Americans in different parts of the country are known to vary significantly in their consumption of particular foods – be it spicy chili, cream-cheese covered bagels or collard greens. Recent federal government data show that the country is equally diverse in its consumption of intoxicating substances.

The Substance Abuse and Mental Health Services Administration annually surveys Americans age 12 and older about whether they use opioid painkillers for non-medical reasons or consume any marijuana, alcohol or cocaine. States are ranked into quintiles based on what proportion of their population uses each substance, thereby creating a “top 10 list” for all four.

Colorado stands out as the only state which is a top consumer of all four substances. The state’s heavy consumption of marijuana is predictable given that the drug is legal there. The other three legalization states are heavy consumers of pot, too (Washington, Alaska and Oregon; the latter is also a leader in non-medical use of prescription opioids). But residents of the mile-high state are also heavy consumers of all non-marijuana intoxicants as well.

Northern New England is another notable concentration of heavy use, with a cluster of states that are top consumers of multiple substances. Although the opioid overdose crisis in that part of the country has attracted extensive attention, none of the New England states is among the nation’s highest for non-medical consumption of prescription painkillers. Instead, Vermont, Massachusetts and New Hampshire are leading consumers of alcohol, marijuana and cocaine, with Maine a leading consumer of alcohol and marijuana. New York, in contrast, is a top consumer of only cocaine.

Like Colorado, Washington, D.C., is a center of extensive substance use despite not being in a particularly heavy-consuming part of the country. The District of Columbia ranks among the nation’s leaders for cocaine, alcohol and marijuana use.

As the most religious region of the country, the Southeast and Bible Belt have long tended to have lower consumption of intoxicating substances – particularly alcohol – than the rest of the country. Yet non-medical painkiller use is an exception to this general rule, with most of its top consumers being in or near this region: Oklahoma, Arkansas, Louisiana, Alabama, Virginia, Maryland and Ohio.

The Midwest and Plains states are not leading consumers of any of the three illicit drugs. But Wisconsin, Minnesota and North Dakota are all national leaders in their proportion of drinkers, continuing a pattern established during the period of heavy migration from Scandinavia and beer-loving, beer-brewing Germany.

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