Current drinking rates in the US

During the COVID-19 pandemic, alcohol use in the United States surged, which also led to a significant jump in alcohol-related deaths. According to a CDC report, alcohol-related deaths in the United States increased by almost 30% in 2021, reaching almost 500 deaths a day.

Now, almost seven years after the start of the pandemic, U.S. drinking rates may finally be declining again.

In a new study published in the Annals of Internal Medicine, researchers analyzed data from over 114,000 U.S. adults who participated in CDC's annual National Health Interview Survey from 2018 to 2024 to understand their drinking habits, including heavy drinking. The researchers defined heavy drinking as five or more drinks per day/16 or more drinks per week for men and four or more drinks per day/eight or more drinks per week for women.

Between 2022 and 2024, the share of adults who reported drinking any alcohol in the past year decreased by almost 2%, and the share who drank heavily decreased by over 8%. Although men had a larger decline in drinking during this time period (2.4% vs. 1.1%, respectively), women had a greater decline in heavy drinking compared to men (9% vs. 7.7%, respectively).

According to the study, younger adults had the largest decline in drinking rates. Total drinking rates decreased by almost 6% for Gen Z adults (ages 18 to 29) and by roughly 2% for millennials (ages 30 to 39). Both generations saw a roughly 20% decline in heavy drinking.

However, the opposite was true for older adults, specifically those in the 50 to 64 age group. Among this group, overall drinking increased by 4% and heavy drinking increased by 36% between 2018 and 2024. 

"This 30% increase, that's about a million people drinking heavily in that age group alone," said study author Brian Lee, a hepatologist and liver transplant specialist at Keck Medicine at USC.

Although the study did not examine the reasons behind the generational differences in drinking rates, some potential theories include younger people using other substances (like cannabis) more than alcohol, having less disposable income for alcohol, or shifts in societal expectations around drinking.

"When fewer people around you drink, there is less and less societal pressure," Lee said. "Older adults grew up in an era where everyone was drinking heavily around them and it was acceptable, whereas that's no longer the case among Gen Z or Millennials."

Commentary

According to Jagpreet Chhatwal, director of the Institute for Technology Assessment at Massachusetts General Hospital, the decline in overall drinking rates "is an encouraging trend — at least there's a change in direction."

Both Lee and Chhatwal also expressed concerns about the increase in drinking among older adults, especially since they have a greater risk of negative health effects from alcohol.

"We're seeing the biggest increases in heavy drinking in exactly the group that we're worried the most about in terms of their health related to alcohol," Lee said. "[…] This age group faces some of the greatest risks of harm from alcohol, including cirrhosis and alcohol-related cancer."

According to the National Center for Drug Abuse Statistics, people between the ages of 50 to 64 are over 2.5 times more likely to die from chronic alcohol abuse compared to acute alcohol-related conditions.

"That's a concerning sign and we need to think about interventions, something that can really reduce the impact of that high-risk drinking in that cohort," Chhatwal said.

For individuals who are concerned about alcohol-related diseases, Lee recommends talking to a doctor about screening tests for the liver to get ahead of any potential issues.

"A lot of people know that alcohol isn't healthy for their body, and they make that choice for certain reasons that for them are important," he said. "Doctors understand that and it's OK to have these conversations."