DENVER (KDVR) — Coloradans enjoy their liquid holiday cheer, but there are drawbacks to the merriment.

Colorado ranks among the nation’s heaviest-drinking states. It has the nation’s fourth-highest rate of survey respondents who drank alcohol in the last 30 days. Nearly two-thirds (61%) of Colorado’s adults have had a drink in the last month. Only Vermont, Wisconsin and the District of Columbia have higher rates.

All of that alcohol consumption has negative consequences, however. Though Colorado has one of the overall healthiest populations among U.S. states, it also has one of the highest rates of alcohol-related deaths. There are 18.8 alcohol-related deaths for every 100,000 people, according to the U.S. Centers for Disease Control and Prevention.

This is the nation’s seventh-highest rate of alcohol-related deaths.

Rates are higher in the western U.S., particularly in the Rocky Mountain states and the Southwest. New Mexico has the nation’s highest rate, with 34.3 alcohol-related deaths per 100,000 people, followed by Wyoming, Alaska, South Dakota and Montana.

The Southeast and Mid-Atlantic states have the lowest rates. Hawaii has only a fraction of Colorado’s alcohol deaths rate (5.9), slightly lower than Maryland, Pennsylvania, New Jersey and Louisiana.

Colorado also ranks high on the list of the costs of excessive alcohol consumption, such as lost economic output and criminal or car crash costs. Per capita, Colorado pays $1,005 per person for these costs.

This is the nation’s fourth-highest rate among states. Only Alaska, New Mexico and Wyoming incur higher per capita costs.