America's History of Drinking
As the opioid crisis dominates discourse about substance abuse in America, a separate challenge has quietly emerged in recent years. Some medical research suggests Americans are drinking alcohol more frequently overall, and high-risk forms of drinking are also on the rise. According to these studies, increased alcohol use is particularly evident in a few demographics, including women, minorities, and older individuals. Although dependence on alcohol has long plagued large swaths of the American public, these findings necessitate new conversations about the prevalence and treatment of alcoholism across the country.
In this project, we sought to create a recent history of Americans' consumption of alcohol. To do so, we analyzed two large-scale federal data sets, the National Survey on Drug Use and Health and the CDC's Behavioral Risk Factor Surveillance System. We studied data from 2004 through 2016 (the latest data on record) to track drinking trends and make demographic comparisons by age and gender. To learn how America's drinking habits have shifted in recent years, keep reading.
American Drinking: On Occasion and in Excess
Between 2004 and 2016, roughly two-thirds of Americans reported drinking on at least one occasion within the last year. Similarly, rates of heavy drinking in the last 30 days held largely constant, declining only slightly during that period. Likewise, the percentage of people reporting dependence on alcohol was slightly lower in 2016 than in 2014. Each of these data points can be interpreted as neutral or marginally encouraging, but the reality for many American drinkers is far less rosy.
Researchers have described a troubling rise in binge drinking, and our findings attest to a gradual but definite increase over the 12-year period studied. Interestingly, many people unknowingly meet the binge-drinking standard on a typical night out. Whereas some think of binges as all-night benders, they typically consist of four drinks in one sitting for women and five drinks for men. And while binges might not indicate alcohol dependence, they pose massive health and safety challenges for the country as a whole.
Intoxication Across the Nation
To study geographical differences in drinking trends, we turned to data from the CDC's Behavioral Risk Factor Surveillance System. In some states, drinking patterns changed significantly over the period studied. Tennessee, home to an eclectic set of drinking laws and dry counties, saw a substantial surge in the percentage of residents drinking overall and serious spikes in binge and heavy drinking as well.
Likewise, South Carolina witnessed a 21.9 percent uptick in adult drinking and a similar increase in binge-drinking rates. North Dakota, noted for consuming quite a lot of alcohol relative to its modest population, also saw increases in each drinking category. Conversely, places such as Oklahoma saw significant declines in binge, heavy, and overall drinking rates. Puerto Rico, which exhibited a similar pattern of lowered rates across the board, represents an interesting case: The territory has a drinking age of just 18, which would make more people legally eligible to indulge in alcohol.
Drinking Habits, by Gender
Historically, researchers have concluded American men drink alcohol more heavily and frequently than their female counterparts. To some extent, our 2016 data confirm this pattern. Men were more than twice as likely as women to report heavy drinking in 2016. Additionally, nearly 3 in 10 men reported binge drinking in the past 30 days. Just 2 in 10 women said the same.
Our data suggest that gender gap may be gradually closing, however. Between 2004 and 2016, rates of binge drinking and heavy alcohol use among men declined. For women, rather, these metrics increased noticeably. Some academics attribute changes in female drinking patterns to the dissolution of old gender norms: Women no longer face as much judgment for indulging in alcohol as they did in decades past. This shift can come with challenges, however. Relative to male drinkers, women encounter a different set of health risks associated with excessive alcohol use, including an additional risk of liver inflammation and breast cancer.
Alcohol Abuse, by Age
Among younger Americans, the prevalence of alcohol abuse declined drastically between 2004 and 2016. In the 12- to 17-year-old cohort, the incidence of dependence and abuse was more than 100 percent lower in 2016 than in 2004. For those aged 18 to 25, the rate declined 48 percent over that period. Those between the ages of 26 and 49 also saw reduced rates of alcohol abuse and dependence, although to a much more modest extent.
Among those 50 and older, however, alcohol abuse and dependence increased slightly during the 12-year period considered. This trend is especially concerning, as researchers note older Americans face grave consequences related to excessive drinking, including an elevated risk of disability, illness, and death. Moreover, older adults are more likely to take medication for chronic conditions, and alcohol use can greatly reduce the efficacy of these medicines (or make for a dangerous combination).
The Age of Experimentation
Our data depict a definite trend in younger Americans delaying their first drinking experiences. Between 2004 and 2016, the percentage of individuals waiting until they reached the legal drinking age to try alcohol rose incrementally. Additionally, by 2016, nearly a fifth of individuals had never tried alcohol, a significant increase over 2004 figures. These findings support other research suggesting declining rates of drinking among American teenagers, although alcohol abuse remains a serious problem for many young people.
According to our 2016 figures, women were 46.6 percent more likely than men to wait until turning 21 to start drinking. They also elected not to drink at all at higher rates than their male counterparts. This difference may decrease in the coming years, however. Recent national data indicates adolescent females are catching up to male peers in their binge-drinking patterns.
The medical community warns that mixing drugs and alcohol can produce dangerous and unpredictable interaction effects. But our findings suggest a significant portion of drinkers may be attempting this risky experiment. According to 2016 figures, nearly a third of individuals who reported heavy drinking in the last 30 days also used illicit drugs during that time frame. More than a fifth of people who had been binge drinking in the last month used drugs as well.
In each successive age group, however, the percentage of drinkers who also used drugs declined. Among heavy drinkers aged 12 to 17, for example, more than two-thirds also used drugs in the last month. Conversely, less than 18 percent of heavy drinkers aged 50 and older had consumed drugs in the last month. The same pattern was evident among recent binge drinkers. Although the majority of binge drinkers aged 12 to 17 had also gotten high within the last month, that percentage steadily shrunk in older age groups.
Drinking History, Hopeful Futures
Our results suggest significant changes in the drinking patterns and preferences of some demographics. That such substantial shifts could occur over just 12 years demonstrates the need for ongoing research. If public health officials can proactively perceive a growing need for treatment, the nation can adapt to problematic drinking trends with lower costs and greater efficiency. Adequate solutions will never be simple or easy, but real change begins with an accurate understanding of those in need. Until we acknowledge the scope of the challenges before us, little improvement will be possible at the national level.
When it comes to individuals struggling with alcohol dependence, however, American families have much reason for hope. The evidence-based treatment for alcoholism can permanently transform lives for the better. With so many options at your disposal, selecting the appropriate level of care for yourself or a loved one can be confusing. Consult our resources or speak with our team of professionals to get help today.
For this project, we compiled data from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, and the National Survey on Drug Use and Health (NSDUH), 2004-2016.
"The National Survey on Drug Use and Health (NSDUH) series, formerly titled National Household Survey on Drug Abuse, is a major source of statistical information on the use of illicit drugs, alcohol, and tobacco and on mental health issues among members of the U.S. civilian, non-institutional population aged 12 or older. The survey tracks trends in specific substance use and mental illness measures and assesses the consequences of these conditions by examining mental and/or substance use disorders and treatment for these disorders."
NSDUH data were weighted by each year to account for the American population, and data before 2002 were not comparable to more recent years due to population estimate changes.
By tapping into over a decade of government data, we constructed a broad look at alcohol use and preferences over the past to view changes in trends.
In addition, we accessed data from the CDC's Behavioral Risk Factor Surveillance System to create the geographical drinking view. Data directly comparable were available for a five-year period from 2012 to 2016.
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