Americans are drinking slightly less now than they were at the height of the pandemic, but the overall level of alcohol use remains above pre‑2020 figures, a new analysis of national health data shows.
Overall drinking trends
The study, published Monday in Annals of Internal Medicine, examined four years of the National Health Interview Survey (NHIS) – 2018, 2020, 2022 and 2024 – to track changes in both any alcohol use and heavy drinking. From 2022 to 2024, the prevalence of drinking fell by roughly 1%, a modest but statistically notable reversal after the sharp pandemic‑era spike.
Men reported a larger decline in any drinking than women (2.4% versus 1.1%). Heavy drinking, defined as five or more drinks per day (or 15 per week) for men and four per day (or eight per week) for women, dropped by 7.7% among men and 9% among women over the same period.
Age‑specific patterns
Reductions were not uniform across age groups. Generation Z adults showed the biggest drop in overall drinking – more than 5% between 2022 and 2024 – while millennials recorded the steepest decline in heavy drinking, a 17% fall. Despite these improvements, both cohorts still reported drinking rates that were marginally higher than in 2018.
In contrast, adults aged 50 to 64 experienced a rise in heavy drinking. The share of heavy drinkers in this bracket grew by about 2% from 2022 to 2024, and the increase represents more than a one‑third rise since 2018. Dr. Brian P. Lee, a liver‑transplant surgeon at Keck Medicine of USC and senior author of the study, described the change as a “30% increase, that’s about a million people drinking heavily in that age group alone.”
Health risks and expert concerns
Lee warned that the middle‑aged group is especially vulnerable to alcohol‑related damage. “The average age of developing cirrhosis is in the 50s, and a 50‑year‑old liver is more likely to scar with the same amount of alcohol as a 20‑year‑old liver,” he said. He added that heavy drinking raises the risk of high blood pressure, stroke, digestive problems, and that alcohol‑related liver disease is now the leading cause of liver transplants in the United States. Cancer deaths linked to alcohol have doubled over the past three decades.
Dr. Michael Siegel, a public‑health professor at Tufts University School of Medicine, echoed the concern, noting that many heavy drinkers in their 50s and 60s have likely been consuming large amounts for years, compounding health risks.
Historical context of alcohol use
Alcohol consumption in the United States has been on an upward trajectory since around 2000, following a decline in the late 1980s and 1990s. The pandemic amplified this trend, with 2020 seeing a 20% jump in heavy alcohol use and a 4% rise in any use compared with 2018, according to the study. Priscilla Martinez‑Matyszczyk, deputy scientific director of the nonprofit Alcohol Research Group, linked the spike to “traumatic population‑wide events,” citing a similar post‑9/11 increase. She noted that such spikes are often followed by modest declines, but the underlying long‑term trend remains upward.
While the recent modest drop offers a glimmer of optimism, the continued elevation of overall drinking and the pronounced increase among middle‑aged adults suggest that public‑health interventions remain essential.
Steve Lopez is a Senior Editorial Columnist and Health & Public Policy reporter for News Raise. Steve focuses on healthcare advancements, medical technologies, and public health policies.
