North Carolina Alcohol Data

North Carolina Alcohol Data

Jump to: Alcohol Use | Alcohol-Related Harms | Alcohol Environment | Access to Care | Monthly Reports | Interactive Alcohol Data | Other Resources

When alcohol is available, accessible, and inexpensive, people tend to drink more.1 Drinking too much alcohol leads to injuries, illnesses, death, and community problems, like crime and violence.2

North Carolina has a lower percentage of adults who drink, binge drink, and heavily drink when compared to the rest of the United States.3 However, North Carolina communities still experience many harms due to alcohol. In 2023, North Carolina experienced more than 5,600 deaths, 66,000 emergency department visits, and a loss of $15.2 billion due to excessive alcohol use. These metrics, along with several others, are some of the highest values to date when compared to previous years. See the Interactive Alcohol Data at the bottom of this page for more information.

The North Carolina Injury and Violence Prevention Branch (IVPB) monitors data related to alcohol use, alcohol-related harms, and the alcohol environment. This site includes monthly alcohol-related surveillance updates, statewide summary data, and interactive visuals of state and county-level metrics for partners across North Carolina to understand the impacts of excessive alcohol use in their communities.

For more information:

Alcohol Use

Excessive alcohol use includes four types of drinking that can lead to alcohol-related harms:

  • Binge drinking: Four or more drinks for women, or five or more drinks for men during one occasion
  • Heavy drinking: Eight or more drinks for women, or fifteen or more drinks for men during a week
  • Underage drinking: Any alcohol use by people under the age of 21
  • Drinking while pregnant: Any alcohol use during pregnancy 2

To reduce alcohol-related harms, the 2020-2025 Dietary Guidelines for Americans recommends that all adults of legal drinking age choose not to drink, or to drink in moderation by limiting intake to one drink or less in a day for women, or two drinks or less in a day for men. If adults of legal age choose to drink, drinking less is better for health than drinking more.4

Adult Alcohol Use

Approximately 4.1 million adults in North Carolina drink alcohol, which is about 1 in 2 adults. Of those who drink, 1 in 4 adults binge drink and 1 in 10 adults drink heavily.3

Three pie charts: Left chart shows 48% of NC adults currently drink (4.1 million adults). Middle chart shows 28% of drinkers binge drink (1.2 million adults). Right chart shows 10% of drinkers drink heavily (445,000 adults).

 

Youth Alcohol Use

Approximately 136,000 high school students in North Carolina drink alcohol, which is about 1 in 5 students. Half of these students binge drink. Of those who drink, 2 in 5 usually get alcohol from someone, such as family or friends, giving it to them versus buying it for themselves.5

Alcohol-Related Harms

Excessive alcohol use can have both immediate and long-term health risks. 

Drinking excessively on occasion can lead to several negative health impacts, such as motor vehicle crashes, homicide, violence, and other immediate injuries.2 There were 2,029 preventable deaths of NC residents due to immediate health impacts of alcohol use in 2023.6,7

Drinking alcohol over time can lead to cancer, high blood pressure, stroke, heart disease, and many other chronic diseases.2 There were 3,652 preventable deaths of NC residents due to long-term health impacts of alcohol use in 2023.6,7 

While drinking too much can lead to death and emergency department visits, it also contributes to long-term health, mental health,  relationship, and community issues including crime.2

Alcohol-Attributable Deaths

Alcohol-attributable deaths include 58 causes of death due to immediate and long-term alcohol use. 

Alcohol-Related ED Visits

Alcohol-related ED visits include visits caused by immediate issues, such as alcohol intoxication, as well as long-term conditions, such as liver cirrhosis.

Alcohol Environment

The alcohol environment can impact alcohol use. It includes the physical availability of alcohol, price of alcohol, type of alcoholic beverage, and exposure to alcohol advertisements.8 Policies that regulate the alcohol environment promote the health and well-being of North Carolina communities. To learn more about the policies that protect the health of North Carolinians, please see the Reducing Excessive Alcohol Use to Build Healthier North Carolina Communities fact sheet.

Alcohol Outlet Density

Alcohol outlet density measures the physical availability of alcohol. It measures the number of places that sell alcohol in a given area and can be expressed as a count, rate per person, or rate per square mile. There are two main types of places that sell alcohol, on-premises locations and off-premises locations.9

Higher alcohol density exposes youth and adults to more choices of retailers, more advertising, and more product options, leading to worse alcohol-related population health outcomes. For more alcohol outlet density measures, please see the Interactive Alcohol Data below.

There is no specific number for a "high" alcohol outlet density. To determine if an area has "high" or "low" density, we can compare areas with similar geography, areas with similar demographics, or the same area (e.g., a county) at different points in time. 

North Carolina currently measures alcohol outlet density in two ways, and each way gives us different information. While most places may be "high" in only one measure, some places may be "high" in both.

For example, the maps below show that some coastal counties have "high" alcohol outlet density in both measures. Alcohol outlet density per person measures how many alcohol outlets there are for every 10,000 people who live there. Coastal counties have a lot of tourists, so they often have more alcohol stores to serve visitors. Alcohol outlet density per square mile measures how many alcohol outlets there are for each square land mile in the county. Some coastal counties have a small land area, so there are more alcohol stores in a smaller space.

Alcohol Outlets Per Person

Places that have a small or changing population may have a "high" alcohol outlet density per person, even when compared to places that have more alcohol outlets. 

Alcohol Outlets Per Square Mile

Places that have a lot of alcohol outlets and a small land area will have a "high" alcohol outlet density per square mile, even when compared to places with more alcohol outlets. 

Access to Care

Alcohol use disorder is a treatable, chronic disease in which someone continues to drink alcohol despite it causing substantial personal, social, work, or health problems.10 Multiple evidence-based behavioral interventions and FDA-approved medications exist to treat alcohol use disorder.12 Nine out of 10 people who excessively drink do not meet the criteria for alcohol use disorder but still may benefit from professional help due to risk of bad health outcomes.12, 13

Data on treatment rates for North Carolina residents with alcohol use disorder are currently unavailable. Prior estimates suggest that roughly 8 in every 100 people in the U.S. with alcohol use disorder in the past year sought treatment.14 In the U.S., about 1 in every 4 people seeking treatment for alcohol use disorder reported receiving treatment with medication.13 NCDHHS provides resources for finding treatment for alcohol and other substance issues here. 

Monthly Reports

For the most up-to-date state information about alcohol-related emergency department visits, including provisional data and demographics, see the Monthly Alcohol Data Reports.

To receive email updates of these reports email us at substanceusedata@dhhs.nc.gov. 

Interactive Alcohol Data 

Alcohol data included on this page are updated annually, except for YRBS percent rates which are updated every two years. Maps include the most recent year of data. Data points (both rates and counts) are colored by the relative rates seen for that metric across NC and/or counties ever recorded, accounting for population differences between places. See How to Interpret Data and Technical Notes at bottom of page for more.

The visualizations below include additional information that appear when you hover over data points in the map or graphs. You can also select a county and a metric from the drop-down menus to see different data.

Tab/Accordion Items

Use critical thinking when comparing and interpreting rate ranks (HIGHEST, HIGH, MIDDLE, LOW, LOWEST) and colors in graphs and maps. Here are three examples:

  • Some metrics have obvious good or bad directionality. For example, more alcohol-attributable deaths are always “bad.” Other measures may be more clearly “good” when they are high, like increased treatment access. Some metrics are more complex. Visits to the emergency department (ED) for alcohol-related conditions, at face-value, are not “good.” However, a higher alcohol-related ED visit rate may mean that more people were able to get lifesaving care.
  • Even if a metric is ranked LOW or LOWEST, prevention programs can and should continue to lower rates of negative health outcomes. Even if rates are currently low, they may still be increasing.
  • Rates that are ranked as HIGH or HIGHEST may increase over time. Rate rankings may change in the future as new data points are added that expand the ranges of LOW and HIGH.

More Data Resources

Tab/Accordion Items

Data Considerations: For important data considerations, see overall injury data technical notes and injury metric case definitions.

Funding Disclaimer: This work is partially supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $166,667. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Suggested citation:  NC Department of Health and Human Services Division of Public Health Injury & Violence Prevention Branch. “North Carolina Alcohol Data | Division of Public Health.” North Carolina Alcohol Data. Accessed <access date>. https://www.dph.ncdhhs.gov/north-carolina-alcohol-data

  1. Centers for Disease Control and Prevention. 2024. Preventing Alcohol-Related Harms. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/prevention/index.html
  2. Centers for Disease Control and Prevention. 2024. Alcohol Use and Your Health. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/about-alcohol-use/index.html
  3. North Carolina State Center for Health Statistics. Behavioral Risk Factor Surveillance System (BRFSS) 2023 Annual Survey Results. North Carolina State Center for Health Statistics. Retrieved December 18, 2024 from https://schs.dph.ncdhhs.gov/data/brfss/survey.htm
  4. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.
  5. North Carolina Department of Public Instruction. North Carolina 2021 Youth Risk Behavior Survey. North Carolina Department of Public Instruction. Retrieved December 18, 2024 from https://www.dpi.nc.gov/districts-schools/classroom-resources/academic-standards/programs-and-initiatives/nc-healthy-schools/nc-healthy-schools-data
  6. North Carolina State Center for Health Statistics. Statistics and Reports: Vital Statistics. North Carolina State Center for Health Statistics. Retrieved December 18, 2024 from https://schs.dph.ncdhhs.gov/data/vital.cfm
  7. Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Centers for Disease Control and Prevention. Retrieved December 18, 2024 from https://nccd.cdc.gov/DPH_ARDI/default/default.aspx
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  9. Centers for Disease Control and Prevention. Guide for Measuring Alcohol Outlet Density. Atlanta, GA: Centers for Disease Control and Prevention, US Dept. of Health and Human Services; 2017.
  10. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787 
  11. Reus VI, Fochtmann LJ, Bukstein O, Eyler AE, Hilty DM, Horvitz-Lennon M, Mahoney J, Pasic J, Weaver M, Wills CD, McIntyre J, Kidd J, Yager J, Hong SH. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90. doi: 10.1176/appi.ajp.2017.1750101. PMID: 29301420.
  12. Centers for Disease Control and Prevention. 2024. Data on Excessive Alcohol Use. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/excessive-drinking-data/index.html
  13. Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report
  14. Chen, C.M., Slater, M.E., Castle, I-J.P., and Grant, B.F. 2016. Alcohol Use and Alcohol Use Disorders in the United States: Main Findings from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). U.S. Alcohol Epidemiologic Data Reference Manual, Volume 10, April 2016, NIH. Publication No. 16-AA-8020. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.