Binge Drinking Rates Increasing Among Young Female Adults, Study Finds

New research is shedding light on sex-based differences in binge and heavy drinking patterns among US adults, highlighting notable fluctuations in drinking patterns relative to historical trends.1

Leveraging National Survey on Drug Use and Health (NSDUH) data from 2017 to 2019 and 2021 to 2023, the study found past-month binge drinking rates were greater among young adult females than males during the 2021 to 2023 period, reversing 2017 to 2019 patterns, whereas males in other age groups continued to binge and heavy drink at higher rates than females.1

According to alcohol-associated liver disease practice guidance from the American Association for the Study of Liver Diseases, women have a greater risk of liver injury compared with men for any level of drinking. While rates of alcohol use disorder and high-risk drinking have increased in the US in recent years, some of the greatest surges have been observed among women.2

“Sex-based differences in alcohol use have narrowed over the last decade,” Bryant Shuey, MD, MPH, a clinician investigator in the Center for Research on Health Care and an assistant professor in the department of general internal medicine at the University of Pittsburgh, and colleagues wrote.1 “Alcohol-related liver disease and mortality have increased more rapidly among young and middle-aged adult females than males, a trend that worsened beginning in 2020.”

To examine sex-based differences in binge and heavy drinking in recent years, investigators conducted a cross-sectional analysis of NSDUH data for adults ≥ 18 years of age in the 2017 to 2019 and 2021 to 2023 periods. Investigators noted that since NSDUH incorporated web-based interviews beginning in 2020, they excluded that year and did not statistically compare trends between the 2 periods.1

Using NSDUH data, investigators assessed sex-based differences in past-month binge drinking, defined by the Substance Abuse and Mental Health Services Administration as ≥ 5 alcoholic drinks for males or ≥ 4 alcohol drinks for females on the same occasion, and heavy drinking, defined as binge drinking on ≥ 5 days in the past 30 days, across NSDUH-derived age groups: 18 to 25, 26 to 49, 50 to 64, and ≥65 years of age.1

In total, the unweighted sample included 267,843 respondents, the majority of whom were female (51.5%) and 26 to 49 years of age (40.5%).1

From 2017 to 2019, investigators noted females had significantly lower overall past month binge drinking levels than males (22.6 vs 29.2 per 100 persons; rate difference, −6.6; 95% CI, −7.3 to −5.8) and among adults 18 to 25 years of age (36.4 vs 37.7 per 100 persons; rate difference, −1.2; 95% CI, −2.3 to −1.1).1

From 2021 to 2023, females had significantly lower overall past month binge drinking levels than males (21.8 vs 25.7 per 100 persons; rate difference, −3.9; 95% CI, −4.7 to −3.1). In contrast, females 18 to 25 years of age had greater binge drinking levels than males (31.6 vs 29.9 per 100 persons; rate difference, 1.8; 95% CI, 0.2 to 3.3).1

Additionally, from 2017 to 2019, females had significantly lower past month heavy drinking levels than males (4.5 vs 8.3 per 100 persons; rate difference, −3.7; 95% CI, −4.1 to −3.4). This trend persisted during the 2021 to 2023 period, where females again had significantly reduced heavy drinking levels compared with males (5.0 vs 7.8 per 100 persons; rate difference, −2.8; 95% CI, −3.2 to −2.3).1

Investigators pointed out female adults had significantly lower heavy drinking levels than male adults across all age groups from 2017 to 2019 and 2021 to 2023.1

“Given rising alcohol-related liver disease and mortality among females relative to males, clinicians should ensure that young adult female populations are being appropriately screened for binge and heavy drinking to mitigate downstream alcohol-related health impacts,” investigators concluded.1

References

1. Shuey B, Wen H, Suda KJ, et al. Sex-Based Differences in Binge and Heavy Drinking Among US Adults. JAMA. doi:10.1001/jama.2025.2726

2. Crabb DW, Im GY, Szabo G, et al. Diagnosis and Treatment of Alcohol‐Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology. doi:10.1002/hep.30866