Heavy drinking among Americans in their 50s and early 60s has surged even as younger adults cut back, according to new national data from Keck Medicine of USC. The study, published this week in Annals of Internal Medicine, finds that overall alcohol use in the United States fell between 2022 and 2024, while heavy drinking among adults ages 50 to 64 rose by more than 36 percent since 2018.
Researchers at Keck Medicine analyzed responses from 114,352 adults who took part in the National Health Interview Survey between 2018 and 2024, one of the country’s largest ongoing health surveys. Using self-reported data collected privately online rather than over the phone, the team tracked trends in both “any alcohol use” and “heavy drinking,” allowing them to compare pre-pandemic patterns with those that emerged during and after COVID-19.
Across all adults, the share of people who drank at all fell by nearly 2 percent from 2022 to 2024, and heavy drinking declined by more than 8 percent. The shift was most pronounced among younger generations: alcohol use among Gen Z adults dropped by more than 5 percent over that two-year span, while millennials saw heavy drinking fall by about 17 percent. Coverage of the study by national outlets such as NBC News and CNN notes that these declines line up with broader cultural trends, including “sober curious” social identities and the growing popularity of non-alcoholic options in restaurants and bars.
Adults ages 50 to 64, many of whom fall in Generation X with some younger Baby Boomers, moved in the opposite direction. From 2018 to 2024, any alcohol use in this age bracket increased by nearly 4 percent, and heavy drinking climbed by more than one-third. “Heavy drinking among ages 50-64 is up by more than a third since 2018, a concerning trend because this age group faces some of the greatest risks of harm from alcohol, including cirrhosis and alcohol-related cancers,” hepatologist Brian P. Lee said in a statement released by Keck Medicine.
Lee and his co-authors stress that the risks for middle-aged adults are not theoretical. In the Keck Medicine release summarizing the findings, Lee notes that alcohol now accounts for roughly half of liver-related deaths and that alcohol-associated cirrhosis has become the leading cause of liver transplants in the United States. Data from the National Institute on Alcohol Abuse and Alcoholism similarly show millions of Americans reporting heavy alcohol use each month, with older adults disproportionately affected by chronic liver disease and other complications.
The new report follows an earlier Keck Medicine study, also published in Annals of Internal Medicine, which documented a sharp rise in drinking during the pandemic. That research found heavy alcohol use increased by about 20 percent from 2018 to 2020, with elevated levels persisting into 2022. Lee said in the latest statement that it is “encouraging” to see alcohol use declining for the first time since COVID-19, but he cautioned that overall drinking remains above pre-pandemic levels and that some groups now face “concerning trends.”
For pastors and ministry leaders, the numbers highlight a generational split: younger adults are increasingly open to cutting back, while many in midlife are drinking more often and more heavily. While the Keck Medicine team did not investigate why younger adults are reducing their alcohol use, they suggest that changing social attitudes, health awareness, and the availability of non-alcoholic alternatives may be part of the explanation. The findings point to a need for age-specific prevention and treatment efforts, with clinicians and communities paying particular attention to alcohol risks among adults approaching retirement.
Study authors call for continued monitoring of alcohol trends and for health systems to prioritize screening and counseling for older adults who may not see their drinking as a problem. As congregations and Christian recovery ministries walk with members through chronic illness, grief, and economic stress—factors often linked to increased substance use—the data suggest that intentional outreach to Gen X and younger Boomers could become an increasingly important part of pastoral care.