Top 10 Drunkest Cities in America

Think about what defines your city. Is it the skyline? The sports team? The special way of making pizza, barbecue, or chili? America is often called a “melting pot,” a place where cultures from all over the world blend together to form a collective national identity. The amalgam of global culture in America is a point of pride for many residents, almost as much as the unique quirks of their local culture.

Each region, city, town, and neighborhood in the country has its own flavor, its own identity, whether that’s a regional cuisine, a particular sports team, rich traditions, or a vibrant nightlife. Today, let’s take a look at America’s cities through the lens of drinking culture and determine which cities have the highest rates of excessive drinking.

Defining Excessive Drinking

Before we look at which cities love their booze the most, it’s important to define “excessive drinking” and social drinking expectations. These concepts inform a city’s drinking culture and explain why certain areas tend to hit the bottle harder.

Drinking to Excess

Excessive drinking describes a pattern of alcohol consumption that significantly increases the risk of alcohol-related illness. All alcohol carries some risk, but public health officials often refer to specific guidelines for balancing risk with enjoyment.

In general, experts recommend sticking to fewer than 2 drinks per day for men and 1 drink per day for women. But wait, how is it possible to drink fewer than a drink per day? The idea is that we should not be drinking every day. This may come as a surprise to those of us who like to wind down with a daily glass of wine, but it’s good advice for avoiding some of the most risky consequences of alcohol dependence.

Excessive drinking is primarily associated with two types of drinking behaviors: binge drinking and heavy drinking.


• Binge drinking involves consuming a large amount of alcohol in a short period of time — 5 or more drinks for men and 4 or more drinks for women in a period of about 2 hours.


  
  Binge drinking doesn’t necessarily mean we are alcohol dependent, but it can lead to dangerous consequences, including accidents, alcohol poisoning, or long-term health issues.
• Heavy drinking is characterized by a pattern of drinking that exceeds the recommended maximum drinking levels. Consistent heavy drinking poses serious health risks, including chronic diseases like liver cirrhosis, heart disease, and an increased risk of developing certain cancers.

Alcohol Consumption and Public Health

A regional pattern of excessive drinking is often a part of an area’s cultural identity. Many cities pride themselves on local specialties or boozy celebrations after local sports teams win a big game.

There are also influences from social pressure and groupthink, which create a feedback loop that perpetuates and expands local drinking culture — with serious consequences for public health.

• Health implications. Chronic diseases like liver cirrhosis, heart disease, and certain cancers are more prevalent among heavy drinkers. Mental health issues, including depression and anxiety, are also associated with excessive alcohol use. 

• Societal impact. All of those issues tax public health resources and reduce the quality of community engagement. People spend more money treating alcohol-related illnesses, lose productivity in the workplace, and have less time, energy, and money to engage with their community in healthy ways.

• DUIs and vehicular accidents. A substantial number of road accidents and fatalities are linked to alcohol impairment. DUIs often result in the revocation of the offender’s driver’s license. Many jobs consider this a fireable offense, and, at the very least, it costs time and money to resolve.

• Violence and crime. Everyone has seen those viral videos of crowds rioting with joy after a Super Bowl win. Beyond these rare celebrations, there is a well-documented correlation between excessive alcohol consumption and increased rates of violence, domestic abuse, and crime.

• Emergency response and resources. High rates of alcohol consumption strain emergency response systems and healthcare resources. One study determined that alcohol-related EMS calls cost the city of Denver approximately $7 million annually.


Many cities and metro areas implement public safety programs with the aim of reducing the impact of high alcohol consumption. These programs include public awareness campaigns, policy interventions such as alcohol taxes and legal drinking age enforcement, and promotion of responsible drinking behaviors.

National Statistics

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) regularly collects data on drinking in the United States. In a 2022 survey by the NIAAA, excessive drinking among American adults is incredibly common:

• 6 million adults ages 18 and older (6.3% of this age group) reported heavy alcohol use in the past month
• 60.3 million adults ages 18 and older (23.5% in this age group) reported binge drinking in the past month

These numbers have been on the rise, increasing by 12% from 2011 to 2017. According to the 2020 Census, 80% of the American population lives in urban areas. To understand America's drinking habits, let’s look at some of the cities that consume the most alcohol.

Top 10 Drunkest Cities in the United States

With all that out of the way, let’s get down to business.

10. Austin, Texas

Excessive drinking rate: 21.4%

Austin is known for being the “Live Music Capital of the World.” It’s home to several major festivals, including the South by Southwest arts festival, where movies, music, food, and drinking take center stage. Austinites are fiercely loyal to the Texas tradition of pairing barbeque with a cold brew, and the city is home to more than 20 craft breweries.

9. Portland, Oregon

Excessive drinking rate: 21.4%

Portland is known for its slogan “Keep Portland Weird,” and residents certainly take pride in living up to it. Portlanders’ progressive social attitudes have destigmatized the use of drugs and alcohol, leading to wider social acceptance of personal choices to drink. Oregon is known as an ideal region for making wines like pinot grigio, pinot gris, and pinot noir, and many Oregon vineyards operate tasting rooms in Portland, the largest city in Oregon.

8. Sacramento, California

Excessive drinking rate: 21.6%

Home to dozens of craft breweries and close to one of the world’s top-producing wine-growing regions, Sacramento takes the prize for the drunkest city in California, beating out Los Angeles — a city 7 times its size. Californians consume more alcohol than any other state in America, with 85.7 million gallons consumed in 2020 (although this is probably because it is by far the most populous state in America). Excessive drinking during the COVID-19 pandemic increased deaths from alcoholic liver disease so dramatically that the condition killed more Californians than car accidents or breast cancer in 2020. 

7. New Orleans, Louisiana 

Excessive drinking rate: 21.9%

New Orleans is well-known as a party city, hosting several alcohol-oriented festivals every year. About 1.5 million people attend New Orleans’ world-famous Mardi Gras celebrations each year, and revelers drink an average of 4.5 beverages per person. New Orleans is also home to specialty cocktails synonymous with the city, such as the Sazerac, and unique drinking experiences like drive-through daiquiri shops.

6. Pittsburgh, Pennsylvania

Excessive drinking rate: 22.5%

Pittsburgh’s drinking culture stems from its working-class roots; Pittsburgh has a rich history tied to the steel and manufacturing industries, where drinking after long shifts was a common way for workers to unwind and socialize. Pittsburgh is also home to major sports teams with intensely devoted fans. Sports culture often goes hand-in-hand with alcohol consumption, especially during game days, both in stadiums and at local bars.

5. Chicago, Illinois

Excessive drinking rate: 22.7%

The notorious drinking habits of the Windy City date back to the Prohibition Era, when it was a hub for bootleggers trafficking illegal alcohol. With a heavy roster of professional sports teams, including two major-league baseball teams, sports fans make up the bulk of excessive drinkers. Chicago is also known for its regional specialty spirit, Malört, and a huge variety of craft beers.

4. Buffalo, New York

Excessive drinking rate: 22.8%

Buffalo is located in Upstate New York on the Canadian border. The harsh northern winters drive people indoors to socialize, and alcohol is often the center of attention. In many areas of the U.S., bars are a so-called “third place,” a location where people can socialize outside of work and home. During the summer, there are more opportunities to hang out outdoors, but options are more limited in the winter. Public events often center around wine to celebrate Upstate New York’s many respected wineries.

3.  Boston, Massachusetts

Excessive drinking rate: 23.1%

Boston has deep roots in Irish heritage stemming from the many waves of Irish immigration in the late 1800s and early 1900s. Many Irish holidays and celebrations center around alcohol. For example, St. Patrick’s Day, a worldwide celebration of Irish culture, is huge in Beantown: city officials estimate that St. Patrick’s Day celebrations bring in around $6.85 billion to the city’s businesses each year. Boston is also home to avid sports fans and several Ivy League colleges with long-standing drinking traditions.

2. Minneapolis, Minnesota

Excessive drinking rate: 23.5%

Drinking picks up during wintertime in Minneapolis for the same reason it does in Buffalo. Bars are a center of socialization when residents are seeking to escape the frigid temperatures. The Midwest is known for its drinking culture, owing in part to the cultural influences of German, Irish, and Scandinavian immigrants who settled there. In the Midwest’s many rural towns, bars are one of the few places to socialize outside of the home. Minneapolis is also home to a vibrant live music scene, and alcohol is often prominently featured at music venues.

1. Milwaukee, Wisconsin

Excessive drinking rate: 24.6%

Taking the top spot is Milwaukee, the largest city in the state that consumes the most alcohol. Drinking culture runs deep in Milwaukee, which is home to two of the biggest breweries in the country. Wisconsin also has one of the lowest alcohol tax rates in the nation, resulting in lower retail and wholesale prices of alcoholic beverages. Many of the “drunkest” counties and towns in America are in Wisconsin, and the state has 7 of the 10 U.S. cities with the highest alcohol consumption per capita. Milwaukee, with its sprawling beer gardens, is usually the city that drinks the most year after year.

If you live in one of these cities, you may be well aware of its active drinking culture. Luckily, there are ways to overcome peer pressure and develop healthier drinking habits.

Tips for Responsible Drinking

Whether we’re looking to be a good influence or simply improve our personal health, cutting back on drinking is a great way to avoid negative effects on our finances, health, and emotional well-being. Let’s take a look at a few ways to manage our alcohol intake.

1. Set a limit. If you’ll be drinking, decide beforehand how much you’re going to drink — and stick to your plan! Practice mindful drinking and make a choice that allows you to get the most out of fewer sips, and remember the guidelines for a standard drink size — your double gin and tonic is not “one drink!”

2. Set boundaries. Be honest when socializing and set a clear boundary to avoid peer pressure: “I’m having only one drink tonight.” “I’m trying to save money for a trip.” “I’m taking a break from alcohol for my health.” 

3. Set a limit beforehand. Decide on a limit for how many drinks you'll have before you start drinking. This self-boundary can help you stay in control and resist the temptation to keep going. The Reframe app offers drink tracking, which can help you get a full picture of our habits.

4. Pace yourself. Slow down your drinking pace by alternating alcoholic drinks with non-alcoholic options like soda, mocktails, or water. Keeping a mocktail in your hand allows you to socialize without being pressured to fill your glass. If you plan to have more than one drink, limit yourself to one per hour: this is roughly the rate at which our body can metabolize alcohol.
5. Choose low-alcohol options. Opt for drinks with lower alcohol content. Light beers, spritzers, and diluted cocktails are lighter choices than wine or shots.

6. Avoid drinking competitions or games. Stay away from activities that encourage rapid drinking. These activities cause us to drink more than we intend, and they can take us from sober to drunk to too drunk very rapidly.

7. Consider quitting or cutting back. With the rise of the sober-curious movement, cultural attitudes about alcohol are shifting and sober living is becoming more socially accepted. If you’re worried about your drinking habits, consider making a plan to quit or cut back on alcohol. You have the power to take control of your drinking habits!

By following these tips, we can overcome drinking culture and make the best decisions for our health goals!

Wrapping Up

When we are surrounded by alcohol or our cultural identity is tied up with alcohol consumption, it takes strength and fortitude to make changes to our drinking habits. Wherever we live, we can rest assured that there is a thriving sober community united in solidarity against the local drinking culture. Whatever our relationship with alcohol, know that we have the biggest say in how much we drink. Now let’s go out there and make good decisions!