46. Virginia
> Drunkest city: Virginia Beach-Norfolk-Newport News
> Pct of MSA adults binge or heavy drinking: 16.8%
> Pct. of state adults binge or heavy drinking: 15.9%
> Pct of driving deaths alcohol related: 35.9%

About 16.8% of adults in the Virginia Beach metro area report excessive drinking in the last 30 days, slightly higher than the 15.9% of adults across the state. Of all eight metro areas in Virginia, Virginia Beach and Richmond are the only ones where the share of adults drinking excessively exceeds the statewide rate of 15.9%. An estimated 7,195 years of life are lost each year per 100,000 Virginia Beach residents due to premature death, versus the comparable statewide estimate of 6,192 years. Excessive alcohol consumption is one of the leading causes of preventable death according to the CDC, and alcohol abuse may be contributing to the incidence of premature death in the Virginia Beach area.

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47. Washington
> Drunkest city: Longview
> Pct of MSA adults binge or heavy drinking: 18.6%
> Pct. of state adults binge or heavy drinking: 16.9%
> Pct of driving deaths alcohol related: 47.5%

More than two in five driving fatalities in Washington are alcohol related, the sixth highest percentage of all states. In Longview, the metro area reporting the highest level of excessive drinking, the incidence of alcohol-related driving deaths is even higher, at 47.5%. Also, while metro areas reporting high levels of excessive drinking do not necessarily report poor health outcomes, more than 18% of adults in the Longview area report poor or fair health. This is higher than both the state and national shares.

48. West Virginia
> Drunkest city: Weirton-Steubenville
> Pct of MSA adults binge or heavy drinking: 14.6%
> Pct. of state adults binge or heavy drinking: 10.0%
> Pct of driving deaths alcohol related: 32.8%

Of the seven metro areas in West Virginia, Weirton-Steubenville area residents report the highest levels of excessive drinking, at 14.6%. However, the metro area is one of only four on this list where the percentage of adults binge or heavy drinking does not exceed the national percentage of 15%. Still, the incidence of premature death in the metro, at an estimated 8,199 years of potential life lost per 100,000 people annually, is far higher than the national level of premature death. However, it is well below the state figure of 9,587 years of potential life lost per 100,000 people annually, which is second most in the nation compared to other states.

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49. Wisconsin
> Drunkest city: Appleton
> Pct of MSA adults binge or heavy drinking: 29.8%
> Pct. of state adults binge or heavy drinking: 24.4%
> Pct of driving deaths alcohol related: 34.6%

Slightly less than a quarter of Wisconsin adults report an excessive drinking habit, a larger share than in any other state in the country. In the Appleton metro area, binge and heavy drinking is even more common, with 29.8% of adults reporting excessive drinking. Not only is binge or heavy drinking more common in Appleton than it is in any of the state’s other 11 metro areas, but also just two metro areas in the entire country have a larger share of adults reporting similar drinking habits.

50. Wyoming
> Drunkest city: Casper
> Pct of MSA adults binge or heavy drinking: 17.6%
> Pct. of state adults binge or heavy drinking: 17.0%
> Pct of driving deaths alcohol related: 43.9%

A sparsely populated state, Wyoming has only two metropolitan statistical areas, and only one that has a larger share of adults who report heavy or binge drinking than the state as a whole. Of the adults in Cheyenne, 15.2% report excessive drinking, roughly in line with the national share. In Casper, on the other hand, 17.6% of adults report similar drinking habits. About 17.0% of adults in Wyoming drink excessively. The relatively heavy drinking habits among area residents may contribute to a higher incidence of driving fatalities — 43.9% of fatal car accidents are alcohol related in Casper, one of the highest shares nationwide.