America has an alcohol problem. Excessive drinking is the third leading cause of preventable death in the United States. The Centers for Disease Control and Prevention says that alcohol contributed to more than 140,000 fatalities each year between 2015 and 2019 – and in some cities and regions of the nation, the problem is much worse than in others. (To take just one peril of excessive drinking, deaths from alcohol-related cirrhosis have gone up almost every year since 2000.)

To identify the U.S. metro areas with the highest excessive drinking rates, 24/7 Tempo reviewed data on the percentage of adults 18 and older who reported binge or heavy drinking within a 30-day period across all metro areas in the country from the 2023 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.

One in six US adults binge-drinks – defined as consuming five or more drinks on one occasion for men or four or more drinks on one occasion for women – with 25% doing so at least weekly. On our list, the percentage of adults who drink excessively in each city tops 22%, well above the US average of 19.79%.

Click here to see the drunkest cities in America

Binge drinking is most common among adults who have household incomes of $75,000 or more, are non-Hispanic white, or who live in the Midwest. Speaking of the Midwest, cities in that region occupy seven of the top 10 places on our list. Wisconsin has the most cities in the top 50 with 12, followed by Iowa with six. Florida, a magnet for booze bingers at spring break, checks in with five cities. (These are the states with the highest rates of binge drinking.)

Binge-drinking is very much a fact of college life, and some of the cities with significant university presences are on the list, among them Boston-Cambridge-Newton, Massachusetts; Ames, Iowa; Burlington-South Burlington, Vermont; and Syracuse, New York.