One in six U.S. adults indulges in binge drinking on a single occasion, according to the Centers for Disease Control and Prevention. The CDC defines binge drinking as consuming five or more drinks on a single occasion for men or four or more drinks on a single occasion for women. 

Like overall alcohol usage, the prevalence of binge drinking varies considerably from state to state. To identify the states with the highest excessive drinking rates, 24/7 Tempo reviewed 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.  

The share of driving deaths that involve alcohol and the metro area with the highest percentage of adults drinking excessively were aggregated from county-level data in the same source and are for the most recent years available. Median household income comes from the U.S. Census Bureau’s 2021 American Community Survey. 

Excessive drinking has the potential for serious health consequences. It can lead to chronic conditions such as liver disease, cancer, heart disease, and hypertension. Binge drinking also raises the danger of motor-vehicle accidents. (Deaths from alcohol-related cirrhosis have gone up almost every year since 2000.)

Adults drink excessively at a national average rate of 19.8%, and those in exactly half of the 50 states drink at that rate or above. The drunkest states in America are those in the Plains, Midwest, and Far West. Three of the four states with the highest incidence of alcohol-related driving deaths are Montana, North Dakota, and Alaska. These are also some of America’s largest states by size and areas that experience the coldest weather in the U.S., which may encourage alcohol consumption. Other cold-weather states among the top 10 binge-drinkers on this list are Massachusetts and Vermont. (On a more granular level, these are the drunkest cities in America.)

Click here for a list of the drunkest states in America

Seven of the 10 states with the lowest binge-drinking rates are in the South. Mississippi, the fifth-lowest excessive-drinking state at 15.9%, has the lowest rate of alcohol-related driving deaths at 18.5%. All of the Southern states at the low end of excessive drinking rates also have the lowest median incomes in the nation. Utah has by far the lowest incidence of binge drinking at 11.9%. The state has a large Mormon population that does not drink alcohol.