U.S. — The analysis relied on data from the National Health Interview Survey conducted by the Centers for Disease Control and Prevention. This survey included more than 114,000 respondents. Researchers examined results from the years 2018, 2020, 2022, and 2024 to track changes in consumption habits.

Both heavy and occasional drinking declined among Gen Z and millennials from 2022 to 2024. Gen Z adults reported a decrease in any alcohol use of more than 5% from 2022 to 2024. Millennials reported a 17% decline in heavy drinking from 2022 to 2024.

Men reported a larger decline in any alcohol use than women did from 2022 to 2024, with a 2.4% decrease for men compared to 1.1% for women. Heavy drinking declined by 9% among women from 2022 to 2024, compared with 7.7% among men.

Drinking rates increased among people ages 50 to 64 from 2022 to 2024. About 2% more people ages 50 to 64 reported heavy drinking in 2024 compared with 2022. Heavy drinking among adults ages 50 to 64 has increased by more than one-third since 2018.

Specifically, heavy drinking for the 50 to 64 age group increased by more than 36% from 2018 to 2024. Any alcohol use for the 50 to 64 age group increased by 4% from 2018 to 2024.

Dr. Brian P. Lee, a liver transplant doctor at Keck Medicine of USC in Los Angeles and the senior author of the study, noted the uneven nature of these shifts. "These trends haven’t been even across the board," Lee 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." "Seeing this first decline gives you something to hope for as a doctor, but you have to be appropriately cautious too, because one change doesn’t necessarily mean a sustained trend," Brian P. Lee said.

"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," Brian P. Lee said. "Doctors understand that and it’s OK to have these conversations," he said.

Lee pointed to the physiological vulnerabilities of this demographic. "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. He quantified the scale of the increase in heavy drinking within this cohort. "This 30% increase, that’s about a million people drinking heavily in that age group alone," he said.

Despite the recent decline, alcohol use rates in 2024 remain higher than they were in 2018. Alcohol consumption has been steadily on the rise since around the year 2000 after a decline in the late 1980s and 1990s. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), apparent per capita alcohol consumption in the U.S. rose by 4% from 2018 to 2020. Heavy alcohol use among Americans rose by 20% in 2020 compared to 2018, while any alcohol use among Americans rose by 4% in 2020 compared to 2018.

Dr. Michael Siegel, a professor of public health and community medicine at Tufts University School of Medicine in Boston, expressed concern about the persistent high levels of consumption. "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," Siegel said.

Priscilla Martinez-Matyszczyk, the deputy scientific director of the Alcohol Research Group, contextualized the recent fluctuations within historical patterns. "We’ve seen this before, where there is a spike in alcohol use after traumatic populationwide events," Martinez-Matyszczyk said. "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."

Why It Matters

The health implications of these drinking patterns are notable given the established risks associated with alcohol consumption. Alcohol-related liver disease is the leading cause of liver transplants in the U.S. Yearly cancer deaths linked to alcohol have doubled over the last three decades. People between the ages of 50 to 64 are over two and a half times as likely to die from chronic alcohol abuse compared to acute alcohol-related conditions. The concentration of heavy drinking in this age group coincides with heightened biological vulnerability to liver damage.

What's New

Later reporting provided additional context on the mechanisms behind drinking trends and the scope of existing research. "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," he said. The National Health Interview Survey is conducted by the Centers for Disease Control and Prevention and has been used for over 50 years to provide accurate population estimates on health behaviors, including alcohol use.

The Alcohol Research Group has conducted the National Alcohol Surveys since the 1960s, with the most recent survey conducted in 2014-2015, providing long-term data on alcohol use patterns in the U.S. "Alcohol relates to cultural norms and societal peer pressure, so drinking less might start amongst a couple people in your peer group for certain reasons, but then it becomes a domino effect, and the whole peer group might drink less," he said. "But overall, I would not see this as a big victory in any way because the rates have been so high, even before the pandemic," Siegel said. The Alcohol Research Group has completed over 153 studies and supported 137 affiliated projects over the past 45 years, focusing on a broad range of health and mental health outcomes related to alcohol use. In a prior meta-analysis of six national survey series, adult alcohol use and binge drinking trends were analyzed from the early 21st century, showing a steady rise in alcohol use since the 2000s before the pandemic. According to the National Institute on Alcohol Abuse and Alcoholism, apparent per capita alcohol consumption in the U.S. rose by 4% from 2018 to 2020, aligning with the observed increase in alcohol use during the pandemic.