Drinking finally slows after pandemic spike, but not for every age group

Americans are drinking less for the first time since the pandemic, but alcohol use remains higher than it was before 2020, according to a study published Monday in the journal Annals of Internal Medicine. The decline in drinking rates, though modest at roughly 1%, is welcome news after heavy alcohol use spiked sharply during the pandemic, said senior study author Dr. Brian P. Lee, a liver transplant doctor at Keck Medicine of USC in Los Angeles. However, Lee said, “these trends haven’t been even across the board.” While both heavy and occasional drinking declined among Gen Z and millennials from 2022 to 2024, drinking increased in people ages 50 to 64, according to the study, which used data from the National Health Interview Survey conducted by the Centers for Disease Control and Prevention. Lee and his team looked at survey results for four years: 2018, 2020, 2022 and 2024. Overall, men reported a larger decline in drinking than women did from 2022 to 2024 — 2.4% compared with 1.1% — but heavy drinking declined by 9% among women compared with 7.7% among men. The survey defined heavy drinking as either five or more drinks per day or 15 or more per week for men and four drinks per day or eight drinks per week for women. Gen Z adults reported the biggest decrease in drinking from 2022 to 2024, more than 5%, while millennials reported the largest decline in heavy drinking over the same time period, a drop of 17%. For both age groups, however, the rates of drinking or heavy drinking were still slightly higher than they were in 2018. Lee said the most concerning finding was that heavy drinking among adults ages 50 to 64 has steadily climbed since 2018. About 2% more people in this age group reported drinking heavily in 2024 compared with 2022, and that number has increased by more than one-third since 2018. “This 30% increase, that’s about a million people drinking heavily in that age group alone,” Lee said. Drinking raises a person’s risk of high blood pressure, stroke and digestive problems, and alcohol-related liver disease is now the leading cause of liver transplants in the U.S. Yearly cancer deaths linked to alcohol have doubled over the last three decades. The older you are, the more vulnerable you are to the damage alcohol can cause, Lee said. “The average age of developing cirrhosis is in the 50s, and we know someone with a 50-year-old liver is more likely to develop liver scarring with the same quantity of alcohol as a 20-year-old liver,” he said. “The risk with alcohol isn’t the same across all age groups, and this middle-aged group is exactly the group we are worried about.” People in their 50s and 60s who are currently heavy drinkers have also likely been drinking for years, further exacerbating their risk for alcohol-related health complications, said Dr. Michael Siegel, a professor of public health and community medicine at Tufts University School of Medicine in Boston. “We’re talking about a substantial amount of alcohol consumption that is probably going to have health effects at that level, and to see that those trends over time have not really decreased is worrisome,” he said. Alcohol consumption has been steadily on the rise since around the year 2000 after a decline in the late 1980s and ’90s, said Priscilla Martinez-Matyszczyk, deputy scientific director of the Alcohol Research Group, a nonprofit organization. Drinking peaked in 2020, when heavy alcohol use among Americans rose by 20% and any alcohol use rose by 4% compared to 2018. “We’ve seen this before, where there is a spike in alcohol use after traumatic populationwide events,” Martinez-Matyszczyk said, noting a documented increase in drinking after the 9/11 terrorist attacks. “You’ll see a spike and then a bit of a decline, but often those trends will go back to wherever the trend was heading in the first place, and there was already an increasing trend before the pandemic.”