81.8
South Dakota
Highest overall Alcohol Harm Score.
A nationwide data study
Alcohol Across America
Where alcohol harm is highest, where it is rising fastest, and how access to treatment differs across all 50 states and Washington, DC.
The national picture
One country. Very different outcomes.
This analysis brings together mortality, road safety, treatment access, and treatment client data to show how the effects of alcohol differ from state to state. Explore the overall Alcohol Harm Index, then switch between individual rankings to see the stories behind the score.
51jurisdictions compared, including Washington, DC
16interactive state rankings across harm and access
2015 to 2024the comparison period for mortality and road trends
3 sourcesSAMHSA, NHTSA, and KFF data based on CDC/NCHS records
35.9
New Mexico
Highest 2024 alcohol-induced death rate per 100,000.
7.60
South Carolina
Highest 2024 alcohol-impaired road death rate per 100,000.
94.6
Wyoming
Highest Alcohol Treatment Access Score.
Explore the data
Every state ranking
Select a measure and search for any state. Tables retain the full underlying ranking supplied for the campaign.
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Scores and rates are shown as supplied in the campaign workbook. Scroll horizontally on smaller screens.
Methodology
Built from national public data.
The study covers the 50 states and Washington, DC. It combines published government tables with state-level calculations from public-use files. Rankings use the campaign workbook without altering its values.
Alcohol Harm Score
The composite score weights the 2024 alcohol-induced death rate at 35%, the 2024 alcohol-impaired road death rate at 30%, change in alcohol-induced mortality from 2015 to 2024 at 20%, and change in the alcohol-impaired road death rate at 15%. Each measure is converted to a percentile rank across all 51 jurisdictions.
Mortality measures
Alcohol-induced death rates are age-adjusted rates per 100,000 residents from KFF State Health Facts, which republishes CDC/NCHS mortality data. Alcohol-induced deaths include alcohol-specific underlying causes and exclude road fatalities.
Road fatality measures
NHTSA defines an alcohol-impaired-driving fatality as a death in a crash involving a driver or motorcycle rider with a blood alcohol concentration of 0.08 g/dL or higher. This does not establish that alcohol caused the crash. The 2024 figures use the Annual Report File and may be revised.
Treatment access measures
The Treatment Access Score combines facilities treating alcohol use disorder per 100,000 adults, weighted at 65%, with the share of substance use facilities accepting Medicaid, weighted at 35%. SAMHSA facility counts are unweighted counts of responding facilities and do not measure capacity or real-time availability.
Client data
Client figures are one-day census counts for March 29, 2024, not annual admissions. A high caseload may reflect greater need, stronger treatment access, or both, so it should not be interpreted in a single direction.