Changes In Drinking 2001-2014

Changes in U.S. drinking: Who is drinking more and who is drinking less?
by Mark Nason, MSW , Research Analyst, PRI

Two large studies in the U.S. were published this year focusing on changes in drinking over approximately a 10-year period. Below are some of the key findings from these studies, as well as data from the largest national annual survey of alcohol and drug choices among youth.

In Short

Who was drinking more? Adults in general, and women and minorities in particular. The percentage of adults using drugs also increased.
Who was drinking less? Youth under the drinking age. This decrease is not explained by substituting drugs for alcohol—drug use dropped for some ages and was stable for others.
The gender gap has continued to narrow; however, adult males still far exceed adult females in drinking large quantities, developing alcohol use disorders, and dying from alcohol-related causes.
The vast majority of Americans of any age either did not drink in the past 30 days or usually did not exceed three drinks in any day in the past 30 days.
Self-reported driving under the influence of alcohol decreased significantly for many age groups.

Comments

While no survey is perfect, the studies overviewed here are among the best. We do not view any particular statistic as “truth.” The greatest value of survey data is seeing changes that occur over time. These studies give us reason for hope and for alarm.

Specifics

Adults ages 18 and older

Comparing results for 2001-2002 to 2012-2013 from the National Epidemiologic Survey on Alcohol and Related Conditions, researchers found significant increases in drinking among adults. The following data is summarized from Dawson, et al. (2015).

In 2012-2013:

Adults who drank in the past year averaged about 1¼ drinks per day, and drank on average about 1.7 days/week.
Nearly three-fourths of past-year drinkers did not consume more than four drinks in a single day in the past 30 days (aka, heavy episodic drinking; HED); even in the heaviest drinking group (ages 18-24), 60% did not engage in HED.

Changes from 2001-2002 to 2012-2013:

Sizable and statistically significant increases in percentage of past year drinkers among all the adult age groups
Fairly large and statistically significant increases in average number of ounces of pure alcohol per day among past year drinkers ages 25-64
Fairly small, but statistically significant increases in number of days of drinking among past year drinkers ages 25-44
Sizable and statistically significant increases in percentage of HED among past year drinkers ages 25 and older

	Past Year Drinkers [Percentage]		Ounces of pure alcohol averaged per day among past-year drinkers		Frequency of drinking [Days in past year; among drinkers]		Five or more drinks in a single day at least once in the past 30 days [Percentage of drinkers]
Ages	2012-2013	Change from 2001-2002	2012-2013	Change from 2001-2002	2012-2013	Change from 2001-2002	2012-2013	Change from 2001-2002
18-24	78	+7*	0.86	-0.11	65	-1	40	+1
25-44	80	+8*	0.82	+0.22*	80	+6*	30	+6*
45-64	72	+8*	0.74	+0.16*	96	+2	20	+5*
65+	55	+10*	0.47	+0.03	114	-2	12	+6*
All adults	73	+7*	0.75 (1.25 drinks/day)	+0.12* (0.2 drinks/day)	88 (1.7 days/week)	+4* (0.1 days/week)	26	+4*
Statistically significant All percentages are rounded Source: Dawson, D. A., Goldstein, R. B., Saha, T. D., & Grant, B. F. (2015). Changes in alcohol consumption: United States, 2001–2002 to 2012–2013. Drug and Alcohol Dependence, 148*, 56-61. [p. 58; Table 2]

Additional findings:

Increases in drinking were greater among women than men; nevertheless, HED rates in 2012-2013 were still substantially lower for females than males (20% versus 32%, respectively) (p. 58: Table 2).
Increases in volume of drinking were limited to wine and liquor consumption (p. 58).
When controlling for other demographics like age, the proportion of past-year drinkers increased for all major race-ethnic minorities (p. 59, Table 3).
Most of the increase in HED was among Blacks. Whites had a slightly higher rate than Blacks in 2001-2002, and in 2012-2013, Blacks had a slightly higher rate than Whites. When controlling for other demographic factors such as age, only Blacks still had a significant increase in HED (p. 59, Table 3).

Other data indicates drug use also increased during this time period. According to 2001 and 2013 National Survey on Drug Use and Health (NSDUH) data, past month illicit drug use rose from 7.1% (Figure 2.1) in 2001 to 9.4% in 2013 for ages 12 and older, combined (Table 1.11B). Examination of data for ages 12-17 indicates the increase in drug use was entirely among adults (18+).

More on Gender Differences

Other researchers compared results from the National Survey on Drug Use and Health (NSDUH) for 2002 through 2012. The results indicate gender differences in drinking appear to be continuing to narrow, at least for most of the drinking measures in the study. Nonetheless, this study found males still have a substantially greater prevalence of alcohol use disorders than females. Other studies suggest there are also extensive gender differences in very heaving drinking and in drinking-related deaths. For example, among ages 18-29 in 2012-2013, 46% of men and 22% of women reported drinking 8 or more drinks and 38% of men and 14% of women reported drinking 10 or more drinks on a single occasion (Grant et al., 2015; p. E8). Data from the Centers for Disease Control indicate that the average number of deaths from alcohol each year from 2006-2010 was 62,104 for males and 25,693 for females (CDC, 2014). The following data is summarized from White, et al. (2015).

In 2012:

About 12% of adults ages 21 and older were lifelong abstainers
Among Americans 12 years of age and older, a little over half had a least one drink in the past 30 days
The average onset of drinking for adults ages 21 and older was about age 17
Past 30-day drinkers averaged about eight days of drinking out of the last 30 days
Past 30-day drinkers averaged nearly three drinks per occasion
About 16% of female past 30-day drinkers and 30% of male past-30 day drinkers reported HED in the past 30 days
Among those engaging in HED, the average number of days of HED in the past 30 days was about 3.5 for females and 5 for males
DSM-IV alcohol use disorders (AUD) were nearly twice as common among males than females in most age groups (for ages 12 and older combined: 9.0% and 4.6% had an AUD, respectively)

From 2002 to 2012:

Among females and males ages 12-17, there was significantly fewer drinkers, less frequent and less heavy drinking among those who did drink, and fewer individuals with alcohol use disorders
Increase in lifetime abstinence for males aged 18-25 and females aged 18-20 and 35-44; otherwise little to no change in lifetime abstinence for adults
A greater percentage of adult females from most age groups reported they drank in the past 30 days
Both genders initiated drinking at a somewhat older age
Number of drinking days in the past 30 days increased for females aged 26-34 and decreased for males aged 18-25
Usual number of drinks per occasion in the past 30 days did not change for most age groups
The percentage of drinkers engaging in HED increased among most adult women and decreased for males aged 12-25
The number of days of HED did not change for females and decreased for males aged 12-25
Any DSM-IV AUD (abuse or dependence) in the past 12 months remained unchanged for adults of both genders, with the exception of significant decreases among males aged 18 to 25
DSM-IV alcohol dependence in the past 12 months remained largely unchanged for adults of both genders, with the exceptions of significant decreases among males aged 18 to 25 and an increase among women aged 45-64

Ages	Lifetime Abstinence [Percentage]				Drank in past 30 days [Percentage]				Average age of onset of drinking among ever drinkers [Years]				Number of drinking days in past 30 days
	Female		Male		Female		Male		Female		Male		Female		Male
	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002
12+	20	0	15	+1*	48	+3*	56	-1	18	+0.3*	16.4	+0.4*	7.3	+0.5*	9.5	-0.4*
12-17	68	+11*	68	+11*	13	-5*	13	-4%*	13.7	+0.5*	13.3	+0.6*	3.9	-0.6*	3.9	-1.4*
21-25	10	-2	9	1	65	+5*	73	0	17	+0.7*	16.5	+0.9*	6.4	+0.4	8.6	-0.4*
26-34	12	-1	7	0	60	+6*	69	0	17.2	+0.5*	16.5	+0.8*	6.5	+0.9*	8.8	+0.3
35-44	14	+3*	7	1	56	2	67	0	17.5	+0.5*	16.4	+1.0*	6.6	+0.2	8.7	-0.4
All percentages are rounded. Data for each year between 2002 and 2012 and additional adult age groups were also reported, but not included here for the sake of brevity. Statistically significant. Source: White, A., Castle, I. J. P., Chen, C. M., Shirley, M., Roach, D., & Hingson, R. (2015). Converging patterns of alcohol use and related outcomes among females and males in the United States, 2002 to 2012. Alcoholism: Clinical and Experimental Research*, 39(9), 1712-1726. [p. 1715, Table 1 and p. 1717, Table 2]

Ages	Usual number of drinks in past 30 days [Drinks among past 30-day drinkers]				Five or more drinks in a single day (HED) at least once in the past 30 days [Percentage of drinkers]				Number of HED days in past 30 days [Days among HED drinkers]				AUD in past 12 months [Percentage]
	Female		Male		Female		Male		Female		Male		Female		Male
	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002	2012	Change from 2002
12+	2.3	-0.1	3.4	-0.2	16	+1*	30	-1	3.5	0	4.9	-0.3	5	0	9	-2*
12-17	3.6	-0.5	5.2	-0.3	7	-3*	7	-4*	2.9	-0.4	3.3	-0.7*	4	-2*	3	-3*
21-25	3.1	-0.2	4.6	-0.5	37	+4*	53	-2	3.5	-0.4	5.0	-0.7*	12	0	19	-5*
26-34	2.7	+0.2	3.9	-0.2	26	+5*	46	0	3.2	0	4.8	-0.1	7	+1	14	-1
35-44	2.3	-0.1	3.5	-0.1	19	-1	38	+1	3.5	+0.3	5.1	+0.4	4	-1	10	-2
All percentages are rounded. Data for each year between 2002 and 2012 and additional adult age groups were also reported, but not included here for the sake of brevity. Statistically significant. Source: White, A., Castle, I. J. P., Chen, C. M., Shirley, M., Roach, D., & Hingson, R. (2015). Converging patterns of alcohol use and related outcomes among females and males in the United States, 2002 to 2012. Alcoholism: Clinical and Experimental Research*, 39(9), 1712-1726. [p. 1717, Table 2; p. 1718, Table 3; and p. 1719, Table 4]

Additional findings:

Self-reported driving under the influence of alcohol decreased significantly for males aged 12-44 and for females aged 12-25 and 35-44. For example, among ages 21 to 25 (the age group with the highest percentage of self-reported driving under the influence), the percentage of females reporting driving under the influence dropped from 24% to 18% and from 36% to 26% for males. With the exception of ages 12-20, males were much more likely than females to report driving under the influence of alcohol (p. 1720, Table 5).
Combining marijuana use with alcohol increased for females aged 12-17 and for males aged 12-25 and 45-64 (p. 1721, Table 6)
HED decreased among college students aged 18-20 and among men aged 18-25 who did not attend college full time. HED remained unchanged for college students aged 21-25 but increased among women aged 21-25 who either did not attend college or were not full-time college students (p. 1723, Table 7)

More on Usual Number of Drinks

The study by White, et al. (2015) reported average usual number of drinks among past 30-day drinkers (as shown in the chart above). For many age groups, these average usual amounts exceeded three drinks which might suggest that most past 30-day drinkers typically exceed three drinks per day. To test this, we ran analyses in the same 2012 NSDUH dataset used by White et al. to determine the percentages of past-30 day drinkers who did not exceed three drinks as their usual amount. As data in the table below indicates, with the exception of males aged 16-20, the majority of past 30-day drinkers did not exceed three drinks as their usual amount. The table also shows percentages for those who did not drink in the past 30 days and those who either did not drink or did not usually exceed three drinks. The data clearly indicates the vast majority of Americans either did not drink or did not usually exceed three drinks in a day.

	Did not drink in past 30 days [Percentage]			Usually drank no more than 3 on any day in past 30 days [Percentage among past 30-day drinkers]			Either did not drink or usually drank no more than 3 on any day in past 30 days [Percentage]
	Female	Male	Total	Female	Male	Total	Female	Male	Total
12-13	98	98	98	75	87	81	100	100	100
14-15	90	91	90	74	67	71	97	97	97
16-17	77	78	78	59	44	52	91	88	89
12-17	88	89	89	64	53	59	96	95	95
18-20	57	55	56	58	39	48	82	73	77
21-25	36	28	32	71	53	62	82	67	74
18-25	43	39	41	68	49	58	82	69	75
26-34	42	32	37	82	60	70	89	73	81
35-49	45	36	41	86	70	78	93	81	87
18-49	44	35	40	80	62	71	89	75	82
50-64	51	42	47	93	79	86	96	88	92
65 and older	64	54	60	98	91	94	99	96	98
50 and older	57	47	52	95	83	89	98	91	95
All percentages are rounded Source: United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health, 2012. ICPSR34933-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2013-11-26. http://doi.org/10.3886/ICPSR34933.v1].

More Youth Data

Data from the Monitoring the Future (MTF) study (the largest annual survey of drinking and drug use among youth) indicates substantial reductions in drinking and drug use among some ages. Below is data for 2001 and 2013 (Johnson et al., 2014). These years were chosen to match the years of the two recently published journal articles. MTF data for 2014 and 2015 indicate alcohol use, getting drunk, and illicit drug use in the past 30 days have each continued to drop for 8^th, 10^th, and 12^th graders.

In 2013:

Among 8^th graders, 96% did not get drunk and 91% did not use illicit drugs in the past 30 days
Among 10^th graders, 87% did not get drunk and 81% did not use illicit drugs in the past 30 days
Among 12^th graders, 74% did not get drunk and 74% did not use illicit drugs in the past 30 days
Among college students, 60% did not get drunk and 77% did not use illicit drugs in the past 30 days

From 2001 to 2013:

Large and statistically significant drops in drinking and getting drunk in the past year and the past 30 days occurred for college students and for 8^th, 10^th, and 12^th graders.
A sizeable and statistically significant drop in illicit drug use occurred among 8^th graders and a proportionately smaller and statistically significant decrease in illicit drug use occurred among 10^th graders.
Since drug use decreased for 8^th and 10^th graders and did not change significantly among 12^th graders or college students, the drop in alcohol consumption for these groups was not a matter of substitution with drugs.
Among ages 19-28, the only statistically significant change in the measures shown below was a fairly small increase in drug use.

	Past Year Drinkers		Been Drunk in past year		Past 30 Days Drinkers		Been Drunk in past 30 days		Any illicit drug use in past 30 days
	2013	Change from 2001	2013	Change from 2001	2013	Change from 2001	2013	Change from 2001	2013	Change from 2001
8th graders	22	-20*	8	-8*	10	-11*	4	-4*	9	-3*
10th graders	47	-16*	27	-13*	26	-13*	13	-9*	19	-3*
12th graders	62	-11*	44	-10*	39	-11*	26	-7*	26	0
College students	76	-7*	58	-11*	63	-4*	40	-5*	23	+1
Young Adults (ages 19-28)	83	-2	63	0	69	+2	38	+1	22	+3*
Statistically significant All percentages are rounded Source: Johnston, L. D., O’Malley, P. M., Bachman, J. G.,Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume 2, College students and adults ages 19*–55. Ann Arbor: Institute for Social Research, The University of Michigan. [p. 57, Table 2-2; pp. 59 & 62, Table 2-3]

References:

CDC (2014) Alcohol-Related Disease Impact (ARDI). Centers for Disease Control and Prevention, Atlanta, GA. Retrieved online 12/10/2015 http://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=AD96A9C1-285A-44D2-B76D-BA2AE037FC56&F=&D=

Center for Behavioral Health Statistics and Quality. (2014). 2013 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD. Retrieved online 8/11/15 http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2013.pdf

Dawson, D. A., Goldstein, R. B., Saha, T. D., & Grant, B. F. (2015). Changes in alcohol consumption: United States, 2001–2002 to 2012–2013. Drug and Alcohol Dependence, 148, 56-61.

Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., ... & Hasin, D. S. (2015). Epidemiology of DSM-5 alcohol use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry, 72(8), 757-766.

Johnston, L. D., O’Malley, P. M., Bachman, J. G.,Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume 2, College students and adults ages 19–55. Ann Arbor: Institute for Social Research, The University of Michigan.

Substance Abuse and Mental Health Services Administration. (2002). Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of National Findings (Office of Applied Studies, NHSDA Series H-17, DHHS Publication No. SMA 02-3758). Rockville, MD.

White, A., Castle, I. J. P., Chen, C. M., Shirley, M., Roach, D., & Hingson, R. (2015). Converging patterns of alcohol use and related outcomes among females and males in the United States, 2002 to 2012. Alcoholism: Clinical and Experimental Research, 39(9), 1712-1726.

Survey Methodologies

Monitoring the Future (MTF)

MTF is an annual survey, first conducted in 1975.

Sample: Multistage random sampling of 8^th, 10^th and 12^th graders; in 2013, about 15,000 8th graders from 143 schools, about 13,000 10th graders from 120 schools, and about 13,000 12th graders from 126 schools

Conducted by: University of Michigan Survey Research Center; sponsored by the National Institute on Drug Abuse

How: Pencil-paper, machine-readable survey forms administered by University of Michigan personnel in the normal classrooms

National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

NESARC was first conducted in 2001-2002, with a 3-year follow-up in 2004-2005, and a survey with new participants in 2012-2013.

Sample: Nationally representative samples of adults ages 18 and older living in households and noninstitutional group quarters; 43,093 in 2001-2002 and 36,309 in 2012-2013

Conducted by: Census Bureau in 2001-2002 and Westat Inc. in 2012-2013; sponsored by the National Institute of Alcohol Abuse and Alcoholism

How: Personal interviews in respondents’ homes

National Survey on Drug Use and Health (NSDUH)

NSDUH, formerly the National Household Survey on Drug Abuse, is an annual survey, first conducted in 1988.

Sample: Nationally representative cross-sectional survey of noninstitutionalized U. S. citizens ages 12 or older; public use dataset included data from 55,268 people in 2012

Conducted by: RTI International; sponsored by the Substance Abuse and Mental Health Services Administration

How: Combination of computer-assisted face-to-face interviews and audio computer-assisted self-administered interviews in homes