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Adult Excessive Alcohol Consumption Rate Trends in the United States
January 08, 2025:From pre-pandemic to during the pandemic, heavy alcohol use among Americans rose nearly 20%. This increase in drinking was sustained through 2022. Excessive alcohol consumption has been linked to adverse health outcomes, such as increased risk of cancer, heart disease, stroke, and mental health conditions, such as anxiety and depression.
To understand the current trends of excessive alcohol consumption at the national and state-levels in the United States, we used SHADAC’s State Health Compare tool to analyze data on the measure, “Percent of Adults Reporting Excessive Alcohol Consumption in the Past 30 Days”.
Continue reading to learn more about these general trends, along with drinking trends amongst various subpopulations.
A Note on Methods
In May of 2024, SHADAC changed the way we measure risky drinking behaviors, pivoting from measuring only "binge drinking" to measuring "excessive alcohol consumption", which encompasses both binge drinking and heavy drinking. Below, you can see the definitions between these drinking terms are similar, but the 'excessive alcohol consumption' definition is the most comprehensive.
To identify any significant changes in excessive alcohol consumption patterns or trends, SHADAC researchers conducted statistical testing to compare 2023 rates to 2022 rates of excessive alcohol consumption at both the national and state level, as well as an analysis by race and ethnicity.
National Excessive Alcohol Consumption Rates 2019-2023
In 2023, the United States experienced its lowest rate of excessive alcohol consumption in the last five years. 16.4% of U.S. adults reported binge and/or heavy drinking in 2023, significantly lower than the 2022 rate of 17.9%.
Figure 1. National Adult Excessive Alcohol Consumption Rate Over Time, 2019-2023
Long description of Figure 1 found in “National Excessive Alcohol Consumption Rates 2019-2023” section of this blog.
Excessive Alcohol Consumption by Race and Ethnicity
At the national level, excessive alcohol consumption rates decreased for all available racial and ethnic groups - African American/Black, Hispanic/Latino, Other/Multiple Races, and White - from 2022 to 2023.
Note: these racial/ethnic groups were selected based on available data. State Health Compare does not have available data for some racial/ethnic groups, due to low response rates. However, SHADAC is hopeful this data gap will be addressed in the future in order to conduct equitable analyses. Learn more in SHADAC’s presentation on demographic data collection to advance health equity.
Rates of excessive alcohol consumption were significantly lower for Hispanic/Latino, Other/Multiple Races, and White adults in 2023 compared to 2022.
17.1% of Hispanic/Latino adults reported excessive alcohol consumption in 2023, a decrease from 19.8% in 2022. The rate for individuals of Other/Multiple Races decreased from 14.9% in 2022 to 13.1% in 2023. White adults reported a decrease in excessive alcohol consumption from 18.8% in 2022 to 17.6% in 2023.
The rate for African American/Black adults was statistically unchanged from 2022 to 2023, with a reported rate of 13.7% in 2022 and 13.3% in 2023.
This breakdown also follows the national trend of an overall reduction in reported excessive alcohol consumption.
Figure 2. National Adult Excessive Alcohol Consumption Rate by Race / Ethnicity Over Time, 2019-2023
Long description of Figure 2 found in “Excessive Alcohol Consumption by Race and Ethnicity” section of this blog.
Geographic Region Highlight: Excessive Alcohol Consumption in the Midwest
Midwest states, such as Iowa, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin, have had historically higher rates of binge or heavy drinking compared to other states. From 2022 to 2023, though, nearly all midwestern states, except South Dakota, saw a decrease in their reported excessive alcohol consumption.
Minnesota and Wisconsin had significantly lower rates of excessive alcohol consumption in 2023 compared to 2022 (18.1% compared to 21.0% in Minnesota and 19.6% compared to 21.4% in Wisconsin).
The rate in Iowa decreased from 22.5% in 2022 to 21.2% in 2023. Nebraska’s rate decreased from 20.3% in 2022 to 19.9% in 2023. North Dakota reported a 1.6 percentage-point decrease from 2022 to 2023, with 23.8% in 2022 and 22.2% in 2023. Finally, South Dakota saw an increase in excessive alcohol consumption with 20.1% reporting in 2022 and 21.2% reporting in 2023.
Although all of these states reported higher rates of excessive alcohol consumption than the national rate, it is still promising to note that nearly all are following the national trend of an overall reduction in excessive alcohol consumption from years prior. And, while some of the midwestern reductions were not significant decreases, the overall lower levels of excessive alcohol consumption in a region with historically high drinking rates could reflect an overall shift in drinking trends in the U.S.
Continued monitoring of these trends in coming years will help to understand whether these reductions in the Midwest, and nationally, reflect a change in trend trajectory or whether they represent an anomaly amongst the historic trends.
Figure 3. Adult Excessive Alcohol Consumption by State, Midwest Region, 2019-2023
Long description of Figure 3 found in “Geographic Region Highlight: Excessive Alcohol Consumption in the Midwest” section of this blog.
Excessive Alcohol Consumption: Looking Forward
As trends of excessive alcohol consumption at both the national and state-level are decreasing, this is a promising step in the right direction for public health. Less alcohol consumption can improve overall health, quality of life, and safety. Reducing alcohol consumption also may lead to a reduction in alcohol-related deaths, as there are more than 178,000 deaths attributable to excessive alcohol consumption.
However, as we mentioned earlier, it will be important to continue to monitor these trends to answer important questions, like:
- Is this current trend of decreasing excessive alcohol consumption one that will continue?
- Will historic regional trends continue despite national reductions?
- What other subpopulations could benefit from disaggregated data analysis?
- How are varied demographic subpopulations rates of drinking different from the national and/or state-level rates? How can we target interventions specifically to reduce drinking in communities that have higher rates of excessive drinking?
Continue to monitor the data on State Health Compare and check out some related measures like Adult Smoking and Opioid Related and Other Drug Poisoning Deaths.
You can also read one of our latest SHADAC briefs for insight into alcohol-related deaths.
