Special Report

The 50 Drunkest Cities in America

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Though alcohol is enjoyed responsibly by millions of Americans every day, it is also misused by many — and over consumption can have serious consequences. Excessive drinking is the third leading preventable cause of death in the United States.

About a fifth of American adults regularly consumed unhealthy amounts of alcohol in 2018, the latest year for which data is available.

To identify the U.S. metro areas with the highest excessive drinking rates, 24/7 Tempo reviewed the percentage of adults 18 and older who report binge or heavy drinking within a 30-day period across all 382 metro areas in the country. Data came from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.

Excessive drinking includes both binge and heavy drinking. Heavy drinking is defined as consuming at least 15 drinks a week or averaging two or more drinks a day for men, according to the CDC. For women, it’s eight drinks or more per week or more than one drink on average a day. Binge drinking is defined as a pattern of alcohol consumption that brings a person’s blood alcohol concentration level to 0.08% or higher — estimated to take about five or more drinks within two hours for men and four or more drinks for women.

Excessive alcohol consumption rates appear associated with some economic factors. Alcohol can be expensive, and people’s ability to drink to excess can be limited by their income. Cities with higher excessive drinking rates tend to have higher incomes, and vice-versa.

Social factors also play a role. In Wisconsin, alcohol consumption is, for many, an integral part of the state’s culture. Twelve of the 20 heaviest drinking cities on this list are in Wisconsin.

On the other end of the spectrum, large segments of the population in Utah are teetotalers. Four of the five cities with the lowest rates of excessive drinking are in Utah. About 68% of the state’s population identify as Mormon, a religion that teaches its followers to avoid alcohol consumption.

Regular and excessive consumption of alcohol can result in chronic conditions and other long-term health problems, such as high blood pressure, heart disease, stroke, liver disease, and certain cancers. About half of alcohol-related deaths nationwide are due to liver disease or overdoses involving alcohol or alcohol combined with other drugs. These are the 25 most dangerous drugs currently on the market.

Click here for the 50 drunkest cities in the U.S.

While the health risks associated with excessive alcohol consumption are well established, having a large share of excessive drinkers often does not translate to poor health outcomes across a population. Alcohol consumption is just one of many factors that can affect a person’s health. In fact, because cities with higher excessive drinking rates also tend to have higher incomes, residents tend to have easier access to quality health care and can afford healthier diets and lifestyles.

In fact, just one of the 20 cities with the highest excessive drinking rates is home to a larger share of adults in fair or poor health than the 16.5% national average.

Fatal car accidents that involve alcohol appear to be more common in the cities with the highest excessive drinking rates. Nationwide, 27.0% of all driving deaths involve alcohol. In all but 14 of the 50 cities with the highest excessive drinking rates, the share is lower than the nationwide rate.

Source: photoquest7 / Getty Images

50. Reno, Nevada
> Pct. of adults who drink excessively: 22.3% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 38.9% — No. 23 out of 382 (US rate: 27.0%)
> Median household income: $72,132 — No. 57 out of 382 (US median: $65,712)
> Metro area population: 475,290

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49. Buffalo-Cheektowaga, New York
> Pct. of adults who drink excessively: 22.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 17.5% — No. 353 out of 382 (US rate: 27.0%)
> Median household income: $60,105 — No. 186 out of 382 (US median: $65,712)
> Metro area population: 1,127,983

Source: DenisTangneyJr / E+ via Getty Images

48. Scranton–Wilkes-Barre, Pennsylvania
> Pct. of adults who drink excessively: 22.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 27.2% — No. 214 out of 382 (US rate: 27.0%)
> Median household income: $54,304 — No. 267 out of 382 (US median: $65,712)
> Metro area population: 553,885

Source: Asher196 / Wikimedia Commons

47. Bay City, Michigan
> Pct. of adults who drink excessively: 22.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 34.0% — No. 74 out of 382 (US rate: 27.0%)
> Median household income: $49,610 — No. 328 out of 382 (US median: $65,712)
> Metro area population: 103,126

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46. Norwich-New London, Connecticut
> Pct. of adults who drink excessively: 22.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 35.2% — No. 54 out of 382 (US rate: 27.0%)
> Median household income: $75,633 — No. 47 out of 382 (US median: $65,712)
> Metro area population: 265,206

Source: DenisTangneyJr / Getty Images

45. Fargo, North Dakota
> Pct. of adults who drink excessively: 22.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 36.5% — No. 40 out of 382 (US rate: 27.0%)
> Median household income: $62,820 — No. 129 out of 382 (US median: $65,712)
> Metro area population: 246,145

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Source: Kruck20 / Getty Images

44. Deltona-Daytona Beach-Ormond Beach, Florida
> Pct. of adults who drink excessively: 22.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 22.2% — No. 309 out of 382 (US rate: 27.0%)
> Median household income: $54,533 — No. 264 out of 382 (US median: $65,712)
> Metro area population: 668,365

Source: Spondylolithesis / Getty Images

43. Napa, California
> Pct. of adults who drink excessively: 22.6% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 39.7% — No. 20 out of 382 (US rate: 27.0%)
> Median household income: $92,769 — No. 7 out of 382 (US median: $65,712)
> Metro area population: 137,744

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42. Billings, Montana
> Pct. of adults who drink excessively: 22.7% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 37.0% — No. 35 out of 382 (US rate: 27.0%)
> Median household income: $60,962 — No. 165 out of 382 (US median: $65,712)
> Metro area population: 181,667

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41. Albany-Schenectady-Troy, New York
> Pct. of adults who drink excessively: 22.7% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 24.1% — No. 281 out of 382 (US rate: 27.0%)
> Median household income: $73,398 — No. 53 out of 382 (US median: $65,712)
> Metro area population: 880,381

Source: csfotoimages / Getty Images

40. Monroe, Michigan
> Pct. of adults who drink excessively: 22.8% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 40.6% — No. 14 out of 382 (US rate: 27.0%)
> Median household income: $62,839 — No. 128 out of 382 (US median: $65,712)
> Metro area population: 150,500

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Source: DenisTangneyJr / Getty Images

39. Springfield, Massachusetts
> Pct. of adults who drink excessively: 22.8% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.1% — No. 123 out of 382 (US rate: 27.0%)
> Median household income: $62,346 — No. 139 out of 382 (US median: $65,712)
> Metro area population: 697,382

Source: StevenGaertner / Getty Images

38. Minneapolis-St. Paul-Bloomington, Minnesota
> Pct. of adults who drink excessively: 22.9% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.4% — No. 117 out of 382 (US rate: 27.0%)
> Median household income: $83,698 — No. 18 out of 382 (US median: $65,712)
> Metro area population: 3,640,043

Source: peeterv / Getty Images

37. Rapid City, South Dakota
> Pct. of adults who drink excessively: 23.0% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 34.3% — No. 70 out of 382 (US rate: 27.0%)
> Median household income: $58,361 — No. 205 out of 382 (US median: $65,712)
> Metro area population: 142,191

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36. Kahului-Wailuku-Lahaina, Hawaii
> Pct. of adults who drink excessively: 23.0% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 49.0% — No. 3 out of 382 (US rate: 27.0%)
> Median household income: $80,754 — No. 24 out of 382 (US median: $65,712)
> Metro area population: 167,488

Source: DenisTangneyJr / Getty Images

35. Sioux Falls, South Dakota
> Pct. of adults who drink excessively: 23.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 27.4% — No. 212 out of 382 (US rate: 27.0%)
> Median household income: $65,566 — No. 105 out of 382 (US median: $65,712)
> Metro area population: 268,833

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34. The Villages, Florida
> Pct. of adults who drink excessively: 23.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 13.1% — No. 373 out of 382 (US rate: 27.0%)
> Median household income: $60,287 — No. 183 out of 382 (US median: $65,712)
> Metro area population: 132,420

Source: marekuliasz / Getty Images

33. Fort Collins, Colorado
> Pct. of adults who drink excessively: 23.2% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 32.6% — No. 92 out of 382 (US rate: 27.0%)
> Median household income: $75,186 — No. 50 out of 382 (US median: $65,712)
> Metro area population: 356,899

Source: Wicki58 / iStock via Getty Images

32. Cape Coral-Fort Myers, Florida
> Pct. of adults who drink excessively: 23.2% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 24.4% — No. 278 out of 382 (US rate: 27.0%)
> Median household income: $62,240 — No. 140 out of 382 (US median: $65,712)
> Metro area population: 770,577

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31. Iowa City, Iowa
> Pct. of adults who drink excessively: 23.3% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 25.9% — No. 248 out of 382 (US rate: 27.0%)
> Median household income: $63,761 — No. 118 out of 382 (US median: $65,712)
> Metro area population: 173,105

Source: Sean Pavone / Getty Images

30. Boston-Cambridge-Newton, Massachusetts
> Pct. of adults who drink excessively: 23.3% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 29.7% — No. 160 out of 382 (US rate: 27.0%)
> Median household income: $94,430 — No. 5 out of 382 (US median: $65,712)
> Metro area population: 4,873,019

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29. Cedar Rapids, Iowa
> Pct. of adults who drink excessively: 23.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 18.3% — No. 345 out of 382 (US rate: 27.0%)
> Median household income: $64,088 — No. 115 out of 382 (US median: $65,712)
> Metro area population: 273,032

Source: akpakp / Getty Images

28. Missoula, Montana
> Pct. of adults who drink excessively: 23.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 36.2% — No. 44 out of 382 (US rate: 27.0%)
> Median household income: $57,347 — No. 221 out of 382 (US median: $65,712)
> Metro area population: 119,600

Source: Anh Luu / Shutterstock.com

27. St. Cloud, Minnesota
> Pct. of adults who drink excessively: 23.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 28.6% — No. 184 out of 382 (US rate: 27.0%)
> Median household income: $66,076 — No. 100 out of 382 (US median: $65,712)
> Metro area population: 201,964

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26. Santa Rosa-Petaluma, California
> Pct. of adults who drink excessively: 23.6% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 32.7% — No. 91 out of 382 (US rate: 27.0%)
> Median household income: $87,828 — No. 12 out of 382 (US median: $65,712)
> Metro area population: 494,336

Source: EQRoy / Shutterstock.com

25. Ames, Iowa
> Pct. of adults who drink excessively: 23.7% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 20.0% — No. 329 out of 382 (US rate: 27.0%)
> Median household income: $62,181 — No. 142 out of 382 (US median: $65,712)
> Metro area population: 123,351

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24. Omaha-Council Bluffs, Nebraska
> Pct. of adults who drink excessively: 23.9% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 32.9% — No. 89 out of 382 (US rate: 27.0%)
> Median household income: $70,373 — No. 71 out of 382 (US median: $65,712)
> Metro area population: 949,726

Source: Sean Pavone / Getty Images

23. Hilton Head Island-Bluffton, South Carolina
> Pct. of adults who drink excessively: 24.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 26.7% — No. 225 out of 382 (US rate: 27.0%)
> Median household income: $71,252 — No. 62 out of 382 (US median: $65,712)
> Metro area population: 222,195

Source: Sean Pavone / Getty Images

22. Portland-South Portland, Maine
> Pct. of adults who drink excessively: 24.2% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 30.4% — No. 145 out of 382 (US rate: 27.0%)
> Median household income: $71,913 — No. 59 out of 382 (US median: $65,712)
> Metro area population: 538,500

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Source: Sean Pavone / Getty Images

21. North Port-Sarasota-Bradenton, Florida
> Pct. of adults who drink excessively: 24.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 26.4% — No. 237 out of 382 (US rate: 27.0%)
> Median household income: $65,526 — No. 106 out of 382 (US median: $65,712)
> Metro area population: 836,995

Source: russokm1105 / Getty Images

20. San Luis Obispo-Paso Robles, California
> Pct. of adults who drink excessively: 24.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 40.5% — No. 17 out of 382 (US rate: 27.0%)
> Median household income: $77,265 — No. 37 out of 382 (US median: $65,712)
> Metro area population: 283,111

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19. Des Moines-West Des Moines, Iowa
> Pct. of adults who drink excessively: 24.7% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 35.0% — No. 61 out of 382 (US rate: 27.0%)
> Median household income: $71,164 — No. 63 out of 382 (US median: $65,712)
> Metro area population: 699,292

Source: Jeramey Jannene (Grassferry49) / Wikimedia Commons

18. Janesville-Beloit, Wisconsin
> Pct. of adults who drink excessively: 25.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 42.1% — No. 8 out of 382 (US rate: 27.0%)
> Median household income: $61,243 — No. 158 out of 382 (US median: $65,712)
> Metro area population: 163,354

Source: DenisTangneyJr / iStock via Getty Images

17. Racine, Wisconsin
> Pct. of adults who drink excessively: 25.2% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 36.4% — No. 43 out of 382 (US rate: 27.0%)
> Median household income: $60,779 — No. 169 out of 382 (US median: $65,712)
> Metro area population: 196,311

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16. Duluth, Minnesota
> Pct. of adults who drink excessively: 25.2% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 34.5% — No. 67 out of 382 (US rate: 27.0%)
> Median household income: $60,316 — No. 182 out of 382 (US median: $65,712)
> Metro area population: 289,383

Source: ChrisBoswell / Getty Images

15. Lincoln, Nebraska
> Pct. of adults who drink excessively: 25.3% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 29.4% — No. 168 out of 382 (US rate: 27.0%)
> Median household income: $61,539 — No. 150 out of 382 (US median: $65,712)
> Metro area population: 336,541

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Source: Sean Pavone / Getty Images

14. Milwaukee-Waukesha, Wisconsin
> Pct. of adults who drink excessively: 25.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 30.5% — No. 140 out of 382 (US rate: 27.0%)
> Median household income: $65,845 — No. 102 out of 382 (US median: $65,712)
> Metro area population: 1,575,179

Source: Thieded / Wikimedia Commons

13. Eau Claire, Wisconsin
> Pct. of adults who drink excessively: 25.9% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 37.7% — No. 28 out of 382 (US rate: 27.0%)
> Median household income: $63,460 — No. 122 out of 382 (US median: $65,712)
> Metro area population: 169,304

Source: benkrut / iStock via Getty Images

12. Wausau-Weston, Wisconsin
> Pct. of adults who drink excessively: 26.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 17.2% — No. 357 out of 382 (US rate: 27.0%)
> Median household income: $65,094 — No. 109 out of 382 (US median: $65,712)
> Metro area population: 163,285

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Source: DenisTangneyJr / iStock via Getty Images

11. Pittsfield, Massachusetts
> Pct. of adults who drink excessively: 26.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 27.7% — No. 208 out of 382 (US rate: 27.0%)
> Median household income: $58,895 — No. 197 out of 382 (US median: $65,712)
> Metro area population: 124,944

Source: Jacob Boomsma / Getty Images

10. Waterloo-Cedar Falls, Iowa
> Pct. of adults who drink excessively: 26.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 18.2% — No. 347 out of 382 (US rate: 27.0%)
> Median household income: $63,131 — No. 124 out of 382 (US median: $65,712)
> Metro area population: 168,522

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Source: Jason_Ray_Photography / iStock Editorial via Getty Images

9. La Crosse-Onalaska, Wisconsin
> Pct. of adults who drink excessively: 26.4% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 26.0% — No. 245 out of 382 (US rate: 27.0%)
> Median household income: $59,608 — No. 191 out of 382 (US median: $65,712)
> Metro area population: 136,616

Source: Kevin Rutherford / Flickr

8. Barnstable Town, Massachusetts
> Pct. of adults who drink excessively: 26.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 37.3% — No. 34 out of 382 (US rate: 27.0%)
> Median household income: $85,042 — No. 16 out of 382 (US median: $65,712)
> Metro area population: 212,990

Source: DenisTangneyJr / Getty Images

7. Fond du Lac, Wisconsin
> Pct. of adults who drink excessively: 26.5% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.6% — No. 112 out of 382 (US rate: 27.0%)
> Median household income: $65,329 — No. 107 out of 382 (US median: $65,712)
> Metro area population: 103,403

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Source: Sean Pavone / Getty Images

6. Madison, Wisconsin
> Pct. of adults who drink excessively: 27.6% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.7% — No. 109 out of 382 (US rate: 27.0%)
> Median household income: $75,545 — No. 48 out of 382 (US median: $65,712)
> Metro area population: 664,865

Source: DenisTangneyJr / iStock via Getty Images

5. Oshkosh-Neenah, Wisconsin
> Pct. of adults who drink excessively: 27.6% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.4% — No. 119 out of 382 (US rate: 27.0%)
> Median household income: $58,347 — No. 206 out of 382 (US median: $65,712)
> Metro area population: 171,907

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Source: DenisTangneyJr / iStock via Getty Images

4. Green Bay, Wisconsin
> Pct. of adults who drink excessively: 27.8% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 42.9% — No. 7 out of 382 (US rate: 27.0%)
> Median household income: $65,026 — No. 111 out of 382 (US median: $65,712)
> Metro area population: 322,906

Source: DenisTangneyJr / iStock via Getty Images

3. Sheboygan, Wisconsin
> Pct. of adults who drink excessively: 27.9% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.5% — No. 115 out of 382 (US rate: 27.0%)
> Median household income: $60,706 — No. 172 out of 382 (US median: $65,712)
> Metro area population: 115,340

Source: cosmonaut / Getty Images

2. Dubuque, Iowa
> Pct. of adults who drink excessively: 28.1% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 15.6% — No. 366 out of 382 (US rate: 27.0%)
> Median household income: $62,178 — No. 143 out of 382 (US median: $65,712)
> Metro area population: 97,311

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Source: DenisTangneyJr / iStock via Getty Images

1. Appleton, Wisconsin
> Pct. of adults who drink excessively: 30.8% (US rate: 19.2%)
> Pct. of fatal car accidents involving alcohol: 31.1% — No. 123 out of 382 (US rate: 27.0%)
> Median household income: $68,335 — No. 83 out of 382 (US median: $65,712)
> Metro area population: 237,974

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