WASHINGTON, September 22 — Alcohol use across the United States has fallen for the first time since the COVID-19 pandemic, federal survey data show, and the decline is being driven almost entirely by younger Americans while their elders drink more.
The National Survey on Drug Use and Health, the annual federal study run by the Substance Abuse and Mental Health Services Administration under the Department of Health and Human Services, found that 47.6 percent of Americans aged 12 and older reported drinking in the past month in 2023, down from 48.7 percent in 2022 and 50.0 percent in 2021. The NSDUH has tracked alcohol, tobacco and illicit drug use among Americans aged 12 and older since 1971, making it the nation’s most comprehensive ongoing source of behavioral health data.
A generational split
The pullback is sharpest among 18- to 25-year-olds. Past-month drinking in that group fell to 45.7 percent in 2023 from 49.4 percent in 2022. Binge drinking — five or more drinks for men, four or more for women, on one occasion in the past month — dropped among young adults from 29.8 percent to 27.0 percent over the same period.
A 2023 Gallup poll pointed the same direction, finding that 62 percent of adults under 35 said they drink alcohol, down from 72 percent two decades earlier. Researchers attribute the shift among Millennials and Generation Z — those born between 1981 and 2012 — to greater health consciousness, the rise of alcohol-free social alternatives, the legalization of recreational cannabis in many states, and changing social norms around drinking.
The pandemic years ran the other way. In 2020, U.S. alcohol sales rose 3.1 percent in volume, according to the National Institute on Alcohol Abuse and Alcoholism — the largest annual increase in more than 50 years — and emergency department visits involving alcohol climbed sharply through 2020 and 2021. Only in 2022 and 2023 did younger adults begin pulling back.
Older drinkers move against the current
Adults aged 50 to 64 are bucking the trend. Past-month alcohol use in that cohort rose from 54.5 percent in 2021 to 56.6 percent in 2023, and binge drinking increased from 12.6 percent to 13.4 percent. Researchers point to stress, social isolation and retirement transitions as possible drivers.
The NIAAA has warned that older adults metabolize alcohol more slowly and are more likely to take medications that interact with it, raising the risk of falls, chronic disease and alcohol-related hospitalizations. The divergence carries consequences for both public health and business.
Major producers including Anheuser-Busch InBev, Molson Coors and Diageo have invested in non-alcoholic beer, wine and spirits, a category that grew by more than 20 percent in volume in 2023, according to NielsenIQ data. The NIAAA estimates alcohol contributes to about 178,000 deaths in the United States each year, making it a leading preventable cause of death.
Strategically, the calculus here is demographic: the aging of the Baby Boomer generation — those born between 1946 and 1964 — means the 50-to-64 cohort will soon move into the 65-plus group, where alcohol-related health risks run higher still. Younger Americans are drinking less, but the overall public health burden may not decline for years as heavier-drinking older adults age into higher-risk categories.
What this signals for the next round of NSDUH data is a test of whether the youth decline holds or merely reflects a generational handoff. Watch the 65-plus numbers, and watch whether the non-alcoholic category keeps absorbing the demand that younger drinkers are no longer supplying.
