FARGO - Binge drinking rates in the Fargo-Moorhead area are among the highest in the nation, according to recently released 2011 data from the Centers for Disease Control and Prevention.

The proportion of people in the F-M area who said they had more than four drinks on one occasion for women and five drinks for men is 28.2 percent - the third-highest binge drinking rate among 200 other large and small metropolitan areas.

Area residents also reported some of the highest heavy drinking rates - two or more drinks daily for men and one for women - at 9.6 percent. Just eight other cities have a larger proportion of heavy drinkers.

Robyn Litke Sall, alcohol and tobacco prevention coordinator for Fargo Cass Public Health, said those high drinking rates come at a cost. She pointed to a study published last year in the American Journal of Preventative Medicine that calculated the cost of excessive drinking such as health care expenses, productivity loss, car accidents and crimes.

Researchers estimate excessive drinking in North Dakota cost more than $419 million in 2006, with a nearly $170 million estimated cost to the state and federal government.

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"A wide range of impact costs are factored into that number," Litke Sall said. "The cost of alcohol is quite a bit greater than people realize."

She said the environment throughout the Fargo-Moorhead area - such as low alcohol taxes, saturation of liquor licenses and availability of drink specials - contributes to high usage rates.

While the area's three college campuses would seem to be hubs of social life and excessive drinking, Litke Sall said she wouldn't "single out the college students."

Erika Beseler Thompson, assistant director for alcohol and other drug abuse prevention at North Dakota State University, agreed, saying students are just a small proportion of the area's drinking population who are "reflective of the environment they're in."

A Boston University School of Medicine study published last month in the American Journal of Preventative Medicine found that states with stronger alcohol policies, such as strict drunken-driving laws and restrictions on the days and hours of alcohol sales, had lower binge drinking rates.

Beseler Thompson said many of the metropolitan areas recently ranked as "the 10 drunkest cities in America" due to their combined binge drinking and heavy usage rates are located in Midwest states where there's little alcohol policy to curb drinking. The Fargo-Moorhead area took the top spot.

She said environmental policy changes are needed to shift the culture around binge drinking and used indoor smoking as an example. When bars went smoke-free, she said, it was a "huge cultural statement about smoking" and there was a lot of pushback on the policy.

"Sometimes it takes a more unpopular stance to make some of those changes," she said.

Metro areas with highest binge drinking rates

1. Midland, Texas - 32.5 percent

2. Columbus, Neb. - 28.4

3. Fargo-Moorhead - 28.2

4. Missoula, Mont. - 26.9

5. Fort Collins-Loveland, Colo. - 26.4

6. Milwaukee-Waukesha-West Allis, Wis. - 26.3

7. Lawrence, Kan. - 25.9

8. Lincoln, Neb. - 25.4

9. Toledo, Ohio - 25

10. Bozeman, Mont. - 24.9

Havre, Mont. - 24.9

Metro areas with highest heavy drinking rates

1. Tallahassee, Fla. - 12.1 percent

2. Brookings, S.D. - 11.8

3. Missoula, Mont. - 10.4

4. Kahului-Wailuku, Hawaii - 10.3

5. Ocean City, N.J. - 10.1

6. Grand Rapids, Wyo. - 10

7. Jacksonville, Fla. 9.7

San Antonio, Texas- 9.7

8. Tampa-St. Petersburg-Clearwater, Fla. - 9.6

Fargo- 9.6

Keene, N.H. - 9.6

Readers can reach Forum reporter Cali Owings at (701) 241-5599