A new study has revealed which U.S. states are drinking the most — and North Dakota tops the list for binge drinking and excessive alcohol use.

The analysis, conducted by Wellbrook Recovery, examined data from the CDC and Mental Health America (MHA) to uncover which states are most likely to binge drink or report a substance use disorder.

The findings highlight where residents may be at higher risk this winter as cold weather, holidays, and social events make heavy drinking more tempting.

‘Binge drinking’ is defined as consuming four or more drinks for women or five or more for men on one occasion, while ‘heavy drinking’ means eight or more drinks per week for women or 15 or more for men.

Even moderate drinking can impair judgment and coordination, while consistent overconsumption raises risks of liver damage, depression, and dependency.

North Dakota leads the nation in binge drinking

Nearly one in four North Dakotans (23.9%) report binge or heavy drinking — far above the national average of 18.4%. The state also has a high rate of substance use disorders (16.4%), signaling that excessive alcohol use is both common and concerning.

Montana and Iowa close behind

Montana ranks second, with 23.4% of adults admitting to overconsuming alcohol weekly, and nearly one-fifth (19.2%) acknowledging a substance abuse problem. Iowa follows in third place with 22.6% binge drinking but a slightly lower rate of diagnosed substance use disorder (15.7%), suggesting that many drinkers there may not be seeking help.

Other heavy-drinking states

Wisconsin (21.6%), Minnesota (21.2%), and Colorado (20.7%) round out the top six, with all three reporting higher-than-average rates of heavy drinking. Vermont and Nebraska tie in seventh and eighth place at 20.5%, followed by South Dakota (20.3%) and Missouri (20.2%).

Top 10 states for binge drinking

1. North Dakota – 23.9% binge/heavy drinking | 16.4% substance use disorder
2. Montana – 23.4% | 19.2%
3. Iowa – 22.6% | 15.7%
4. Wisconsin – 21.6% | 15.9%
5. Minnesota – 21.2% | 17.3%
6. Colorado – 20.7% | 17.3%
7. Vermont – 20.5% | 17.7%
8. Nebraska – 20.5% | 18.0%
9. South Dakota – 20.3% | 18.6%
10. Missouri – 20.2% | 15.9%

Utah has the healthiest relationship with alcohol

On the opposite end of the spectrum, Utah reports the lowest rate of binge drinking in America, with only 13.6% of adults drinking excessively — 26% below the national average.

The state’s low rate of substance use disorders (12.6%) suggests residents there are more likely to choose soda over spirits.

Kentucky (13.8%) and Alabama (14.1%) also report lower-than-average drinking levels, followed by Oklahoma (14.4%) and West Virginia (14.5%).

While these states drink less overall, Oklahoma stands out with a higher substance use rate (16.1%), suggesting that other forms of addiction may be prevalent.

Top 10 states with the lowest binge drinking rates

1. Utah – 13.6% binge/heavy drinking | 12.6% substance use disorder
2. Kentucky – 13.8% | 13.0%
3. Alabama – 14.1% | 14.9%
4. Oklahoma – 14.4% | 16.1%
5. West Virginia – 14.5% | 14.9%
6. Maryland – 14.7% | 15.3%
7. Mississippi – 15.1% | 15.5%
8. Delaware – 15.2% | 15.6%
9. Georgia – 15.7% | 11.3%
10. Indiana – 15.8% | 14.6%

Expert advice: How to avoid overdrinking this winter

Meir Kasnett, CEO of Wellbrook Recovery, says the winter season often leads to increased drinking due to festive gatherings and social pressure.

“The holidays are a tough time for anyone trying to manage their relationship with alcohol,” Kasnett explains.

He says, “If you’re attending a party, go with a friend who also plans to stay sober — you’ll keep each other accountable. And if you’re worried about being questioned for not drinking, order a soda or cranberry juice — no one can tell whether it’s mixed with alcohol or not.”

Kasnett emphasizes that no one should feel uncomfortable for choosing not to drink and that moderation or abstaining entirely is a sign of strength, not deprivation.

The takeaway: while drinking culture is deeply rooted in many states, these findings show where awareness, mental health support, and healthy coping mechanisms are most needed — especially as the holiday season approaches.