America has an alcohol problem. Excessive drinking is the third leading cause of preventable death in the United States. The Centers for Disease Control and Prevention says that alcohol contributed to more than 140,000 fatalities each year between 2015 and 2019 – and in some cities and regions of the nation, the problem is much worse than in others. (To take just one peril of excessive drinking, deaths from alcohol-related cirrhosis have gone up almost every year since 2000.)
To identify the U.S. metro areas with the highest excessive drinking rates, 24/7 Tempo reviewed data on the percentage of adults 18 and older who reported binge or heavy drinking within a 30-day period across all metro areas in the country from the 2023 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.
One in six US adults binge-drinks – defined as consuming five or more drinks on one occasion for men or four or more drinks on one occasion for women – with 25% doing so at least weekly. On our list, the percentage of adults who drink excessively in each city tops 22%, well above the US average of 19.79%.
Click here to see the drunkest cities in America
Binge drinking is most common among adults who have household incomes of $75,000 or more, are non-Hispanic white, or who live in the Midwest. Speaking of the Midwest, cities in that region occupy seven of the top 10 places on our list. Wisconsin has the most cities in the top 50 with 12, followed by Iowa with six. Florida, a magnet for booze bingers at spring break, checks in with five cities. (These are the states with the highest rates of binge drinking.)
Binge-drinking is very much a fact of college life, and some of the cities with significant university presences are on the list, among them Boston-Cambridge-Newton, Massachusetts; Ames, Iowa; Burlington-South Burlington, Vermont; and Syracuse, New York.
50. Myrtle Beach-Conway-North Myrtle Beach, South Carolina
>Pct. of adults who drink excessively: 22.65 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 27.11 — No. 208 out of 386 (US rate: 26.56)
>Median household income: $59,073 — No. 251 out of 386 (US median: $69,717)
>Population: 509,794
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49. Glens Falls, New York
>Pct. of adults who drink excessively: 22.72 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 19.64 — No. 334 out of 386 (US rate: 26.56)
>Median household income: $65,557 — No. 146 out of 386 (US median: $69,717)
>Population: 126,574
48. Kingston, New York
>Pct. of adults who drink excessively: 22.75 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 19.32 — No. 343 out of 386 (US rate: 26.56)
>Median household income: $78,938 — No. 48 out of 386 (US median: $69,717)
>Population: 182,951
47. Bismarck, North Dakota
>Pct. of adults who drink excessively: 22.75 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 40.38 — No. 16 out of 386 (US rate: 26.56)
>Median household income: $67,793 — No. 118 out of 386 (US median: $69,717)
>Population: 134,028
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46. Naples-Marco Island, Florida
>Pct. of adults who drink excessively: 22.81 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 23.47 — No. 286 out of 386 (US rate: 26.56)
>Median household income: $74,215 — No. 72 out of 386 (US median: $69,717)
>Population: 385,980
45. Cape Coral-Fort Myers, Florida
>Pct. of adults who drink excessively: 22.88 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 23.98 — No. 276 out of 386 (US rate: 26.56)
>Median household income: $66,256 — No. 139 out of 386 (US median: $69,717)
>Population: 787,976
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44. Pittsfield, Massachusetts
>Pct. of adults who drink excessively: 22.89 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 20.59 — No. 324 out of 386 (US rate: 26.56)
>Median household income: $60,749 — No. 219 out of 386 (US median: $69,717)
>Population: 128,657
43. Boston-Cambridge-Newton, Massachusetts
>Pct. of adults who drink excessively: 23.00 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 30.40 — No. 129 out of 386 (US rate: 26.56)
>Median household income: $100,750 — No. 7 out of 386 (US median: $69,717)
>Population: 4,899,932
42. Minneapolis-St. Paul-Bloomington, Minnesota
>Pct. of adults who drink excessively: 23.14 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 31.86 — No. 106 out of 386 (US rate: 26.56)
>Median household income: $87,433 — No. 20 out of 386 (US median: $69,717)
>Population: 3,690,512
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41. Ames, Iowa
>Pct. of adults who drink excessively: 23.21 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 27.78 — No. 192 out of 386 (US rate: 26.56)
>Median household income: $64,569 — No. 161 out of 386 (US median: $69,717)
>Population: 126,195
40. Burlington-South Burlington, Vermont
>Pct. of adults who drink excessively: 23.31 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 35.29 — No. 48 out of 386 (US rate: 26.56)
>Median household income: $81,852 — No. 37 out of 386 (US median: $69,717)
>Population: 226,715
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39. Waterloo-Cedar Falls, Iowa
>Pct. of adults who drink excessively: 23.32 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 22.06 — No. 309 out of 386 (US rate: 26.56)
>Median household income: $61,833 — No. 201 out of 386 (US median: $69,717)
>Population: 167,796
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38. Des Moines-West Des Moines, Iowa
>Pct. of adults who drink excessively: 23.34 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 28.57 — No. 171 out of 386 (US rate: 26.56)
>Median household income: $74,208 — No. 73 out of 386 (US median: $69,717)
>Population: 719,146
37. Utica-Rome, New York
>Pct. of adults who drink excessively: 23.35 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 29.75 — No. 149 out of 386 (US rate: 26.56)
>Median household income: $60,313 — No. 230 out of 386 (US median: $69,717)
>Population: 290,211
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36. Kahului-Wailuku-Lahaina, Hawaii
>Pct. of adults who drink excessively: 23.41 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 44.83 — No. 4 out of 386 (US rate: 26.56)
>Median household income: $76,273 — No. 63 out of 386 (US median: $69,717)
>Population: 164,268
35. Baton Rouge, Louisiana
>Pct. of adults who drink excessively: 23.47 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 35.09 — No. 52 out of 386 (US rate: 26.56)
>Median household income: $58,276 — No. 261 out of 386 (US median: $69,717)
>Population: 871,905
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34. Monroe, Michigan
>Pct. of adults who drink excessively: 23.51 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 42.59 — No. 7 out of 386 (US rate: 26.56)
>Median household income: $65,512 — No. 148 out of 386 (US median: $69,717)
>Population: 155,274
33. Syracuse, New York
>Pct. of adults who drink excessively: 23.53 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 28.63 — No. 170 out of 386 (US rate: 26.56)
>Median household income: $64,296 — No. 164 out of 386 (US median: $69,717)
>Population: 658,281
32. Madison, Wisconsin
>Pct. of adults who drink excessively: 23.53 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 31.87 — No. 105 out of 386 (US rate: 26.56)
>Median household income: $76,731 — No. 62 out of 386 (US median: $69,717)
>Population: 683,183
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31. Punta Gorda, Florida
>Pct. of adults who drink excessively: 23.53 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 29.55 — No. 153 out of 386 (US rate: 26.56)
>Median household income: $59,285 — No. 246 out of 386 (US median: $69,717)
>Population: 194,843
30. Iowa City, Iowa
>Pct. of adults who drink excessively: 23.54 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 27.27 — No. 203 out of 386 (US rate: 26.56)
>Median household income: $66,216 — No. 141 out of 386 (US median: $69,717)
>Population: 177,239
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29. Lincoln, Nebraska
>Pct. of adults who drink excessively: 23.56 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 33.90 — No. 68 out of 386 (US rate: 26.56)
>Median household income: $65,229 — No. 153 out of 386 (US median: $69,717)
>Population: 343,035
28. Deltona-Daytona Beach-Ormond Beach, Florida
>Pct. of adults who drink excessively: 23.74 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 22.54 — No. 302 out of 386 (US rate: 26.56)
>Median household income: $59,171 — No. 249 out of 386 (US median: $69,717)
>Population: 685,344
27. North Port-Sarasota-Bradenton, Florida
>Pct. of adults who drink excessively: 23.80 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 26.52 — No. 218 out of 386 (US rate: 26.56)
>Median household income: $70,095 — No. 107 out of 386 (US median: $69,717)
>Population: 859,760
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26. Bend, Oregon
>Pct. of adults who drink excessively: 23.80 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 27.03 — No. 210 out of 386 (US rate: 26.56)
>Median household income: $79,796 — No. 46 out of 386 (US median: $69,717)
>Population: 204,801
25. Springfield, Illinois
>Pct. of adults who drink excessively: 23.81 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 24.04 — No. 274 out of 386 (US rate: 26.56)
>Median household income: $68,796 — No. 112 out of 386 (US median: $69,717)
>Population: 207,245
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24. Grand Forks, North Dakota
>Pct. of adults who drink excessively: 23.87 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 33.96 — No. 67 out of 386 (US rate: 26.56)
>Median household income: $62,568 — No. 191 out of 386 (US median: $69,717)
>Population: 103,462
23. Cedar Rapids, Iowa
>Pct. of adults who drink excessively: 23.93 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 21.93 — No. 310 out of 386 (US rate: 26.56)
>Median household income: $69,923 — No. 109 out of 386 (US median: $69,717)
>Population: 275,435
22. Sheboygan, Wisconsin
>Pct. of adults who drink excessively: 24.03 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 35.56 — No. 47 out of 386 (US rate: 26.56)
>Median household income: $62,188 — No. 195 out of 386 (US median: $69,717)
>Population: 117,747
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21. Billings, Montana
>Pct. of adults who drink excessively: 24.04 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 44.17 — No. 5 out of 386 (US rate: 26.56)
>Median household income: $70,018 — No. 108 out of 386 (US median: $69,717)
>Population: 187,037
20. Duluth, Minnesota
>Pct. of adults who drink excessively: 24.44 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 38.21 — No. 28 out of 386 (US rate: 26.56)
>Median household income: $64,960 — No. 156 out of 386 (US median: $69,717)
>Population: 292,285
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19. Janesville-Beloit, Wisconsin
>Pct. of adults who drink excessively: 24.47 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 42.98 — No. 6 out of 386 (US rate: 26.56)
>Median household income: $66,090 — No. 143 out of 386 (US median: $69,717)
>Population: 164,381
18. Mankato, Minnesota
>Pct. of adults who drink excessively: 24.66 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 12.50 — No. 373 out of 386 (US rate: 26.56)
>Median household income: $70,130 — No. 106 out of 386 (US median: $69,717)
>Population: 103,612
17. Milwaukee-Waukesha, Wisconsin
>Pct. of adults who drink excessively: 24.73 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 28.04 — No. 184 out of 386 (US rate: 26.56)
>Median household income: $68,449 — No. 116 out of 386 (US median: $69,717)
>Population: 1,566,487
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16. Wausau-Weston, Wisconsin
>Pct. of adults who drink excessively: 24.96 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 23.17 — No. 289 out of 386 (US rate: 26.56)
>Median household income: $71,486 — No. 97 out of 386 (US median: $69,717)
>Population: 166,189
15. Oshkosh-Neenah, Wisconsin
>Pct. of adults who drink excessively: 24.97 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 31.48 — No. 114 out of 386 (US rate: 26.56)
>Median household income: $64,095 — No. 168 out of 386 (US median: $69,717)
>Population: 171,623
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14. Great Falls, Montana
>Pct. of adults who drink excessively: 25.08 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 51.92 — No. 1 out of 386 (US rate: 26.56)
>Median household income: $57,706 — No. 270 out of 386 (US median: $69,717)
>Population: 84,511
13. Hilton Head Island-Bluffton, South Carolina
>Pct. of adults who drink excessively: 25.18 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 28.87 — No. 166 out of 386 (US rate: 26.56)
>Median household income: $67,779 — No. 119 out of 386 (US median: $69,717)
>Population: 222,072
12. Racine, Wisconsin
>Pct. of adults who drink excessively: 25.31 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 32.56 — No. 95 out of 386 (US rate: 26.56)
>Median household income: $68,758 — No. 113 out of 386 (US median: $69,717)
>Population: 196,896
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11. Portland-South Portland, Maine
>Pct. of adults who drink excessively: 25.37 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 28.19 — No. 182 out of 386 (US rate: 26.56)
>Median household income: $78,558 — No. 53 out of 386 (US median: $69,717)
>Population: 556,893
10. Barnstable Town, Massachusetts
>Pct. of adults who drink excessively: 25.41 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 38.81 — No. 22 out of 386 (US rate: 26.56)
>Median household income: $83,537 — No. 32 out of 386 (US median: $69,717)
>Population: 232,411
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9. Fond du Lac, Wisconsin
>Pct. of adults who drink excessively: 25.41 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 35.19 — No. 50 out of 386 (US rate: 26.56)
>Median household income: $69,068 — No. 111 out of 386 (US median: $69,717)
>Population: 104,362
8. Green Bay, Wisconsin
>Pct. of adults who drink excessively: 25.64 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 37.59 — No. 33 out of 386 (US rate: 26.56)
>Median household income: $66,652 — No. 133 out of 386 (US median: $69,717)
>Population: 329,490
7. Dubuque, Iowa
>Pct. of adults who drink excessively: 25.93 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 19.35 — No. 342 out of 386 (US rate: 26.56)
>Median household income: $75,590 — No. 69 out of 386 (US median: $69,717)
>Population: 98,718
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6. Appleton, Wisconsin
>Pct. of adults who drink excessively: 25.97 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 37.50 — No. 34 out of 386 (US rate: 26.56)
>Median household income: $74,331 — No. 71 out of 386 (US median: $69,717)
>Population: 244,084
5. La Crosse-Onalaska, Wisconsin
>Pct. of adults who drink excessively: 26.26 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 30.43 — No. 128 out of 386 (US rate: 26.56)
>Median household income: $61,342 — No. 210 out of 386 (US median: $69,717)
>Population: 139,211
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4. Charleston-North Charleston, South Carolina
>Pct. of adults who drink excessively: 26.30 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 34.41 — No. 60 out of 386 (US rate: 26.56)
>Median household income: $72,719 — No. 87 out of 386 (US median: $69,717)
>Population: 813,052
3. Eau Claire, Wisconsin
>Pct. of adults who drink excessively: 26.43 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 37.84 — No. 30 out of 386 (US rate: 26.56)
>Median household income: $61,684 — No. 206 out of 386 (US median: $69,717)
>Population: 173,317
2. Missoula, Montana
>Pct. of adults who drink excessively: 26.90 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 34.29 — No. 61 out of 386 (US rate: 26.56)
>Median household income: $66,803 — No. 128 out of 386 (US median: $69,717)
>Population: 119,533
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1. St. Cloud, Minnesota
>Pct. of adults who drink excessively: 26.93 (US rate: 19.79)
>Pct. of fatal car accidents involving alcohol: 27.40 — No. 200 out of 386 (US rate: 26.56)
>Median household income: $65,641 — No. 145 out of 386 (US median: $69,717)
>Population: 200,406
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