This Is the Drunkest City in the US: Ranking America’s Top 50 Cities

Wisconsin takes pride as the cheese capital of America, as well as in the success of its pro  sports teams the Milwaukee Bucks, Milwaukee Brewers, and the Green Bay Packers. When it comes to drinking liquor, however, the state might be a bit sheepish about its standing as the alcohol-quaffing capital of the nation. No state has more drunker cities than Wisconsin.

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 2023 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.

Excessive drinking is defined as adults who reported heavy or binge drinking within the previous 30 days. Binge drinking is consuming four or more drinks for women and five or more drinks for men on a single occasion.

Midwestern and Plains cities occupy most of the 50 spots on our excessive-drinking list. Thirteen are Wisconsin cities, and nine of the 10 places that imbibe the most are in the Badger State (the outlier is Dubuque, Iowa.) The CDC tracked the prevalence of adults who reported binge drinking by state in 2021 and found that Wisconsin led the U.S. with 23.5% of adults reporting excessive-drinking behavior.  (Also see the states with the highest rates of binge drinking.)

In a report by Wisconsin Public Radio, Julia Sherman, the coordinator for the Wisconsin Alcohol Policy Project in Wisconsin, discounted the state’s German heritage as a factor behind the excessive drinking and outlined other reasons. She said alcohol is sold in more places in Wisconsin than other states. The price of liquor has some of the lowest prices in the nation. Liquor is heavily advertised, particularly on public transit. And there is a cultural expectation in Wisconsin to drink.

Other Midwestern states with cities on our list for excessive drinking rates are Iowa (seven) and  Minnesota (four).

Excessive drinking also has been associated with automobile accidents and fatalities, and Wisconsin cities have five of the 10 highest percentages of fatal car accidents involving alcohol. Billings, Montana, had the highest percentage of fatal car accidents involving liquor on our list with 44.2%.

Here are America’s drunkest cities.

1. Dubuque, Iowa

• Pct. of adults who drink excessively: 27.40% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 19.40% — #342 out of 387 metros (US rate: 26.5%)
• Metro area population: 98,677

2. Wausau-Weston, Wisconsin

• Pct. of adults who drink excessively: 27.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 23.20% — #289 out of 387 metros (US rate: 26.5%)
• Metro area population: 166,334

3. Madison, Wisconsin

• Pct. of adults who drink excessively: 26.90% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 31.90% — #105 out of 387 metros (US rate: 26.5%)
• Metro area population: 687,077

4. Eau Claire, Wisconsin

• Pct. of adults who drink excessively: 26.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.80% — #30 out of 387 metros (US rate: 26.5%)
• Metro area population: 173,644

5. Green Bay, Wisconsin

• Pct. of adults who drink excessively: 26.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.60% — #33 out of 387 metros (US rate: 26.5%)
• Metro area population: 330,292

6. La Crosse-Onalaska, Wisconsin-Minnesota

• Pct. of adults who drink excessively: 26.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 30.40% — #128 out of 387 metros (US rate: 26.5%)
• Metro area population: 139,094

7. Oshkosh-Neenah, Wisconsin

• Pct. of adults who drink excessively: 26.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 31.50% — #114 out of 387 metros (US rate: 26.5%)
• Metro area population: 170,718

8. Fond du Lac, Wisconsin

• Pct. of adults who drink excessively: 26.40% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 35.20% — #50 out of 387 metros (US rate: 26.5%)
• Metro area population: 103,836

9. Appleton, Wisconsin

• Pct. of adults who drink excessively: 26.00% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.50% — #34 out of 387 metros (US rate: 26.5%)
• Metro area population: 244,845

10. Sheboygan, Wisconsin

• Pct. of adults who drink excessively: 25.70% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 35.60% — #47 out of 387 metros (US rate: 26.5%)
• Metro area population: 117,841

11. Racine, Wisconsin

• Pct. of adults who drink excessively: 25.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 32.60% — #95 out of 387 metros (US rate: 26.5%)
• Metro area population: 195,846

12. Milwaukee-Waukesha, Wisconsin

• Pct. of adults who drink excessively: 25.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 28.00% — #184 out of 387 metros (US rate: 26.5%)
• Metro area population: 1,559,792

13. Janesville-Beloit, Wisconsin

• Pct. of adults who drink excessively: 25.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 43.00% — #6 out of 387 metros (US rate: 26.5%)
• Metro area population: 164,060

14. Missoula, Montana

• Pct. of adults who drink excessively: 24.90% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 34.30% — #61 out of 387 metros (US rate: 26.5%)
• Metro area population: 121,041

15. Waterloo-Cedar Falls, Iowa

• Pct. of adults who drink excessively: 24.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 22.10% — #309 out of 387 metros (US rate: 26.5%)
• Metro area population: 167,889

16. Barnstable Town, Massachusetts

• Pct. of adults who drink excessively: 24.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 38.80% — #22 out of 387 metros (US rate: 26.5%)
• Metro area population: 232,457

17. Duluth, Minnesota-Wisconsin

• Pct. of adults who drink excessively: 24.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 38.20% — #28 out of 387 metros (US rate: 26.5%)
• Metro area population: 291,931

18. Lincoln, Nebraska

• Pct. of adults who drink excessively: 24.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 33.90% — #68 out of 387 metros (US rate: 26.5%)
• Metro area population: 341,229

19. Des Moines-West Des Moines, Iowa

• Pct. of adults who drink excessively: 24.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 28.60% — #171 out of 387 metros (US rate: 26.5%)
• Metro area population: 729,053

20. Bay City, Michigan

• Pct. of adults who drink excessively: 23.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 28.30% — #178 out of 387 metros (US rate: 26.5%)
• Metro area population: 102,821

21. Ocean City, New Jersey

• Pct. of adults who drink excessively: 23.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 31.70% — #112 out of 387 metros (US rate: 26.5%)
• Metro area population: 95,634

22. Billings, Montana

• Pct. of adults who drink excessively: 23.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 44.20% — #5 out of 387 metros (US rate: 26.5%)
• Metro area population: 190,208

23. Santa Rosa-Petaluma, California

• Pct. of adults who drink excessively: 23.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 32.80% — #88 out of 387 metros (US rate: 26.5%)
• Metro area population: 482,650

24. Bismarck, North Dakota

• Pct. of adults who drink excessively: 23.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 40.40% — #16 out of 387 metros (US rate: 26.5%)
• Metro area population: 134,427

25. Pittsburgh, Pennsylvania

• Pct. of adults who drink excessively: 23.00% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 28.40% — #175 out of 387 metros (US rate: 26.5%)
• Metro area population: 2,349,172

26. Cedar Rapids, Iowa

• Pct. of adults who drink excessively: 23.00% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 21.90% — #310 out of 387 metros (US rate: 26.5%)
• Metro area population: 275,592

27. Bellingham, Washington

• Pct. of adults who drink excessively: 22.90% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 24.70% — #261 out of 387 metros (US rate: 26.5%)
• Metro area population: 230,677

28. San Luis Obispo-Paso Robles, California

• Pct. of adults who drink excessively: 22.90% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.30% — #38 out of 387 metros (US rate: 26.5%)
• Metro area population: 282,013

29. Ames, Iowa

• Pct. of adults who drink excessively: 22.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 27.80% — #192 out of 387 metros (US rate: 26.5%)
• Metro area population: 126,282

30. Omaha-Council Bluffs, Nebraska-Iowa

• Pct. of adults who drink excessively: 22.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 33.30% — #77 out of 387 metros (US rate: 26.5%)
• Metro area population: 976,875

31. Fargo, North Dakota – Minnesota

• Pct. of adults who drink excessively: 22.80% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.70% — #31 out of 387 metros (US rate: 26.5%)
• Metro area population: 258,663

32. Houma-Thibodaux, Louisiana

• Pct. of adults who drink excessively: 22.70% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.00% — #41 out of 387 metros (US rate: 26.5%)
• Metro area population: 200,656

33. Reno, Nevada

• Pct. of adults who drink excessively: 22.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 37.10% — #39 out of 387 metros (US rate: 26.5%)
• Metro area population: 501,206

34. Iowa City, Iowa

• Pct. of adults who drink excessively: 22.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 27.30% — #203 out of 387 metros (US rate: 26.5%)
• Metro area population: 178,991

35. Bend, Oregon

• Pct. of adults who drink excessively: 22.60% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 27.00% — #210 out of 387 metros (US rate: 26.5%)
• Metro area population: 206,549

36. Gettysburg, Pennsylvania

• Pct. of adults who drink excessively: 22.50% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 18.80% — #349 out of 387 metros (US rate: 26.5%)
• Metro area population: 106,027

37. Santa Cruz-Watsonville, California

• Pct. of adults who drink excessively: 22.40% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 30.90% — #118 out of 387 metros (US rate: 26.5%)
• Metro area population: 264,370

38. Pittsfield, Massachusetts

• Pct. of adults who drink excessively: 22.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 20.60% — #324 out of 387 metros (US rate: 26.5%)
• Metro area population: 127,859

39. Glens Falls, New York

• Pct. of adults who drink excessively: 22.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 19.60% — #334 out of 387 metros (US rate: 26.5%)
• Metro area population: 126,440

40. Albany-Schenectady-Troy, New York

• Pct. of adults who drink excessively: 22.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 20.50% — #325 out of 387 metros (US rate: 26.5%)
• Metro area population: 904,617

41. Lafayette, Louisiana

• Pct. of adults who drink excessively: 22.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 29.70% — #150 out of 387 metros (US rate: 26.5%)
• Metro area population: 481,125

42. Lake Havasu City-Kingman, Arizona

• Pct. of adults who drink excessively: 22.30% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 22.50% — #304 out of 387 metros (US rate: 26.5%)
• Metro area population: 220,816

43. St. Cloud, Minnesota

• Pct. of adults who drink excessively: 22.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 27.40% — #200 out of 387 metros (US rate: 26.5%)
• Metro area population: 201,868

44. Bloomsburg-Berwick, Pennsylvania

• Pct. of adults who drink excessively: 22.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 16.00% — #367 out of 387 metros (US rate: 26.5%)
• Metro area population: 83,017

45. Fort Collins, Colorado

• Pct. of adults who drink excessively: 22.20% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 33.30% — #77 out of 387 metros (US rate: 26.5%)
• Metro area population: 366,778

46. Altoona, Pennsylvania

• Pct. of adults who drink excessively: 22.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 18.30% — #353 out of 387 metros (US rate: 26.5%)
• Metro area population: 121,032

47. Baton Rouge, Louisiana

• Pct. of adults who drink excessively: 22.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 35.10% — #52 out of 387 metros (US rate: 26.5%)
• Metro area population: 873,060

48. Lansing-East Lansing, Michigan

• Pct. of adults who drink excessively: 22.10% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 29.90% — #146 out of 387 metros (US rate: 26.5%)
• Metro area population: 540,870

49. Lake Charles, Louisiana

• Pct. of adults who drink excessively: 22.00% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 33.80% — #69 out of 387 metros (US rate: 26.5%)
• Metro area population: 206,636

50. New Orleans-Metairie, Louisiana

• Pct. of adults who drink excessively: 22.00% (US rate: 18.9%)
• Pct. of fatal car accidents involving alcohol: 30.00% — #145 out of 387 metros (US rate: 26.5%)
• Metro area population: 1,246,176