Excessive drinking cost the United States $250 billion in 2010, according to a 2015 study from the Centers for Disease Control and Prevention (CDC). The study estimated lost productivity and added health care costs associated with alcohol consumption. States report different drinking habits, as do metropolitan areas within each state.

Binge drinking is defined by the CDC as consuming four or more drinks for women and five or more drinks for men during a single sitting. The organization defines heavy drinking as around 15 or more drinks consumed by men per week, and typically eight or more drinks for women. 24/7 Wall St. reviewed the metropolitan areas (MSA) reporting the highest levels of binge and heavy drinking in each state. Dubuque leads Iowa and the nation, with 30.8% of adults reporting binge or heavy drinking in the metropolitan area. Salt Lake City, where 12.6% of adults report such a drinking habit, is the booziest city in Utah.

Consuming excessive amounts of alcohol is associated with a range of health problems. One in 10 deaths among U.S. adults is due to excessive drinking, according to the CDC. Researchers at the organization have found that, “excessive alcohol use is responsible for 2.5 million years of potential life lost annually, or an average of about 30 years of potential life lost for each death.”

Click here to see the city with the highest alcohol consumption in each state.

While the relationship between alcohol use and negative health outcomes is widely accepted, drinking is only one of the many factors that can affect the health of a population. For this reason, many of the cities with high rates of excessive alcohol consumption do not exhibit the negative consequences that might be expected to accompany binge and heavy drinking.

For example, only slightly more than half of the cities with the highest rates of alcohol consumption in each state report an above average number of years of life lost due to premature death. Of the 50 cities, 35 have higher than average shares of adults self-reporting as being in good health.

The data does support the expected relationship between alcohol use and another negative outcome, alcohol-related driving fatalities. Driving under the influence of alcohol has declined in recent years. In 2013, 10.9% of Americans reported driving after drinking alcohol at least once in the past year, down from 14.2% in 2002. While the trend is encouraging, cities with a higher incidence of excessive drinking nonetheless tend to have more alcohol-related driving fatalities. In 34 of the 50 metro areas reviewed, the share of alcohol-related driving deaths exceeded the national share of 31%.

In the metro areas with the highest heavy or binge drinking rate in a majority of states, however, alcohol-related driving fatalities were more likely. In 34 of the 50 metro areas reviewed, the share of alcohol-related driving deaths exceeded the national share of 31%.

To identify the drunkest city in each state, 24/7 Wall St. reviewed the percentage of men and women who report binge or heavy drinking in each state’s metro areas. Metro level data was aggregated from county level data provided by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. Health outcomes, including the number of potential life lost per 100,000 people due to premature death annually and the percentage of adults who report fair or poor health was also aggregated from county-level data obtained from County Health Rankings & Roadmaps. All data are as of the most recent available year.

These are the drunkest cities in each state.

Correction: Due to a data processing error, El Paso, TX and San Jose-Sunnyvale-Santa Clara, CA were identified as the metro areas with the highest rate of excessive drinking in each state, reported at 56.2% and 23.8%, respectively. In fact, the El Paso metro area’s excessive drinking rate is 17.9%. Corpus Christi, TX is the city in Texas with the highest excessive drinking rate, at 27.5%. Napa is the city in California with the highest excessive drinking rate, at 23.7%.

1. Alabama
> Drunkest city: Auburn-Opelika
> Pct of MSA adults binge or heavy drinking: 17.8%
> Pct. of state adults binge or heavy drinking: 12.2%
> Pct of driving deaths alcohol related: 26.1%

Nearly 18% of adults in the Auburn-Opelika metro area report heavy drinking or binge drinking — defined as more than five drinks for men and four drinks for women on a single occasion — in the past 30 days, according to the CDC. This is the highest proportion compared with the other 10 metro areas in Alabama, where 12.2% of adults report such heavy drinking habits. More than 26% of all driving deaths in the Auburn area are associated with alcohol consumption. Unlike most of the metro areas on this list, this percentage was actually lower than the national proportion of 31%.

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2. Alaska
> Drunkest city: Fairbanks
> Pct of MSA adults binge or heavy drinking: 20.0%
> Pct. of state adults binge or heavy drinking: 19.2%
> Pct of driving deaths alcohol related: 34.9%

Alaska is one of the heaviest drinking states in the nation. In Fairbanks, one-fifth of men and women report excessive drinking in the past 30 days. Alaska has one of the strictest Driving Under the Influence (DUI) penalties of any state. The minimum fine for drunk driving in Alaska is $1,500, which doubles for the second offense. Even with these punishments in place, almost 35% of driving deaths in Fairbanks are alcohol related, higher than the national proportion of 31%.

3. Arizona
> Drunkest city: Phoenix-Mesa-Scottsdale
> Pct of MSA adults binge or heavy drinking: 17.1%
> Pct. of state adults binge or heavy drinking: 16.1%
> Pct of driving deaths alcohol related: 27.9%

Across Arizona, 16.1% of adults drink excessively, slightly more than the national rate of 15%. In Phoenix, more than 17% of adults report binge or heavy drinking, a larger share than in any other metro area in the state. While Arizona residents are slightly more likely to drink excessively than Americans, the state has the eighth lowest rate of alcohol-related driving deaths in the country, at 26.6%. In Phoenix, 27.9% of driving fatalities are alcohol related, slightly higher than the state figure, but lower than the nation’s.

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4. Arkansas
> Drunkest city: Hot Springs
> Pct of MSA adults binge or heavy drinking: 17.4%
> Pct. of state adults binge or heavy drinking: 12.6%
> Pct of driving deaths alcohol related: 40.8%

Hot Springs has one of the highest levels nationwide of life lost due to premature death with an estimated 10,279 years of life lost each year per 100,000 residents. This reflects relatively poor health among area residents, which could be related to the high alcohol consumption, particularly while driving. More than two in five car fatalities in the Hot Spring metro area are alcohol related, one of the highest proportions in the country.

5. California
> Drunkest city: Napa
> Pct of MSA adults binge or heavy drinking: 23.7%
> Pct. of state adults binge or heavy drinking: 17.2%
> Pct of driving deaths alcohol related: 35.7%

The Napa region of California is famous for its wineries, and the area attracts tourists from around the country to go on tours and sample the local wines. While those tourists would not be counted in these numbers, it is not surprising that the Napa metropolitan area has one of the highest rates of excessive alcohol consumption in the country. Roughly 23.7% of area adults engaged in binge drinking or heavy drinking.

6. Colorado
> Drunkest city: Denver-Aurora-Lakewood
> Pct of MSA adults binge or heavy drinking: 19.0%
> Pct. of state adults binge or heavy drinking: 17.6%
> Pct of driving deaths alcohol related: 35.1%

A higher share of adults in the Denver metro area drink in excess than in any of the six other metro areas across Colorado. Altogether, nearly one in five Denver adults report excessive drinking habits. In Colorado Springs,just 11% of adults do not drink in moderation. More than 35% of driving fatalities in the Denver area are alcohol related, one of only 21 cities on this list where this percentage exceeded 35%.

7. Connecticut
> Drunkest city: Bridgeport-Stamford-Norwalk
> Pct of MSA adults binge or heavy drinking: 20.6%
> Pct. of state adults binge or heavy drinking: 19.0%
> Pct of driving deaths alcohol related: 35.2%

More than one in five Bridgeport metro area adult residents drink excessively at least once per month, above both the state and national proportions of 19.0% and 15.0% respectively. While area residents have some of the nation’s lowest incidence of self-reported poor health and premature death, driving fatalities in the Bridgeport-Stamford-Norwalk metro are more likely to be alcohol related than across the state and the nation. More than 35% of driving deaths each year are associated with alcohol consumption, compared to 34.2% across the state, and 31.0% nationwide.

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8. Delaware
> Drunkest city: Dover
> Pct of MSA adults binge or heavy drinking: 16.1%
> Pct. of state adults binge or heavy drinking: 19.9%
> Pct of driving deaths alcohol related: 46.5%

Each year, 38.6% of driving fatalities in Delaware are attributed to alcohol consumption, the eighth highest percentage of all states. In Dover, an even higher 46.5% of driving deaths are alcohol related, one of the highest such percentages in the country. Drunk driving is a problem in the metro area despite the fact that state residents as a whole report higher levels of excessive drinking than residents in Dover, which is the only metro in the state.

9. Florida
> Drunkest city: Sebastian-Vero Beach
> Pct of MSA adults binge or heavy drinking: 19.7%
> Pct. of state adults binge or heavy drinking: 15.9%
> Pct of driving deaths alcohol related: 20.2%

Binge and heavy drinking is more prevalent in the Sebastian-Vero Beach metro area than it is in any of the 20 other metro areas across Florida. Roughly one in five Sebastian-Vero Beach residents report excessive drinking. Despite higher than average alcohol consumption, the city reports a smaller share of alcohol-related fatalities on the road than the state as a whole. In Vero Beach, 20.2% of fatal car accidents involve alcohol, compared to 29.2% of fatal car accidents across the state.

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10. Georgia
> Drunkest city: Hinesville
> Pct of MSA adults binge or heavy drinking: 18.3%
> Pct. of state adults binge or heavy drinking: 13.8%
> Pct of driving deaths alcohol related: 32.8%

Georgians drink less excessively than Americans in most states. About 14% of Georgia adults report heavy or binge drinking, one of the smaller shares compared to other states. Also, alcohol is involved in less than 24% of driving deaths, the fourth lowest share nationwide. In Hinesville, however, more than 18% of adult residents drink excessively, about 4 percentage points higher than the state, and 3 percentage points higher than the national rate. Almost 33% of driving deaths in the metro area are alcohol related, roughly 9 percentage points higher than in Georgia as a whole.

11. Hawaii
> Drunkest city: Kahului-Wailuku-Lahaina
> Pct of MSA adults binge or heavy drinking: 20.5%
> Pct. of state adults binge or heavy drinking: 19.5%
> Pct of driving deaths alcohol related: 46.7%

Alcohol is a major contributor to fatal car accidents in Hawaii. Alcohol is involved in 40.5% of driving deaths on the islands, the fifth largest share of any state. In Kahului-Wailuku-Lahaina, where more than one-fifth of adults report an excessive drinking habit, alcohol is even more lethal. Of the driving deaths that occur each year in the Kahului area, 46.7% are alcohol related, roughly 16 percentage points higher than the national rate and one of the highest of any metro area. Despite widespread excessive alcohol consumption, Hawaii and Kahului-Wailuku-Lahaina have relatively good health outcomes. Less than 14% of adults report fair or poor health in both the state and the metro area compared to 16% of adults who do nationwide.

12. Idaho
> Drunkest city: Lewiston
> Pct of MSA adults binge or heavy drinking: 18.6%
> Pct. of state adults binge or heavy drinking: 14.5%
> Pct of driving deaths alcohol related: 25.6%

Of Idaho’s five metro areas, a state-high 18.6% share of Lewiston adults report excessive drinking. Lewiston adults may drink more heavily than Idaho residents as a whole, they are less likely to drive under the influence than residents in other parts of the state. Alcohol is involved in 25.6% of deadly car accidents in Lewiston, 6.2 percentage points less than the 31.8% of alcohol-related car accident fatalities in the rest of the state. However, Lewiston residents have worse health outcomes than residents across both the state and the nation, likely due in part to the incidence of excessive drinking. Lewiston residents lost an aggregate of 8,594 years of potential life per 100,000 people last year due to premature death, compared to the corresponding 6,046 years of life lost in Idaho and 6,622 years of life lost nationwide.

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13. Illinois
> Drunkest city: Chicago-Naperville-Elgin
> Pct of MSA adults binge or heavy drinking: 21.0%
> Pct. of state adults binge or heavy drinking: 20.0%
> Pct of driving deaths alcohol related: 39.2%

Although adults in Chicago-Naperville-Elgin drink the most excessively of any metro area in Illinois, it is by a small margin. This is partly because the state already has one of the highest incidence of excessive drinking. One in every five Illinois adults reports heavy or binge drinking, a higher share than in all but three other states. In Chicago, 21.0% of adults report such drinking habits. Despite frequent excessive alcohol intake, health outcomes in both Chicago and Illinois are similar to national averages. About 15% of adults in the city and the state report being in fair or poor health, 1 percentage point less than the share of adults who report similar health levels nationwide.

14. Indiana
> Drunkest city: Michigan City-La Porte
> Pct of MSA adults binge or heavy drinking: 19.4%
> Pct. of state adults binge or heavy drinking: 15.9%
> Pct of driving deaths alcohol related: 35.0%

Heavy drinking does not always coincide with worse health outcomes. However, in Michigan City-La Porte — where 19.4% of residents report excessive drinking habits — they do. More than 31% of Indiana adults are obese, one of the higher rates in the country. At 33.9%, Michigan City-La Porte’s obesity rate is even higher. An aggregate 8,893 years of life per 100,000 people are lost in the metro area due to premature death, almost 2,300 more years lost per 100,000 people than in the rest of the nation.

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15. Iowa
> Drunkest city: Dubuque
> Pct of MSA adults binge or heavy drinking: 30.8%
> Pct. of state adults binge or heavy drinking: 20.1%
> Pct of driving deaths alcohol related: 19.2%

Almost 31% of Dubuque residents report heavy or binge drinking. Dubuque not only has one of the highest shares of adults consuming alcohol in excess in the state, but this percentage is largest proportions in the country, with 30.8% of adults reporting excessive drinking. The negative health consequences associated with alcohol consumption are well-acknowledged. However, less than 10% of Dubuque adults report fair or poor health compared to the 16% of adults who do nationwide. Alcohol is involved in just 19.2% of fatal car crashes in Dubuque, almost 12 percentage points lower than the share of alcohol-related driving deaths nationwide.

16. Kansas
> Drunkest city: Lawrence
> Pct of MSA adults binge or heavy drinking: 19.2%
> Pct. of state adults binge or heavy drinking: 15.3%
> Pct of driving deaths alcohol related: 27.0%

Adults in Kansas have similar drinking habits to Americans overall, with 15.3% of adults reporting heavy or binge drinking, compared to a national share of 15.0%. However, the city of Lawrence — where 19.2% of adults report excessive drinking — is an exception. Lawrence also has very good health outcomes. Alcohol abuse can contribute to weight problems among drinkers. However, less than one-fourth of area adults are obese, about 6 percentage points less than the state obesity rate.

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17. Kentucky
> Drunkest city: Louisville/Jefferson County
> Pct of MSA adults binge or heavy drinking: 14.4%
> Pct. of state adults binge or heavy drinking: 11.8%
> Pct of driving deaths alcohol related: 30.6%

Although Kentucky is famous for its bourbon whiskey, the state has one of the lowest rates of excessive alcohol use in the country — just 11.8% of adults drink heavily or binge drink compared to 15% of adults nationwide who report such excessive drinking. Home to popular bourbon brand Evan Williams, Louisville has the highest share of adults drinking alcohol to an unhealthy extent of any city in the state. While Louisville residents are more likely to drink excessively than adults across the state, they are less likely to do so compared to the adults across the nation.

18. Louisiana
> Drunkest city: Lafayette
> Pct of MSA adults binge or heavy drinking: 19.3%
> Pct. of state adults binge or heavy drinking: 15.5%
> Pct of driving deaths alcohol related: 38.3%

Unlike the rest of Louisiana, It is legal to consume alcohol from an open container in New Orleans. Surprisingly, it is not New Orleans that has the largest share of binge and heavy drinking in the state, but Lafayette, located in the southern central part of the state. Despite this, Lafayette has relatively better health outcomes compared to Louisiana. Less than 18% of adults report being in fair or poor health, lower than the 19.6% of adults who do statewide. Annually, 8,633 years of life per 100,000 people in Lafayette are lost due to premature death. While the incidence of premature death is lower than the state — where 9,131 years are lost — it is significantly worse than across the nation, where 6,622 years of potential life are lost per year per 100,000.

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19. Maine
> Drunkest city: Portland-South Portland
> Pct of MSA adults binge or heavy drinking: 19.1%
> Pct. of state adults binge or heavy drinking: 17.2%
> Pct of driving deaths alcohol related: 35.2%

Adults in Maine are more likely to drink in excess than adults across the United States. The 15.0% of adults drinking excessively across the country is eclipsed by the 17.2% of adults doing so in Maine. In Portland, the rate is even higher, at 19.1%. Maine is one of only five states where repeated DUI offences do not trigger an automatic felony charge. It also has a relatively high incidence of alcohol-related fatalities on the road. While about 31% of deadly car accidents nationwide involve alcohol, nearly 34% involve alcohol in Maine. In the Portland metro area, 35.2% of fatal car accidents are alcohol related.

20. Maryland
> Drunkest city: Baltimore-Columbia-Towson
> Pct of MSA adults binge or heavy drinking: 17.4%
> Pct. of state adults binge or heavy drinking: 15.4%
> Pct of driving deaths alcohol related: 33.4%

The Baltimore metropolitan area has the largest share of adults drinking excessively in Maryland. While it is the worst in the state, Baltimore’s alcohol abuse is much less severe than in many cities outside of the state with 17.4% of adults reporting binge or heavy drinking. That figure ranks 138th among all U.S. metro areas. Alcohol use is tied to a variety of poor health outcomes, and the metro area’s excessive drinking may have contributed to the metro area’s poor health outcomes. Each year, Baltimore loses an average of 8,184 years of life per 100,000 area residents due to premature death, compared to 6,622 years of life lost per 100,000 people on a national scale.

21. Massachusetts
> Drunkest city: Pittsfield
> Pct of MSA adults binge or heavy drinking: 21.3%
> Pct. of state adults binge or heavy drinking: 19.5%
> Pct of driving deaths alcohol related: 25.4%

Massachusetts is one of 11 states where happy hour deals are outlawed. Nevertheless, nearly one-fifth of Massachusetts adults drink excessively, a higher share than in all but five other states. High rates of heavy and binge drinking are widespread across Massachusetts, and one metropolitan area leads the state — Pittsfield. Among Pittsfield adults, 21.3% report heavy drinking or binge drinking, slightly higher than the state proportion of 19.5% and well above the national share of 15.0%.

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22. Michigan
> Drunkest city: Monroe
> Pct of MSA adults binge or heavy drinking: 22.0%
> Pct. of state adults binge or heavy drinking: 18.3%
> Pct of driving deaths alcohol related: 35.8%

Across the United States, 15.0% of adults drink excessively. In Monroe, the Michigan metropolitan area with the highest share of adults drinking to excess, 22.0% do so. Widespread heavy and binge drinking in a city can increase the health risks among its population. Almost 36% of driving deaths in Monroe are alcohol related, about 5 percentage points higher than both the state and national figures.

23. Minnesota
> Drunkest city: Duluth
> Pct of MSA adults binge or heavy drinking: 20.7%
> Pct. of state adults binge or heavy drinking: 19.3%
> Pct of driving deaths alcohol related: 42.1%

Almost 21% of Duluth residents report an excessive drinking habit, slightly higher than Minnesota’s share of 19.3%, and well above the national proportion of 15.0%. Excessive alcohol use is tied to a variety of poor health outcomes. However, while Minnesota has one of the higher heavy and binge drinking rates of any state, it has the among the best health outcomes nationwide. Just 10.5% of Minnesota adults report fair or poor health, the lowest share of any state. Duluth adults are similarly healthy, with just 10.3% of adults reporting fair or poor health.

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24. Mississippi
> Drunkest city: Gulfport-Biloxi-Pascagoula
> Pct of MSA adults binge or heavy drinking: 13.9%
> Pct. of state adults binge or heavy drinking: 11.5%
> Pct of driving deaths alcohol related: 27.6%

In Gulfport-Biloxi-Pascagoula, 13.9% of adults report an excessive drinking habit. While this is the highest of any metro area in the state, it is a relatively small share compared to the rest of the country, where 15.0% of adults report heavy or binge drinking. Just 11.5% of Mississippi residents report drinking to excess, the fourth smallest share of any state. Despite its relatively sensible alcohol consumption, Mississippi has one of the least healthy populations in the country. Across the state, 21.5% of adults report being in fair or poor health, the highest share nationwide.

25. Missouri
> Drunkest city: St. Louis
> Pct of MSA adults binge or heavy drinking: 22.0%
> Pct. of state adults binge or heavy drinking: 17.0%
> Pct of driving deaths alcohol related: 38.3%

Missouri has some of the lowest alcohol taxes nationwide. Perhaps as a result, 17.0% of Missouri adults report heavy or binge drinking, compared to the national share of 15.0%. In St. Louis, meanwhile, 22.0% of adults report excessive drinking. St. Louis is less healthy than the state and the nation as a whole, which may be due at least in part to its population’s drinking habits. An aggregate 8,036 years of potential life per 100,000 people are lost each year due to premature death, compared to 7,714 years in the state and 6,622 years of life lost nationwide.

26. Montana
> Drunkest city: Missoula
> Pct of MSA adults binge or heavy drinking: 22.1%
> Pct. of state adults binge or heavy drinking: 18.8%
> Pct of driving deaths alcohol related: 52.2%

In Missoula, 22.1% of men and women report heavy or binge drinking, a higher share than any other metro in the state. Missoula leads Montana, and nearly the country, in another measure as well. More than 52% of driving deaths in the metro area are alcohol related, 21.2 percentage points above the national proportion and the third highest of any city. Despite having an above average share of residents that drink to excess, Missoula’s population self-reports as healthier than the country as a whole. Nationally, 16.0% of adults report being in only fair or poor health, while just 11.4% of Missoulians say the same.

27. Nebraska
> Drunkest city: Omaha-Council Bluffs
> Pct of MSA adults binge or heavy drinking: 21.1%
> Pct. of state adults binge or heavy drinking: 19.5%
> Pct of driving deaths alcohol related: 42.3%

Nebraska has one of the highest rates of excessive alcohol use in the country. While 15.0% of U.S. adults report binge or heavy drinking, 19.5% of Nebraskan adults report such a habit. In Omaha, 21.1% of adults report excessive drinking, the 33th highest share of any U.S. metropolitan area. Drinking has resulted in some fatalities on Omaha’s roads. Alcohol is a factor in 42.3% of all driving deaths in the metropolitan area each year, compared to 31.0% of alcohol-related car accident fatalities nationwide.

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28. Nevada
> Drunkest city: Reno
> Pct of MSA adults binge or heavy drinking: 20.4%
> Pct. of state adults binge or heavy drinking: 18.2%
> Pct of driving deaths alcohol related: 31.5%

In Nevada, 18.2% of Nevada’s population reports binge or heavy drinking, the 17th highest share of all states. Some might expect that rank to be higher given Las Vegas’s reputation — Sin City is the setting of a great deal of excessive drinking. Much of the binge drinking, however, is done by tourists and not state residents. Las Vegas is not even the heaviest drinking city in the state. That title goes to Reno, where more than one in five adults engage in binge or heavy drinking, compared to a national share of 15.0%.

29. New Hampshire
> Drunkest city: Manchester-Nashua
> Pct of MSA adults binge or heavy drinking: 17.6%
> Pct. of state adults binge or heavy drinking: 17.6%
> Pct of driving deaths alcohol related: 33.6%

In Manchester-Nashua 17.6% of adults report excessive drinking, higher than the national proportion of 15.0%. However, the metro is the only urban area in New Hampshire, so by default it has the highest share of adults drinking to excess. The Manchester metro area is located on the state’s border. Not only are area residents more likely to drink excessively compared to most Americans, but also New Hampshire’s 0% sales tax typically attracts high numbers of shoppers from other states, including alcoholic beverage shoppers.

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30. New Jersey
> Drunkest city: Atlantic City-Hammonton
> Pct of MSA adults binge or heavy drinking: 18.1%
> Pct. of state adults binge or heavy drinking: 16.1%
> Pct of driving deaths alcohol related: 24.3%

America’s Playground, Atlantic City, has the highest share of adults drinking to excess in New Jersey. While 15.0% of U.S. adults report binge or heavy drinking, 18.1% of Atlantic City adults said the same. While that share is high, it is actually lower than many of the cities in other states with a large share of residents drinking to excess. Alcohol abuse has been shown to be linked to health problems, and indeed, Atlantic City actually has significantly more life lost due to premature death than the state, at 7,918 years per 100,000 residents versus 5,558 per 100,000 residents, respectively.

31. New Mexico
> Drunkest city: Las Cruces
> Pct of MSA adults binge or heavy drinking: 16.4%
> Pct. of state adults binge or heavy drinking: 13.7%
> Pct of driving deaths alcohol related: 37.2%

Despite New Mexico having one of the smallest shares of adults who drink excessively compared to other states, the southwestern state has one of the higher rates of alcohol related automobile fatalities in the country. The situation is magnified in Las Cruces, the city reporting the highest level of excessive drinking in New Mexico’s and the state’s second largest city. Some 16.4% of city adults drink excessively and 37.2% of driving deaths are alcohol related, each higher than the respective national figures.

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32. New York
> Drunkest city: Kingston
> Pct of MSA adults binge or heavy drinking: 25.1%
> Pct. of state adults binge or heavy drinking: 17.0%
> Pct of driving deaths alcohol related: 24.7%

More than one in four adults living in the Kingston area report heavy or binge drinking, the highest share compared to the 11 other metro areas in New York, and one of the highest compared to all U.S. metro areas. By contrast, 17% of adults across the state report drinking excessively, slightly higher than the national proportion of 15%. The Kingston metro is located on the western shore of the Hudson River, just under two hours from New York City.

33. North Carolina
> Drunkest city: Jacksonville
> Pct of MSA adults binge or heavy drinking: 17.5%
> Pct. of state adults binge or heavy drinking: 13.2%
> Pct of driving deaths alcohol related: 40.8%

Jacksonville — North Carolina’s drunkest city — has America’s youngest population largely due to the city’s military facilities. Many of the 17.5% of adults who report heavy or binge drinking may therefore be near the city’s median age of 23. The city’s share of residents with heavy or binge drinking habits exceeds the state’s share of 13.2%. However, the city has fairly similar health outcomes to the state’s as a whole. An estimated 7,122 years of potential life are lost per 100,000 people annually due to premature death in Jacksonville, roughly in line with the estimate for the state.

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34. North Dakota
> Drunkest city: Fargo
> Pct of MSA adults binge or heavy drinking: 21.2%
> Pct. of state adults binge or heavy drinking: 21.8%
> Pct of driving deaths alcohol related: 29.7%

While Fargo has the highest rate of excessive drinking among North Dakota’s urban areas, excessive drinking is even more prevalent outside metro areas — the state’s binge drinking rate of 21.8% is higher than that of Fargo. The state’s excessive drinking rate is also the second highest in the nation compared with other states after only Wisconsin. The oil boom that has attracted more men to the area — men are far more likely than women to binge drink — may be another factor.

35. Ohio
> Drunkest city: Toledo
> Pct of MSA adults binge or heavy drinking: 19.6%
> Pct. of state adults binge or heavy drinking: 17.5%
> Pct of driving deaths alcohol related: 33.1%

Nearly one in five Toledo residents has an excessive drinking habit, the highest proportion in all of Ohio’s 11 metro areas. Widespread excessive alcohol consumption poses a risk to the population’s health. Toledo is slightly less healthy than Ohio and the nation. About 17% of Toledo adults report fair or poor health, a higher share than the 16.0% who do nationwide and the 15.3% who do across Ohio.

36. Oklahoma
> Drunkest city: Lawton
> Pct of MSA adults binge or heavy drinking: 17.9%
> Pct. of state adults binge or heavy drinking: 13.2%
> Pct of driving deaths alcohol related: 40.5%

Nearly 18% of Lawton adults report an excessive drinking habit, higher than both the state and national shares of 13.2% and 15.0%, respectively. High alcohol consumption is associated with poor health outcomes. In Lawton, more than 20% of adults report fair or poor health, higher than both the percentages of state and country residents reporting such low levels of health. Excessive drinking habits may also contribute to the area’s high incidence of alcohol-related car accident fatalities. More than 40% of driving fatalities are alcohol related.

37. Oregon
> Drunkest city: Portland-Vancouver-Hillsboro
> Pct of MSA adults binge or heavy drinking: 17.1%
> Pct. of state adults binge or heavy drinking: 16.0%
> Pct of driving deaths alcohol related: 33.4%

As in a number of other metro areas reporting a state’s highest level of excessive drinking, Portland-Vancouver-Hillsboro residents are relatively healthy. The metro reports fewer years of potential life lost due to premature death than both the state and nation, and residents are also less likely to assess their own health poorly than Oregon residents and Americans. On the other hand, like most metro areas on this list, the share driving fatalities that are tied to alcohol in the Portland area of 33.4% exceeds the national share.

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38. Pennsylvania
> Drunkest city: East Stroudsburg
> Pct of MSA adults binge or heavy drinking: 24.2%
> Pct. of state adults binge or heavy drinking: 17.3%
> Pct of driving deaths alcohol related: 38.7%

In the United States, 15% of adults report heavy or binge drinking. In East Stroudsburg, the city where Pennsylvanians are the most likely to binge or heavy drink, the share of adults reporting excessive drinking is 24.2%. Alcohol-related driving deaths are also more common in the area than across the nation. Alcohol is involved in almost 39% of East Stroudsburg driving deaths, a higher rate than in most metro areas. Pennsylvania has some of the most lenient DUI laws in the country, with a minimum fine of just $300 per offense and no minimum jail sentence.

39. Rhode Island
> Drunkest city: Providence-Warwick
> Pct of MSA adults binge or heavy drinking: 20.4%
> Pct. of state adults binge or heavy drinking: 19.4%
> Pct of driving deaths alcohol related: 30.2%

Providence-Warwick is the only metropolitan area in Rhode Island. Despite claiming the highest excessive drinking rate in Rhode Island by default, Providence-Warwick could be a contender for any state’s heaviest drinking city. Over a 30-day period, 20.4% of area men and women report excessive drinking — 5.4 percentage points more than in the rest of the country. Alcohol-related driving fatalities are far less common in the Providence area than across Rhode Island, where 41.4% of fatal car accidents are tied to alcohol consumption, the fourth highest proportion compared to all states.

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40. South Carolina
> Drunkest city: Charleston-North Charleston
> Pct of MSA adults binge or heavy drinking: 19.8%
> Pct. of state adults binge or heavy drinking: 14.3%
> Pct of driving deaths alcohol related: 46.9%

Of the eight metro areas in South Carolina, none has a larger share of adults reporting excessive drinking than Charleston. Excessive drinking is less common across the state than it is across the country as a whole, where 15% of adults report excessive drinking. In Charleston, however, roughly one in five adults report excessive drinking in a 30 day period. Heavy drinking in the historic city may be taking a toll. Nearly 47% of all fatal car accidents in the Charleston metro area involve alcohol. Nationwide, 31% of fatalities on the road are attributable to alcohol consumption.

41. South Dakota
> Drunkest city: Sioux Falls
> Pct of MSA adults binge or heavy drinking: 21.1%
> Pct. of state adults binge or heavy drinking: 19.4%
> Pct of driving deaths alcohol related: 32.7%

The average South Dakota resident consumes around 38 gallons of beer each year, more than in all but three other states, according to a recent study from beer industry data company Beer Insights. The percentage of adults in the state reporting binge or heavy drinking of 19.4% is also one of the highest proportions compared to other states. In Sioux Falls, the metro area with the highest level of excessive drinking, 21.1% of adults report a heavy or binge drinking habit.

42. Tennessee
> Drunkest city: Clarksville
> Pct of MSA adults binge or heavy drinking: 16.8%
> Pct. of state adults binge or heavy drinking: 9.3%
> Pct of driving deaths alcohol related: 27.6%

Most Tennessee city residents drink less than Americans in the rest of the country, and the state as a whole ties Utah as the driest nationwide. Clarksville, however, is an exception. Almost 17% of Clarksville residents report heavy or binge drinking over a 30-day period, slightly higher than the national figure and considerably higher than across Tennessee. Despite the excessive drinking, Clarksville’s health outcomes are on par with statewide levels. In both the city and the state, about 19% of residents report fair or poor health — higher than the national proportion of 16%.

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43. Texas
> Drunkest city: Corpus Christi
> Pct of MSA adults binge or heavy drinking: 27.5%
> Pct. of state adults binge or heavy drinking: 16.0%
> Pct of driving deaths alcohol related: 33.1%

With about 16% of Texas adults reporting heavy or binge drinking, excessive alcohol consumption is not especially common across the Lone Star State. There is one glaring exception, however. More than one quarter of all adults in Corpus Christi report drinking to excess on a regular basis, a higher share than in all but three other cities in the United States. Victoria, where 24.7% of adults report excessive drinking habits, is the next heaviest drinking Texas city.

44. Utah
> Drunkest city: Salt Lake City
> Pct of MSA adults binge or heavy drinking: 12.6%
> Pct. of state adults binge or heavy drinking: 9.3%
> Pct of driving deaths alcohol related: 19.1%

In Salt Lake City, 12.6% of adults report heavy or binge drinking, the highest share of any metro area in the state, but the lowest share compared to the other cities on this list. This may not be surprising considering that only 9.3% of Utah’s adults drink excessively, tied with Tennessee as the lowest proportion of any state, and well below the national percentage of 15.0%. Utah also consumes the least amount of beer per capita. About three-fifths of Utah’s residents belong to The Church of Jesus Christ of Latter-day Saints, a religion that forbids drinking.

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45. Vermont
> Drunkest city: Burlington-South Burlington
> Pct of MSA adults binge or heavy drinking: 20.2%
> Pct. of state adults binge or heavy drinking: 19.4%
> Pct of driving deaths alcohol related: 33.3%

The Burlington area is the only metro in Vermont. As a result, the 20.2% of adults reporting excessive drinking is both the highest and the lowest proportion in Vermont. Still, area residents are more likely to drink excessively than their peers statewide. The metro is home to the University of Vermont and several other colleges, where students tend to consume more alcohol than elsewhere. According to data from beer industry data company Beer Insights, an average Vermont resident consumes around 36 gallons of beer annually, the fifth highest amount compared to other states. Each year, one-third of driving fatalities in the Burlington area are alcohol related. While this is well below the statewide incidence of 37%, it is still higher than the nationwide incidence of 31%.

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.

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