If you’ve ever looked at a map of alcohol consumption in America, you’ve probably noticed a giant, dark-red blob swallowing the Upper Midwest. It's not a glitch. Every year, when the University of Wisconsin Population Health Institute drops its County Health Rankings, the results look remarkably similar.
Basically, if you live in Wisconsin, North Dakota, or Montana, you’re likely living in or near what researchers officially call "excessive drinking" territory.
But what does that actually mean? For the CDC and public health experts, excessive drinking isn’t just about having a few too many at a wedding. It’s a combination of binge drinking (four or more drinks for women, five for men in one sitting) and heavy drinking (eight or more a week for women, 15 for men).
Honestly, the numbers are pretty staggering. In the top-ranking counties, nearly 30% of adults admit to this kind of consumption.
The 2026 Rankings: Gallatin County and the Wisconsin "Wall"
For the last couple of years, Gallatin County, Montana, has been making a lot of noise. It currently sits at the top of several "drunkest" lists, with an excessive drinking rate of about 26.8%.
Gallatin is home to Bozeman and Montana State University. You’ve got a mix of a massive student population, a high-octane "ski town" culture, and a local lifestyle where fishing and beer are basically inseparable.
But while Montana has the individual "winner," Wisconsin owns the leaderboard. If you look at the top 20 drunkest counties in the US, about 15 of them usually reside in the Badger State.
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The Top Heavy-Hitters
- Gallatin County, MT: The current frontrunner. It’s a "work hard, play harder" environment where White Claws and craft brews are part of the outdoor gear.
- St. Croix County, WI: Sitting right on the border of Minnesota, this county consistently reports rates above 27%.
- Chippewa County, WI: Another Wisconsin staple with a 27.9% rate. Here, the culture of local taverns isn't just a hobby; it’s the social fabric.
- Outagamie and Winnebago, WI: These Fox Valley counties are famous for having more bars per capita than almost anywhere else on the planet.
Why is the Midwest so... Thirsty?
You might wonder why a place like Ozaukee County, Wisconsin, drinks so much more than, say, a county in Utah or Alabama. It’s not just "nothing else to do," though the six-month winters definitely play a role.
It’s actually deep-seated history. The Upper Midwest was settled heavily by German, Irish, and Polish immigrants. In these cultures, the "beer garden" or the "local pub" wasn't a place of sin—it was where the family ate dinner.
Take the Wisconsin Friday Night Fish Fry. It’s a religious experience for locals. You go to a tavern, eat fried perch, and drink brandy old fashioneds. Because this is socialized from a young age, the "stigma" of being in a bar is almost non-existent.
Also, price matters. In many of these counties, a pint of beer still costs less than a latte in Seattle. When it’s cheap and socially encouraged, people drink more. Period.
The College Town Factor
You've probably noticed that counties with big universities always rank high.
- Dane County, WI (University of Wisconsin-Madison)
- Albany County, WY (University of Wyoming)
- Missoula County, MT (University of Montana)
Students binge drink. It's a fact of life. When you have 40,000 people in their early 20s in one small geographic area, the "excessive drinking" stats for that county are going to skyrocket.
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The Real-World Consequences (The Not-So-Fun Part)
It’s easy to joke about "Wisconsin livers," but the data shows a darker side. Excessive drinking is the leading cause of preventable death in many of these regions.
In St. Croix County, for example, nearly 48% of driving deaths involve alcohol. That is a massive number. While people in the Midwest often pride themselves on "holding their liquor," the physics of a car crash doesn't care about your tolerance.
There’s also the economic toll. The CDC estimates that excessive drinking costs the US about $249 billion a year. Most of that comes from lost workplace productivity and healthcare costs. If you’re hungover on Monday, you’re not working at 100%. Multiply that by millions of people.
Is the "Drunkest" Label Fair?
Some locals argue that these rankings are skewed. Why? Because people in the Midwest are honest.
If a surveyor calls a guy in Appleton, Wisconsin, and asks how many beers he had last week, he’ll say "20" without blinking. If you ask someone in the "Bible Belt," they might say "two" even if it was ten, because of the social stigma surrounding alcohol there.
There's also the "tourist trap" effect. Counties like Teton, WY, or Walworth, WI, have high consumption rates because thousands of tourists visit every weekend to party, but the "rate" is calculated based only on the small permanent population.
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What’s Changing in 2026?
We are starting to see a shift, even in the "Red Blob" states. The "sober curious" movement is finally hitting the Midwest.
You’ll now find non-alcoholic craft beers on tap in Milwaukee and Bozeman. Gen Z is generally drinking less than Boomers or Gen X did at their age. However, the culture of the "corner bar" is so baked into the infrastructure of these counties that it’s going to take decades to see a massive drop in the rankings.
Actionable Insights for the "Drunkest" Residents
If you happen to live in one of these high-ranking counties, it’s worth checking your own stats against the national average. Most people in Wisconsin or Montana think their drinking is "normal" because everyone around them does it.
- Track your "units": Use an app for a week. You might be surprised to find you’re hitting the "heavy drinker" threshold without ever feeling "drunk."
- Mind the "one-for-one" rule: For every beer, drink a glass of water. It sounds like advice from your mom, but it’s the only way to save your liver (and your Tuesday morning).
- Check your local DUI stats: Knowing that nearly half of road deaths in your area involve booze might make you reconsider that "one last one" for the road.
- Explore the NA scene: The quality of non-alcoholic drinks has exploded. You can still have the social experience of the tavern without the 3:00 AM dehydration.
The map of the drunkest counties in the US tells a story of heritage, climate, and social norms. While it’s part of the local identity for many, the health data suggests it’s a chapter of the story that might need a little editing.
If you're curious about where your specific county stands, you can look up the latest County Health Rankings & Roadmaps interactive map, which breaks down these percentages by zip code.