States With The Heaviest Drinkers Revealed

By Paul Fuhr 03/12/18

The Midwest has some of the highest rates of excess drinking in the country, according to a new report.

Close up image of both female and male hands holding large plastic drinking mugs with United States of America flag in background

Financial news site 24/7 Wall St. released its annual special report on America’s “drunkest states” last Thursday, ranking all 50 states based on a far-reaching array of data, factors and methodologies.

According to the Centers for Disease Control and Prevention (CDC), nearly 90,000 people die every year from excessive drinking. (And according to the new report, “those who die as the result of alcohol abuse do so 30 years prematurely, on average.”)

The report draws an eye-opening map of alcohol abuse across the United States, with the highest rates of excess drinking located in the Midwest and the lowest rates located in the South. 24/7 Wall St. analyzed heavy drinking data from the CDC, census bureaus, as well as the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in order to complete its comprehensive report.  

To fully understand the report’s implications, it’s important to understand what “excessive drinking” actually means. The CDC qualifies an alcoholic “drink” as something that contains 0.6 fluid ounces of pure alcohol. Excessive drinking, the CDC contends, includes binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21.

For women, it means drinking four or more drinks in a single occasion, while for men, excessive drinking requires five or more drinks in one sitting. (Women who consume at least eight alcoholic beverages per week, and men who consume at least 15, are categorized as “heavy drinkers” by the CDC.) 

The 24/7 Wall St. report shows that while 18% of Americans drink to excess, that number varies wildly between states. Among the states ranked lowest are Tennessee, West Virginia, Utah, Alabama and Mississippi. The dubious honor of being counted among the nation’s “drunkest states,” however, goes to Illinois, Montana, Alaska, Wisconsin and North Dakota.

The latter is #1 with a bullet, too: 24.7% of North Dakota’s adults drink excessively. The Peace Garden State also had the nation’s highest number of alcohol-related driving fatalities (a whopping 46.7%). In the lowest-ranked state, Tennessee, only 11.2% of its adults drink excessively—well below the 18% national average. 

George Koob, the director of the NIAAA, told 24/7 Wall St. that “there is a clear correlation between a state’s excessive drinking rate and income.”

The states with the highest excessive drinking rates had similarly high annual median household incomes. Of the top 25 “drunkest states,” 14 have incomes that exceed the national $57,617 average. Of the 10 “least-drunk states,” nine have household incomes well below that same median.

However, Koob claimed that this correlation isn’t as simple as it seems. The same goes for health statistics.

According to the report, “states with the highest excessive drinking rates tend to report better health outcomes than those with lower rates” (#1 North Dakota has a low number of premature deaths, for example, while #50 Tennessee has an above-average one.) “If you look at individuals, the [drinking-to-household income] pattern is somewhat different,” Koob cautioned.

While the report suggests that a large percentage of affluent individuals frequently drink to excess, they don’t appear to drink as heavily. It’s the low-income individuals who make up that difference: while they appear to drink to excess less frequently, when they drink, it’s consistently heavy. (Koob reasons this is because alcohol is expensive.)

Still, other factors certainly come into play when it comes to problematic drinking, Koob says, acknowledging the “availability of alcohol, taxes, cost of living, and even the weather.”

Please read our comment policy. - The Fix

Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at You can also find Paul on Linkedin and Twitter.