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 county or county equivalent with the highest excessive drinking rate in each state.
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 the counties on this list 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 16.6% 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 county in every state
Click here to read our detailed methodology
Alabama: Baldwin County
> Adults binge or heavy drinking: 18.7% (Alabama: 14.9%)
> Driving deaths involving alcohol: 29.6% (Alabama: 26.9%)
> Median household income: $58,320 (Alabama: $50,536)
> Adults reporting poor or fair health: 16.5% (Alabama: 21.4%)
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Alaska: Skagway Municipality
> Adults binge or heavy drinking: 22.2% (Alaska: 17.6%)
> Driving deaths involving alcohol: N/A (Alaska: 37.9%)
> Median household income: $73,906 (Alaska: $77,640)
> Adults reporting poor or fair health: 12.2% (Alaska: 15.6%)
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Arizona: Yavapai County
> Adults binge or heavy drinking: 21.6% (Arizona: 18.1%)
> Driving deaths involving alcohol: 17.3% (Arizona: 24.7%)
> Median household income: $52,451 (Arizona: $58,945)
> Adults reporting poor or fair health: 16.7% (Arizona: 18.6%)
Arkansas: Benton County
> Adults binge or heavy drinking: 18.5% (Arkansas: 17.3%)
> Driving deaths involving alcohol: 27.9% (Arkansas: 26.2%)
> Median household income: $66,362 (Arkansas: $47,597)
> Adults reporting poor or fair health: 19.9% (Arkansas: 23.3%)
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California: Nevada County
> Adults binge or heavy drinking: 24.9% (California: 18.1%)
> Driving deaths involving alcohol: 34.8% (California: 28.7%)
> Median household income: $66,096 (California: $75,235)
> Adults reporting poor or fair health: 13.9% (California: 17.6%)
Colorado: Denver County
> Adults binge or heavy drinking: 25.3% (Colorado: 21.3%)
> Driving deaths involving alcohol: 34.4% (Colorado: 33.7%)
> Median household income: $68,592 (Colorado: $72,331)
> Adults reporting poor or fair health: 15.5% (Colorado: 13.8%)
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Connecticut: Middlesex County
> Adults binge or heavy drinking: 22.7% (Connecticut: 20.5%)
> Driving deaths involving alcohol: 29.9% (Connecticut: 31.5%)
> Median household income: $85,898 (Connecticut: $78,444)
> Adults reporting poor or fair health: 11.1% (Connecticut: 13.0%)
Delaware: Sussex County
> Adults binge or heavy drinking: 20.3% (Delaware: 19.8%)
> Driving deaths involving alcohol: 26.9% (Delaware: 26.0%)
> Median household income: $63,162 (Delaware: $68,287)
> Adults reporting poor or fair health: 18.9% (Delaware: 16.3%)
Florida: Sarasota County
> Adults binge or heavy drinking: 25.6% (Florida: 19.7%)
> Driving deaths involving alcohol: 29.3% (Florida: 22.3%)
> Median household income: $62,236 (Florida: $55,660)
> Adults reporting poor or fair health: 15.7% (Florida: 19.5%)
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Georgia: Chatham County
> Adults binge or heavy drinking: 20.7% (Georgia: 16.8%)
> Driving deaths involving alcohol: 20.6% (Georgia: 20.3%)
> Median household income: $56,842 (Georgia: $58,700)
> Adults reporting poor or fair health: 19.2% (Georgia: 18.4%)
Hawaii: Kauai County
> Adults binge or heavy drinking: 24.9% (Hawaii: 23.0%)
> Driving deaths involving alcohol: 30.3% (Hawaii: 31.2%)
> Median household income: $83,554 (Hawaii: $81,275)
> Adults reporting poor or fair health: 15.7% (Hawaii: 15.4%)
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Idaho: Idaho County
> Adults binge or heavy drinking: 22.1% (Idaho: 17.1%)
> Driving deaths involving alcohol: 39.5% (Idaho: 31.4%)
> Median household income: $41,516 (Idaho: $55,785)
> Adults reporting poor or fair health: 19.5% (Idaho: 15.1%)
Illinois: Woodford County
> Adults binge or heavy drinking: 24.2% (Illinois: 21.5%)
> Driving deaths involving alcohol: 29.4% (Illinois: 31.1%)
> Median household income: $72,808 (Illinois: $65,886)
> Adults reporting poor or fair health: 13.4% (Illinois: 15.9%)
Indiana: Porter County
> Adults binge or heavy drinking: 21.3% (Indiana: 18.6%)
> Driving deaths involving alcohol: 18.1% (Indiana: 18.8%)
> Median household income: $71,152 (Indiana: $56,303)
> Adults reporting poor or fair health: 16.6% (Indiana: 18.2%)
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Iowa: Winneshiek County
> Adults binge or heavy drinking: 28.3% (Iowa: 25.8%)
> Driving deaths involving alcohol: 40.0% (Iowa: 26.8%)
> Median household income: $65,263 (Iowa: $60,523)
> Adults reporting poor or fair health: 11.4% (Iowa: 13.5%)
Kansas: Miami County
> Adults binge or heavy drinking: 22.0% (Kansas: 18.2%)
> Driving deaths involving alcohol: 20.7% (Kansas: 19.9%)
> Median household income: $71,995 (Kansas: $59,597)
> Adults reporting poor or fair health: 14.2% (Kansas: 16.3%)
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Kentucky: Campbell County
> Adults binge or heavy drinking: 20.2% (Kentucky: 17.2%)
> Driving deaths involving alcohol: 33.3% (Kentucky: 25.5%)
> Median household income: $63,050 (Kentucky: $50,589)
> Adults reporting poor or fair health: 18.5% (Kentucky: 21.8%)
Louisiana: St. Tammany Parish
> Adults binge or heavy drinking: 24.3% (Louisiana: 19.7%)
> Driving deaths involving alcohol: 28.2% (Louisiana: 32.3%)
> Median household income: $68,905 (Louisiana: $49,469)
> Adults reporting poor or fair health: 16.2% (Louisiana: 21.4%)
Maine: Cumberland County
> Adults binge or heavy drinking: 24.7% (Maine: 22.0%)
> Driving deaths involving alcohol: 29.0% (Maine: 35.4%)
> Median household income: $73,072 (Maine: $57,918)
> Adults reporting poor or fair health: 11.7% (Maine: 17.1%)
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Maryland: Queen Anne’s County
> Adults binge or heavy drinking: 21.4% (Maryland: 15.4%)
> Driving deaths involving alcohol: 36.6% (Maryland: 28.8%)
> Median household income: $97,034 (Maryland: $84,805)
> Adults reporting poor or fair health: 13.1% (Maryland: 15.2%)
Massachusetts: Barnstable County
> Adults binge or heavy drinking: 26.5% (Massachusetts: 23.5%)
> Driving deaths involving alcohol: 37.3% (Massachusetts: 30.2%)
> Median household income: $74,336 (Massachusetts: $81,215)
> Adults reporting poor or fair health: 12.7% (Massachusetts: 13.5%)
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Michigan: Marquette County
> Adults binge or heavy drinking: 23.5% (Michigan: 20.9%)
> Driving deaths involving alcohol: 42.3% (Michigan: 29.3%)
> Median household income: $53,970 (Michigan: $57,144)
> Adults reporting poor or fair health: 16.9% (Michigan: 18.3%)
Minnesota: Le Sueur County
> Adults binge or heavy drinking: 27.2% (Minnesota: 23.2%)
> Driving deaths involving alcohol: 31.3% (Minnesota: 29.7%)
> Median household income: $71,080 (Minnesota: $71,306)
> Adults reporting poor or fair health: 12.9% (Minnesota: 12.9%)
Mississippi: George County
> Adults binge or heavy drinking: 17.1% (Mississippi: 14.8%)
> Driving deaths involving alcohol: 30.4% (Mississippi: 19.6%)
> Median household income: $47,292 (Mississippi: $45,081)
> Adults reporting poor or fair health: 22.7% (Mississippi: 22.1%)
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Missouri: St. Charles County
> Adults binge or heavy drinking: 24.0% (Missouri: 20.5%)
> Driving deaths involving alcohol: 32.3% (Missouri: 27.1%)
> Median household income: $84,978 (Missouri: $55,461)
> Adults reporting poor or fair health: 14.2% (Missouri: 19.5%)
Montana: Gallatin County
> Adults binge or heavy drinking: 25.8% (Montana: 21.9%)
> Driving deaths involving alcohol: 64.4% (Montana: 44.8%)
> Median household income: $66,397 (Montana: $54,970)
> Adults reporting poor or fair health: 11.3% (Montana: 14.1%)
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Nebraska: Sherman County
> Adults binge or heavy drinking: 26.3% (Nebraska: 23.7%)
> Driving deaths involving alcohol: 50.0% (Nebraska: 32.7%)
> Median household income: $50,781 (Nebraska: $61,439)
> Adults reporting poor or fair health: 14.1% (Nebraska: 13.8%)
Nevada: Humboldt County
> Adults binge or heavy drinking: 24.3% (Nevada: 17.9%)
> Driving deaths involving alcohol: 40.0% (Nevada: 29.1%)
> Median household income: $67,756 (Nevada: $60,365)
> Adults reporting poor or fair health: 20.1% (Nevada: 19.1%)
New Hampshire: Rockingham County
> Adults binge or heavy drinking: 22.7% (New Hampshire: 20.2%)
> Driving deaths involving alcohol: 41.0% (New Hampshire: 31.5%)
> Median household income: $93,756 (New Hampshire: $76,768)
> Adults reporting poor or fair health: 11.5% (New Hampshire: 12.8%)
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New Jersey: Sussex County
> Adults binge or heavy drinking: 21.4% (New Jersey: 16.0%)
> Driving deaths involving alcohol: 21.8% (New Jersey: 21.9%)
> Median household income: $94,520 (New Jersey: $82,545)
> Adults reporting poor or fair health: 13.0% (New Jersey: 15.5%)
New Mexico: Lincoln County
> Adults binge or heavy drinking: 19.4% (New Mexico: 16.7%)
> Driving deaths involving alcohol: 36.0% (New Mexico: 29.8%)
> Median household income: $46,216 (New Mexico: $49,754)
> Adults reporting poor or fair health: 18.3% (New Mexico: 20.3%)
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New York: Rensselaer County
> Adults binge or heavy drinking: 24.9% (New York: 19.2%)
> Driving deaths involving alcohol: 20.0% (New York: 20.6%)
> Median household income: $68,991 (New York: $68,486)
> Adults reporting poor or fair health: 14.9% (New York: 16.3%)
North Carolina: Dare County
> Adults binge or heavy drinking: 22.0% (North Carolina: 17.6%)
> Driving deaths involving alcohol: 10.5% (North Carolina: 27.6%)
> Median household income: $59,381 (North Carolina: $54,602)
> Adults reporting poor or fair health: 15.1% (North Carolina: 18.0%)
North Dakota: Mercer County
> Adults binge or heavy drinking: 27.0% (North Dakota: 23.7%)
> Driving deaths involving alcohol: 57.1% (North Dakota: 42.3%)
> Median household income: $82,181 (North Dakota: $64,894)
> Adults reporting poor or fair health: 13.8% (North Dakota: 13.6%)
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Ohio: Perry County
> Adults binge or heavy drinking: 21.8% (Ohio: 18.5%)
> Driving deaths involving alcohol: 23.8% (Ohio: 32.2%)
> Median household income: $50,150 (Ohio: $56,602)
> Adults reporting poor or fair health: 22.3% (Ohio: 17.8%)
Oklahoma: Alfalfa County
> Adults binge or heavy drinking: 16.9% (Oklahoma: 14.9%)
> Driving deaths involving alcohol: 44.4% (Oklahoma: 26.5%)
> Median household income: $61,852 (Oklahoma: $52,919)
> Adults reporting poor or fair health: 18.8% (Oklahoma: 20.9%)
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Oregon: Columbia County
> Adults binge or heavy drinking: 23.8% (Oregon: 19.5%)
> Driving deaths involving alcohol: 25.0% (Oregon: 31.5%)
> Median household income: $62,257 (Oregon: $62,818)
> Adults reporting poor or fair health: 17.7% (Oregon: 18.2%)
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Pennsylvania: Butler County
> Adults binge or heavy drinking: 23.7% (Pennsylvania: 20.2%)
> Driving deaths involving alcohol: 23.7% (Pennsylvania: 26.2%)
> Median household income: $70,668 (Pennsylvania: $61,744)
> Adults reporting poor or fair health: 14.5% (Pennsylvania: 17.6%)
Rhode Island: Newport County
> Adults binge or heavy drinking: 25.4% (Rhode Island: 19.7%)
> Driving deaths involving alcohol: 21.4% (Rhode Island: 41.6%)
> Median household income: $79,454 (Rhode Island: $67,167)
> Adults reporting poor or fair health: 12.1% (Rhode Island: 16.5%)
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South Carolina: Beaufort County
> Adults binge or heavy drinking: 25.2% (South Carolina: 17.8%)
> Driving deaths involving alcohol: 28.2% (South Carolina: 31.8%)
> Median household income: $68,377 (South Carolina: $53,199)
> Adults reporting poor or fair health: 14.4% (South Carolina: 17.8%)
South Dakota: Stanley County
> Adults binge or heavy drinking: 27.0% (South Dakota: 24.3%)
> Driving deaths involving alcohol: 0.0% reported (South Dakota: 35.5%)
> Median household income: $71,382 (South Dakota: $58,275)
> Adults reporting poor or fair health: 10.9% (South Dakota: 13.4%)
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Tennessee: Knox County
> Adults binge or heavy drinking: 19.5% (Tennessee: 17.1%)
> Driving deaths involving alcohol: 25.0% (Tennessee: 24.6%)
> Median household income: $57,470 (Tennessee: $53,320)
> Adults reporting poor or fair health: 19.2% (Tennessee: 21.2%)
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Texas: Clay County
> Adults binge or heavy drinking: 22.3% (Texas: 19.0%)
> Driving deaths involving alcohol: 29.4% (Texas: 25.7%)
> Median household income: $55,989 (Texas: $61,874)
> Adults reporting poor or fair health: 18.0% (Texas: 18.7%)
Utah: Summit County
> Adults binge or heavy drinking: 16.6% (Utah: 11.1%)
> Driving deaths involving alcohol: 23.8% (Utah: 21.0%)
> Median household income: $102,958 (Utah: $71,621)
> Adults reporting poor or fair health: 10.9% (Utah: 14.8%)
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Vermont: Washington County
> Adults binge or heavy drinking: 24.3% (Vermont: 20.5%)
> Driving deaths involving alcohol: 19.0% (Vermont: 34.3%)
> Median household income: $62,791 (Vermont: $61,973)
> Adults reporting poor or fair health: 12.4% (Vermont: 12.8%)
Virginia: Hanover County
> Adults binge or heavy drinking: 22.6% (Virginia: 17.7%)
> Driving deaths involving alcohol: 33.3% (Virginia: 29.8%)
> Median household income: $89,390 (Virginia: $74,222)
> Adults reporting poor or fair health: 13.0% (Virginia: 16.6%)
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Washington: Jefferson County
> Adults binge or heavy drinking: 22.1% (Washington: 17.1%)
> Driving deaths involving alcohol: 29.6% (Washington: 32.5%)
> Median household income: $55,127 (Washington: $73,775)
> Adults reporting poor or fair health: 14.5% (Washington: 15.0%)
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West Virginia: Marshall County
> Adults binge or heavy drinking: 17.3% (West Virginia: 14.4%)
> Driving deaths involving alcohol: 23.5% (West Virginia: 25.2%)
> Median household income: $48,557 (West Virginia: $46,711)
> Adults reporting poor or fair health: 22.0% (West Virginia: 23.6%)
Wisconsin: Outagamie County
> Adults binge or heavy drinking: 31.0% (Wisconsin: 27.1%)
> Driving deaths involving alcohol: 32.0% (Wisconsin: 35.7%)
> Median household income: $65,572 (Wisconsin: $61,747)
> Adults reporting poor or fair health: 13.7% (Wisconsin: 14.8%)
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Wyoming: Teton County
> Adults binge or heavy drinking: 23.8% (Wyoming: 20.1%)
> Driving deaths involving alcohol: 27.3% (Wyoming: 32.8%)
> Median household income: $84,678 (Wyoming: $64,049)
> Adults reporting poor or fair health: 11.4% (Wyoming: 15.3%)
To determine the drunkest county 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.
While the CHR report is from 2021, excessive drinking rate figures published in the report are from 2018.
Of the 3,220 counties or county equivalents, 3,141 had boundaries that fell within one of the 50 states, while the rest were in the District of Columbia or Puerto Rico. Counties with a 2019 five-year population estimate from the U.S. Census Bureau of less than 1,000 were excluded.
The remaining 3,105 places were ranked within their state based on the excessive drinking rate. 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 five-year estimates from the U.S. Census Bureau’s 2019 American Community Survey.
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