County Health Rankings Model

Alcohol and Drug Use

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Use County Health Rankings’ model of health to explore the measures that influence how long and how well we live.

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When consumed in excess, alcohol is harmful to the health and well-being of those that drink as well as their families, friends, and communities. Prescription drug misuse and illicit drug use also have substantial health, economic, and social consequences.

Why Are Alcohol and Drug Use Important to Health?

Excessive alcohol consumption considers both the amount of alcohol consumed and the frequency of drinking. Prescription drug misuse includes taking a drug in a manner other than prescribed and taking drugs that have been prescribed to another person. Although moderate alcohol use is associated with health benefits such as reduced risk of heart disease and diabetes [1], excessive alcohol use causes 88,000 deaths in the US each year [2]. More than 46 people died every day from drug overdoses involving prescription opioids in 2016 [3].

In 2015, 27% of people ages 18 and older reported binge drinking in the past month, while 7% reported heavy alcohol use in the past month [4]. Over time, excessive alcohol consumption is a risk factor for high blood pressure, heart disease, fetal alcohol syndrome, liver disease, and certain cancers [5]. In the short-term, excessive drinking is also linked to alcohol poisoning, intimate partner violence, risky sexual behaviors, and motor vehicle crashes [2,5]. Alcohol-impaired crashes accounted for nearly one-third of all traffic-related deaths in 2016—more than 10,000 fatalities [6].

From 1999 to 2017, overdose deaths from prescription painkillers have increased fivefold, with 218,000 deaths from overdoses related to prescription opiods during this time period. Prescription drug misuse now accounts for over 35% of opiod drug overdose deaths [3]. Since 2002, rates of use for cocaine and hallucinogens have either declined or remained steady, while rates of marijuana and heroin use have increased [7,8]. As of 2018, more teens smoke marijuana than cigarettes [9] and in 2012, 156,000 people reported starting to use heroin, nearly double the number starting in 2006 [8]. Marijuana, now legal in some states, is the most frequently used illicit drug. Teenagers account for over half of all new illicit drug users. 

Alcohol and drug use have significant economic costs. Excessive alcohol use costs $249 billion in lost productivity, health care, and criminal justice expenses each year, whereas illicit drug use costs $193 billion related to crime, health care, and lost productivity [10].

Adopting and implementing strategies to reduce excessive use of alcohol and abuse of prescription drugs can improve the health and well-being of communities.


[1] Mayo Clinic. Alcohol use: If you drink, keep it moderate. August 30, 2016. Accessed March 5, 2018.
[2] National Center for Chronic Disease Prevention and Health Promotion. Excessive alcohol use: preventing a leading risk for death, chronic disease, and injury. Atlanta: Centers for Disease Control and Prevention (CDC); 2015.
[3] Centers for Disease Control and Prevention. Prescription Drug Overdose Data December 19, 2019. Accessed March 13, 2019.
[4] National Institute on Alcohol Abuse and Alcoholism. Alcohol Facts and Statistics. June 2017. Accessed February 21, 2018.
[5] Centers for Disease Control and Prevention. Fact Sheets – Alcohol Use and Your Health. January 3, 2018. Accessed March 13, 2019.
[6] Dept of Transportation (US), National Highway Traffic Safety Administration (NHTSA). Traffic Safety Facts 2016: Alcohol-Impaired Driving. Washington (DC): NHTSA; January, 2018.
[7] National Institutes of Health, National Institute on Drug Abuse. DrugFacts: Nationwide trends. June 2015. Accessed March 13, 2019.
[8] National Institute on Drug Abuse (NIDA). NIDA Research report series: Heroin. National Institute of Health; 2018. NIH Publication No. 14-0165.
[9] National Institutes of Health, National Institute on Drug Abuse. DrugFacts: Monitoring the Future Survey: High School and Youth Trends 2019. December 2019. Accessed February 7, 2021.
[10] National Institutes of Health, National Institute on Drug Abuse. Trends and statistics: Costs of substance abuse. April 2017. Accessed March 13, 2019.


Our Rankings show how healthy a community is as well as indicators for future health. This provides a starting point for action on improving health for all. Dig deeper into the measures below to learn more about our approaches to measuring health.