The Top 20 Drunkest Cities in America: Why the Midwest Dominates

You might think Las Vegas or New Orleans would take the crown for the highest alcohol consumption. It makes sense, right? Those cities are built on the "party all night" brand. But when you look at the actual data—specifically the excessive drinking rates tracked by the Centers for Disease Control and Prevention (CDC) and analyzed by groups like 24/7 Wall St.—the results are honestly a bit shocking.

The "drunkest" parts of America aren't the neon-lit tourist traps. They are mostly quiet, cold, and incredibly Midwestern.

We’re talking about places where the local culture doesn't just tolerate a few rounds at the bar; it practically demands it. In these cities, "excessive drinking"—defined as either binge drinking (four or more drinks for women, five for men in one sitting) or heavy drinking (eight or more per week for women, fifteen for men)—is a way of life.

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Ranking the Top 20 Drunkest Cities in America

The most recent data from the County Health Rankings & Roadmaps program shows a staggering trend: Wisconsin owns this list. It’s not even a fair fight. Out of the top 20 metro areas with the highest excessive drinking rates, a massive chunk is located in the Badger State.

Here is how the top 20 shakes out based on the percentage of adults reporting excessive drinking:

1. Appleton, Wisconsin (26.2%)
2. Oshkosh-Neenah, Wisconsin (26.0%)
3. Green Bay, Wisconsin (25.6%)
4. Madison, Wisconsin (25.5%)
5. Fargo, North Dakota (25.2%)
6. La Crosse-Onalaska, Wisconsin (25.1%)
7. Fond du Lac, Wisconsin (24.6%)
8. Ames, Iowa (24.4%)
9. Eau Claire, Wisconsin (24.2%)
10. Mankato-North Mankato, Minnesota (24.1%)
11. Wausau, Wisconsin (24.1%)
12. Sheboygan, Wisconsin (24.0%)
13. Missoula, Montana (23.8%)
14. Grand Forks, North Dakota (23.7%)
15. Racine, Wisconsin (23.5%)
16. Janesville-Beloit, Wisconsin (23.4%)
17. Milwaukee-Waukesha-West Allis, Wisconsin (23.3%)
18. Lincoln, Nebraska (23.3%)
19. Iowa City, Iowa (23.1%)
20. Corvallis, Oregon (23.0%)

Basically, if you live in Appleton, more than one in four adults you pass on the street admits to drinking heavily or bingeing regularly. That is wild.

Why Wisconsin Is Always at the Top

It’s the question everyone asks. Why Wisconsin? Is it just the cold? Probably not, since plenty of other states are freezing and don't drink nearly as much.

Historians like Jim Draeger, who co-authored Bottoms Up, point to a "perfect storm" of heritage and geography. The state was settled by German, Polish, and Irish immigrants who brought deep-seated brewing traditions. But more than that, Wisconsin has a unique "tavern culture."

In many of these cities, the local bar is the "third place"—it’s where you go for baby showers, funeral luncheons, and Sunday afternoon Packers games. Honestly, in some small Wisconsin towns, there are more bars than grocery stores.

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There's also the Tavern League of Wisconsin. This is a powerful lobbying group that has, for decades, fought against stricter DUI laws and resisted high alcohol taxes. Because of this, booze is incredibly cheap and easy to find. You can even find beer on tap at some gas stations. No joke.

The College Town Factor

Look at the list again. See Ames, Iowa? Or Iowa City? Missoula? Corvallis?

These are major college towns.

Ames is home to Iowa State, and Iowa City is University of Iowa territory. When you have a massive population of 18-to-24-year-olds, your "excessive drinking" stats are going to skyrocket. It’s basically built into the local economy. In Ames, the concentration of bars per capita is among the highest in the country because the student body provides a never-ending supply of customers.

The Real Cost of the "Drunkest" Label

While these rankings often get shared as a "badge of honor" or a funny meme on social media, the health implications are pretty grim.

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According to America’s Health Rankings, excessive alcohol use is a leading cause of preventable death. It’s linked to liver disease, various cancers, and hypertension. But the most immediate danger in these cities is often on the road.

In St. Croix County, Wisconsin, for example, nearly 48% of driving deaths involve alcohol. In Carbon County, Montana, it’s over 42%. When a quarter of the population is drinking excessively, the risk of someone getting behind the wheel while impaired becomes a statistical inevitability.

Is the Data Flawed?

Some experts argue that Wisconsin appears "drunker" simply because people there are more honest.

There is a theory that in the "Bible Belt," people underreport their drinking because of social stigma. In the Midwest, there is zero stigma. Telling a researcher you had six beers on Friday night is just... Friday night. Whether this "honesty gap" accounts for the entire lead is up for debate, but it definitely plays a role in how the numbers are collected.

What This Means for You

If you live in one of these cities, you’ve likely noticed that alcohol is the "social lubricant" for everything. From the Friday night fish fry to the local softball league, it’s everywhere.

However, "normal" doesn't always mean "healthy." The trend across the U.S. has actually been slightly downward in recent years, with a 7.2% decline in binge drinking reported between 2023 and 2024. People are becoming more aware of "sober curious" movements and the long-term effects of alcohol on mental health.

Actionable Steps for Navigating High-Drinking Cultures:

• Audit your "Third Places": If your only social outlet is the local tavern, try finding a hobby-based group (climbing gyms, gaming cafes, or run clubs) where alcohol isn't the primary focus.
• Track your "Units": Use an app like Reframe or Sunnyside to see if your "social drinking" actually crosses into the CDC's "excessive" category. It’s often more than you think.
• Advocate for Change: Support local initiatives that provide alternative transportation or stricter enforcement of over-serving at bars to help lower those driving death statistics.
• Normalize the "No": In high-pressure drinking cultures like Appleton or Green Bay, being the person with a Diet Coke can feel weird. The more people do it, the less weird it becomes.

The data is clear: America's heartland is also its heaviest drinker. Whether that’s a cultural legacy or a public health crisis depends entirely on who you ask—and how many rounds they've had.