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.