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.