81.8
South Dakota
Highest Alcohol Harm Index score.
Alcohol Across America
This analysis combines alcohol-related mortality, road-fatality, treatment-access, and treatment-client data for all 50 states and the District of Columbia. Explore the Alcohol Harm Index, then compare jurisdictions across five measures.
Explore the state by state map
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Selected jurisdiction
10 jurisdictions with the highest Alcohol Harm Index scores
Higher scores indicate greater measured fatal harm. This is a relative index score, not a rate or probability.
Key findings
142.3%
Mississippi
Largest increase in the alcohol-induced death rate, 2015 to 2024.
124.5%
District of Columbia
Largest increase in the alcohol-impaired road death rate, 2015 to 2024.
94.6
Wyoming
Highest facility-based Treatment Access score.
1,444
Delaware
Highest one-day census rate per 100,000 adults whose treatment involved alcohol.
Explore five focused jurisdiction rankings
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Harm vs. facility-based access
Compare each jurisdiction's Alcohol Harm Index score with its facility-based Treatment Access score. Median lines divide the chart into four relative profiles, not clinical or policy thresholds.
Swipe the chart horizontally to view all four quadrants.
Browse jurisdictions by matrix profile
How to read it: Scores are relative to the 51 jurisdictions in this analysis. Treatment Access is a facility-based proxy and does not measure open beds, wait times, distance, quality, or real-time availability.
Methodology
Built from national public data
Published September 2, 2026. Prepared for Lantana Recovery using 2024 SAMHSA, NHTSA, and CDC-derived data. Scores and rankings are calculated from the published measures described below; source values were not adjusted.
Alcohol Harm Index
This campaign index combines the 2024 alcohol-induced death rate (35%), the 2024 alcohol-impaired road death rate (30%), mortality change from 2015 to 2024 (20%), and road-death-rate change from 2015 to 2024 (15%). Each component is converted to a percentile rank across 51 jurisdictions. Scores are relative comparisons on a 0 to 100 scale, not rates, probabilities, or clinical thresholds. The weights are editorial choices for this campaign, not a clinical standard, and alternative weights could change the rankings. The index measures fatal outcomes and should not be read as a comprehensive measure of every form of alcohol-related harm.
Mortality Change
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. Percentage changes can be volatile where the starting rate is low.
Road Fatality Change
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. NHTSA urges great caution when comparing states. In 2024, known BAC results ranged from 8% of drivers in Mississippi to 86% in Montana, and missing BAC values were estimated through multiple imputation. The 2024 Annual Report File may be revised.
Treatment Access
The facility-based Treatment Access score weights alcohol use disorder treatment facilities per 100,000 adults at 65% and the share of substance use disorder facilities accepting Medicaid at 35%. Medication and detoxification columns are contextual and are not included in the score. The score does not measure capacity, open beds, wait times, distance, treatment quality, or real-time availability.
Clients in Treatment
Client figures are one-day census rates per 100,000 adults for March 29, 2024, not annual admissions or live availability. A higher rate may reflect need, treatment reach, reporting practices, or a combination of factors, so it should not be interpreted in only one direction.
Ranking, ties, and rounding
Rankings use competition ranking: jurisdictions with equal source values share a rank, and subsequent rank numbers are skipped. Public values are rounded for readability after ranking. Percentage changes are shown to one decimal place; composite scores are shown without percent signs.