Top 7 Drunkest Cities in America (2026 Rankings)

The top 7 drunkest cities in America for 2026 are dominated by Wisconsin, with Green Bay leading at a 26.5% excessive drinking rate and 50.5% alcohol-related driving deaths. You’ll find Appleton, Eau Claire, and Madison close behind, each exceeding 25% excessive drinking rates. Fargo, ND stands as the lone non-Wisconsin entry with 49.73 bars per 100,000 residents. Missoula, MT rounds out the list. The factors driving these rankings reveal surprising regional patterns.

What Makes a City One of America’s Drunkest?

When researchers rank America’s drunkest cities, they rely on several measurable factors rather than stereotypes or assumptions. You’ll find excessive drinking rates, defined as binge drinking (4-5 drinks per sitting) or heavy consumption (15+ weekly drinks for men, 8+ for women), serve as the primary metric. Alcohol-related driving deaths and bars per capita also factor into rankings.

Regional culture norms play a significant role. The Upper Midwest dominates these lists, with 17 of the top 20 drunkest cities located there. German and Irish ancestry creates beer-centric social traditions where meeting friends typically involves drinks. Interestingly, excessive drinking rates are higher in the Midwest and lower in the South. Wisconsin’s dominance is particularly striking, with 7 of the top 10 drunkest cities located in the state. The state claims all top 4 spots with Appleton, Oshkosh-Neenah, Green Bay, and Madison leading the rankings.

Demographic characteristics matter too. College towns like Madison and Fargo rank consistently high. You’ll notice cold weather encourages indoor drinking, while larger cities with diverse activities tend to rank lower.

The 7 Drunkest Cities in America for 2026

Where does excessive drinking concentrate most heavily across America? Wisconsin dominates the 2026 rankings, claiming six of the seven spots. You’ll find the factors driving risky behavior include high bar concentrations, cultural acceptance, and cold climate patterns. Roughly 18% of U.S. adults regularly consume more than the recommended amounts of alcohol nationwide.

Green Bay tops the list with over one-quarter of adults drinking excessively. The excessive alcohol sales impact shows clearly in driving fatalities, half involve alcohol. Madison ranks fourth at 25.9%, while Fargo breaks Wisconsin’s stranglehold as the sole non-Wisconsin entry. Missoula, Montana rounds out the top seven at 24.3%. Eau Claire has the second highest concentration of bars in the nation, contributing to its elevated drinking rates. Long-term excessive alcohol consumption can lead to serious health complications including heart and liver damage, high blood pressure, and increased cancer risk.

Why Wisconsin Claims 5 of the Top 7 Spots

Five Wisconsin cities dominating the nation’s drunkest list isn’t coincidental, it’s backed by staggering consumption data. Wisconsin residents consumed 37.3 gallons of alcoholic beverages per person in 2022, averaging 760 standard drinks yearly. The state ranks highest nationally for excessive alcohol use across all categories.

The economic toll of binge drinking reaches $4 billion annually, $700 per resident. Over two-thirds stems from lost productivity, with additional costs hitting healthcare and criminal justice systems. Binge drinking represents the majority of excessive alcohol consumption costs in the state. Long-term alcohol use can increase risk factors for over 200 diseases.

However, drinking culture trends show promising shifts. Overall drinking prevalence dropped from 70% in 2005 to 61% in 2023. Young adults are driving change most dramatically, UW-Madison first-year students abstaining jumped from 37% in 2015 to 61% in 2024. Nationally, the share of Americans who drink fell to 54% in 2025, marking the lowest point in nearly 90 years. Bars are adapting by expanding food options and nonalcoholic beverages, signaling cultural evolution despite Wisconsin’s persistent top rankings.

Fargo: The Only Non-Wisconsin City in the Top 5

While Wisconsin dominates the top rankings, Fargo, North Dakota claims the number one spot overall, the only non-Wisconsin city to crack the top five.

Nearly a quarter of Fargo’s adult residents report binge drinking, driven considerably by NDSU drinking culture. The data reveals why this college town leads the nation:

1. 54.4% of North Dakota college students report binge drinking at least once in the past two weeks
2. 40.43% of young adults ages 18-25 engage in monthly binge drinking, compared to the national average of 29.73%
3. 49.73 bars per 100,000 people, the highest concentration nationally

Excessive college drinking compounds with environmental factors. First-year NDSU students living on campus face heightened peer pressure, while freezing temperatures push drinking indoors. You’ll find one alcohol license for every 445 residents here. This pattern of high consumption is part of a broader trend, as 3 of the 4 metro areas with the highest alcohol-related driving deaths are located in Montana, North Dakota, and Alaska.

How Cheap Alcohol and Cold Winters Fuel Heavy Drinking

Alcohol costs considerably less in the Upper Midwest than in coastal states, creating a direct link between affordability and consumption rates. When you examine alcohol affordability trends across these regions, you’ll find that lower prices remove financial barriers to frequent purchasing. For example, a case of beer in Illinois costs just sixteen dollars and forty-three cents, while the same purchase in Alaska runs over thirty-three dollars.

Cold winters also play a significant role in consumption patterns. You’re more likely to spend extended periods indoors during harsh weather, and social drinking becomes a primary activity when outdoor options disappear for months.

Alcohol marketing strategies target these regional behaviors effectively. Brands recognize that winter-bound populations respond to messaging around warmth, comfort, and social connection. State tax policies further influence affordability, with Missouri boasting the lowest tax in the country at just two dollars per gallon for distilled spirits. In contrast, California maintains one of the lowest spirit taxes in the nation, ranking 40th, which keeps whiskey prices remarkably low despite the state’s high cost of living.

The combination proves powerful: cheap products meet long winters, and you see heightened drinking rates emerge as a predictable outcome in these communities.

The Sobering Safety Data Behind These Rankings

You might expect cities with high excessive drinking rates to also show alarming safety statistics, and the data confirms this connection. Alcohol-related driving fatalities in Wisconsin metros like Janesville-Beloit reach 40% of all traffic deaths, well above the 31% national average, while premature death rates in these areas climb to 346 per 100,000 residents. When you factor in bars per capita and annual excessive drinking fatalities, the correlation between alcohol availability and preventable deaths becomes impossible to ignore. Missoula, Montana stands out with 48.6% of driving deaths involving alcohol, the highest percentage among all ranked cities despite not being in the top ten for excessive drinking rates. Montana’s statewide data reinforces these concerns, with 66% of all vehicle accidents in 2020 resulting from impaired driving, giving the state one of the highest fatality rates in the nation for deaths caused by drunk driving.

Alcohol-Related Traffic Deaths

The statistics paint a grim picture of alcohol’s toll on American roadways. In 2022, you’ll find 13,524 alcohol-impaired driving deaths occurred, representing 32% of all traffic fatalities. While 2023 showed improvement with a 7.6% decrease to 12,429 deaths, the daily average remains stark: 34 people die in drunk driving crashes.

Understanding the factors driving alcohol consumption helps explain these numbers:

1. California leads state fatalities with 4,428 alcohol-impaired deaths in 2022
2. Texas follows closely at 4,408 fatalities, averaging 155 drunk driving deaths monthly
3. Florida ranks third with 3,530 fatalities

Cities are implementing measures to combat drunk driving, yet approximately 30% of U.S. traffic deaths still involve drivers with BAC levels at or above 0.08 g/dL.

Bars Per Capita Impact

Across America’s heartland, a striking pattern emerges: states with the fewest residents often have the highest concentration of drinking establishments. North Dakota leads nationally with 24.92 bars per 100,000 adults 21+, despite having just 1.52 million residents. Montana follows at 48.84 per 100,000, while Wisconsin trails at 46.92.

You’ll notice an inverse relationship between high population density and per capita bar rates. California maintains 3,370 total bars but only 4.28 per 100,000 adults. New York shows similar patterns with 3,389 bars yet just 8.68 per capita.

Bar workforce availability in less populated regions creates drinking access that directly influences consumption patterns. Milwaukee exemplifies this connection, averaging 36.7 bars per 100,000 residents, correlating with its reputation as one of America’s heaviest-drinking cities.

Annual Excessive Drinking Fatalities

Behind every ranking in this list lies a sobering reality: excessive alcohol consumption kills over 178,000 Americans annually. You should recognize the warning signs that contribute to these statistics, as alcohol-involved deaths climbed from 99,017 in 2020 to 108,791 in 2021.

The contributing factors vary by location, but the data reveals clear patterns:

1. Alaska leads per capita deaths at 46.5 per million residents
2. New Mexico follows at 32.7 deaths per million
3. Texas records the highest total fatalities at 1,439 annually

Small and medium metro areas exceed the national average of 10.4 deaths per 100,000, while large metros sit at 9.2. D.C.’s five-year rate increased 82.9% from 2015-2019, with 82.1% of deaths affecting adults 35 and older.

America’s Driest Cities Show the Opposite Pattern

While the drunkest cities cluster in northern and midwestern states, you’ll find a different pattern in America’s driest regions. Southern states consistently report lower alcohol consumption rates, with desert cities like Las Vegas and Phoenix showing drinking patterns influenced by extreme heat and tourism rather than local habits. Climate data reveals that residents in arid southwestern cities consume less alcohol per capita than their counterparts in cold, wet northern states.

Southern States Drink Less

Five southern states claim the lowest per capita alcohol spending in America, creating a stark contrast with the heavy-drinking regions we’ve examined. Utah leads at just $607 per adult annually, followed by West Virginia at $617 and Mississippi at $641. Cultural influences, including religious values and dry county regulations, shape these patterns substantially.

However, socioeconomic factors create a troubling paradox. Despite lower spending, several southern states report heightened alcohol-related death rates:

1. Louisiana averages 6.38 deaths per 10,000 adults from excessive alcohol
2. Arkansas averages 6.08 deaths per 10,000 adults
3. Mississippi averages 6.06 deaths per 10,000 adults

You’ll find Louisiana also reports the nation’s highest rate of under-21 alcohol-related deaths, suggesting spending metrics alone don’t capture consumption’s full impact.

Climate Influences Consumption Rates

Everything about America’s driest cities flips the script on what we’ve seen in heavy-drinking regions. Provo-Orem, UT leads with just 8.5% of adults drinking excessively, less than a third of Wisconsin’s 26.2% rate. You’ll find St. George, UT and Beckley, WV tied at 10.8%, followed by Jackson, TN at 10.9%.

Climate plays a role, but cultural norms and religion drive these numbers more profoundly. Utah’s strong religious influence keeps consumption low across multiple metros, with Ogden-Clearfield at 12.9%. Income levels and limited alcohol access also matter, dry regions average only 127 outlets per 100,000 residents versus the national average of 184.

West Virginia claims the lowest state rate at 11.8%, while Utah County reports just 9.04% excessive drinkers, the driest county nationwide.

Frequently Asked Questions

How Does the National Excessive Drinking Rate of 18% Compare to Other Countries?

You won’t find direct international alcohol consumption trends comparing the US 18% excessive drinking rate in the provided data. However, you should know that global drinking culture comparisons require standardized metrics that vary by country. The US defines excessive drinking through specific binge and heavy drinking thresholds. While the data confirms 17% of Americans binge drink and 6% drink heavily, comparable international benchmarks aren’t available in these sources for accurate cross-country analysis.

Are There Any Alcohol Treatment Programs Specifically Targeting Wisconsin’s Drinking Culture?

Yes, you’ll find programs addressing Wisconsin’s drinking culture. The United Community Center offers culturally targeted treatment for Spanish-speaking communities, while facilities like Burkwood Treatment Center and Aurora Dewey Center provide specialized residential care. Targeted community education programs operate through NAMI Wisconsin and 211 Wisconsin referral services. However, the state lacks widespread alcohol-free social alternatives as formal programming, most resources focus on treatment rather than prevention-oriented cultural change initiatives.

Has Excessive Drinking in These Cities Increased or Decreased Over the Past Decade?

You’ll find mixed trends across these cities. Green Bay’s rate increased from 25.6% to 26.5%, while Appleton’s decreased slightly from 26.8% to 26.2%. Madison saw a minor uptick from 25.5% to 25.9%, and Fargo remained stable at 25.2%. These changing drinking behaviors suggest underlying socioeconomic factors vary by location. Despite individual fluctuations, Wisconsin’s dominance persists with 10 cities in the top 20, indicating regional patterns haven’t shifted dramatically.

What Role Do College Towns Play in These Excessive Drinking Statistics?

College towns profoundly drive excessive drinking statistics. You’ll find cities like Madison, Morgantown, and Chico consistently ranking highest due to strong Greek life, athletic tailgating, and college town culture that normalizes heavy consumption. Nearly half of full-time college students report past-month drinking, with 29.3% binge drinking. Weak underage drinking enforcement compounds the problem, bars in towns like Urbana-Champaign admit 19-year-olds, while local businesses target students with cheap drink specials.

Do These Drunkest Cities Have Higher Rates of Alcohol-Related Health Conditions?

Yes, you’ll find higher rates of alcohol-related health conditions in these cities. The data shows excessive drinking directly causes alcohol related liver disease rates to spike, along with high blood pressure, stroke, and various cancers. When you examine risky binge drinking patterns in places like Green Bay and Eau Claire, you’re seeing populations facing amplified risks of fatty liver, fibrosis, and heart complications. Six Americans die daily from alcohol poisoning alone.