Pandemic-era increase in alcohol use persists, research shows

From pre-pandemic (2018) to the height of the pandemic (2020), heavy alcohol use among Americans rose by 20%, and any alcohol use rose by 4%. In 2022, the increases were sustained.

The rise in drinking was seen across all age groups, genders, race, ethnicities and regions of the country, except for Native Americans and Asian Americans. Adults ages 40-49 had the highest increase in heavy alcohol use.

"These numbers reflect an alarming public health issue that could result in severe health consequences for far too many people," said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine of USC and principal investigator of the study. "Our results suggest men and women under 50 are at special risk."

Excessive alcohol use is a leading preventable cause of illness and death in the United States, according to the Centers for Disease Control and Prevention. Half of all liver-related deaths are caused by alcohol, and alcohol-related cirrhosis is now the leading cause of liver transplants, according to Lee.

To reach their conclusions, researchers studied data from the National Health Interview Survey, one of the largest and most comprehensive health surveys in the country. The survey collected alcohol use information as well as demographic and socioeconomic data for more than 24,000 adults age 18 or older. They compared 2018 with 2020 alcohol use numbers, then 2018 with 2022.

While the U.S. Department of Health and Human Services announced the official end of the pandemic in May 2023, the study defined the year 2022 as post-pandemic, as behaviors were beginning to return to normal.

Adults were characterized as having any alcohol use or heavy alcohol use within one year of the survey, and researchers calculated the rate of both measures of alcohol use. Heavy drinking was defined as greater than or equal to five drinks a day or 15 drinks a week for men, and greater than or equal to four drinks a day or eight drinks a week for women.

The study did not analyze why there was an increase in alcohol consumption between 2018 to 2022, but Lee hypothesizes that pandemic stress may have caused drinking to become more normalized. He further speculates that the effects of the pandemic, including disruptions to school and work, may have driven the increases in alcohol use in adults ages 40-49.

Lee hopes the study will bring more awareness to the issue. "We encourage health care providers to offer more screenings for harmful drinking as well as interventions for at-risk populations," he said.

Divya Ayyala-Somayajula, MD, from Thomas Jefferson University in Philadelphia, was lead author of the study.

Jennifer Dodge, MPH, an associate professor of research medicine and population and public health science at the Keck School of Medicine of USC, Adam Leventhal, PhD, professor of population and public health sciences at the Keck School and director of the USC Institute for Addiction Science, and Norah Terrault, MD, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases at the Keck School, were also study authors.