81.8
South Dakota
Number one in the Alchohol Harm Index.
Alcohol Across America
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 Alchohol Harm Index, then compare each state across the five core campaign tables.
Explore the state-by-state map.
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Top 10 states by Alchohol Harm Index
Key findings
142.31%
Mississippi
Largest increase in the alcohol-induced death rate.
124.50%
Washington, DC
Largest increase in the alcohol-impaired road death rate.
94.6
Wyoming
Number one in the Treatment Access Index.
1,444
Delaware
Highest rate of clients in treatment involving alcohol.
Explore five focused state rankings.
No matching state found.
Harm vs. Access
See how every state compares across two campaign measures: Alchohol Harm Index on the vertical axis and Treatment Access on the horizontal axis. Median lines divide the chart into four need-and-access profiles.
How to read it: States above the horizontal median have higher Alchohol Harm Index scores. States left of the vertical median have lower Treatment Access Scores. The upper-left quadrant shows states with higher harm and lower treatment access.
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.
Alchohol Harm Index
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 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.
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. The 2024 figures use the Annual Report File and may be revised.
Treatment Access
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.
Clients in Treatment
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.