median household income: $80,954 (Texas: $64,034)
> Adults reporting poor or fair health: 16.3% (Texas: 18.7%)
Utah: Salt Lake City
> Adults binge or heavy drinking: 13.6% (Utah: 11.1%)
> Driving deaths involving alcohol: 24.5% (Utah: 21.0%)
> Median household income: $80,196 (Utah: $75,780)
> Adults reporting poor or fair health: 16.3% (Utah: 14.8%)
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Vermont: Burlington-South Burlington*
> Adults binge or heavy drinking: 19.6% (Vermont: 20.5%)
> Driving deaths involving alcohol: 38.6% (Vermont: 34.3%)
> Median household income: $74,909 (Vermont: $63,001)
> Adults reporting poor or fair health: 11.8% (Vermont: 12.8%)
*Because Burlington-South Burlington is the only eligible metro in Vermont, it is the drunkest metro by default.
Virginia: Winchester
> Adults binge or heavy drinking: 19.1% (Virginia: 17.7%)
> Driving deaths involving alcohol: 30.3% (Virginia: 29.8%)
> Median household income: $76,583 (Virginia: $76,456)
> Adults reporting poor or fair health: 18.6% (Virginia: 16.6%)
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Washington: Wenatchee
> Adults binge or heavy drinking: 20.2% (Washington: 17.1%)
> Driving deaths involving alcohol: 30.8% (Washington: 32.5%)
> Median household income: $60,532 (Washington: $78,687)
> Adults reporting poor or fair health: 18.8% (Washington: 15.0%)
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West Virginia: Wheeling
> Adults binge or heavy drinking: 17.7% (West Virginia: 14.4%)
> Driving deaths involving alcohol: 34.6% (West Virginia: 25.2%)
> Median household income: $50,440 (West Virginia: $48,850)
> Adults reporting poor or fair health: 19.9% (West Virginia: 23.6%)
Wisconsin: Appleton
> Adults binge or heavy drinking: 30.8% (Wisconsin: 27.1%)
> Driving deaths involving alcohol: 31.1% (Wisconsin: 35.7%)
> Median household income: $68,335 (Wisconsin: $64,168)
> Adults reporting poor or fair health: 13.5% (Wisconsin: 14.8%)
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Wyoming: Casper
> Adults binge or heavy drinking: 20.7% (Wyoming: 20.1%)
> Driving deaths involving alcohol: 37.5% (Wyoming: 32.8%)
> Median household income: $65,034 (Wyoming: $65,003)
> Adults reporting poor or fair health: 15.6% (Wyoming: 15.3%)
Methodology
To determine the drunkest metro in every state, 24/7 Tempo reviewed rates of excessive drinking from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report.
The rate of excessive drinking is defined as the share of adults who report either binge drinking or heavy drinking in the past 30 days. Binge drinking is defined as a woman consuming more than four drinks or a man consuming more than five drinks in a single occasion. Heavy drinking is defined as a woman consuming more than one drink per day on average or a man consuming more than two drinks per day on average.
We aggregated county-level statistics to metropolitan statistical areas. While the CHR report is from 2021, excessive drinking rate figures published in the report are from 2018.
We used the 384 metropolitan statistical areas as delineated by the United States Office of Management and Budget and used by the Census Bureau as our definition of metros.
Metros were ranked within their state based on the excessive drinking rate. Since many metros cross state lines, the metro was assigned to the state of its first-listed principal city. Thus, the Washington-Arlington-Alexandria, DC-VA-MD-WV metro area was excluded as it is principally in the District of Columbia.
Additional information on the share of driving deaths with alcohol involvement, and the share of adults who report fair or poor health are also from the 2021 CHR. Median household income data are one-year estimates from the U.S. Census Bureau’s 2019 American Community Survey.
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