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Alcohol Abuse Statistics in 2023

Alcohol abuse threatens the health and safety of millions of Americans each year. Rates of alcohol abuse have increased in recent years, and in 2023, it remains a significant problem.

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Key Facts

  • According to the most recent National Survey on Drug Use and Health (NSDUH), nearly 220 million Americans ages 12 and older report having consumed alcohol at some point in their lives.
  • Over 62 million people reported binge drinking in the past year, with over 16.3 million people reporting heavy alcohol use in the past month. Such forms of alcohol abuse raise the risk of health, personal, familial, and economic hardship.

Alcohol Use Disorder 

Millions of Americans struggle with some degree of alcohol use disorder (AUD). As of 2021, over 28 million adults ages 18 and older struggled with consuming alcohol appropriately. AUD exists on a spectrum, ranging from mild to severe. It includes both binge drinking and having an addiction to alcohol. 

The initial onset of drinking at an early age greatly increases the risk of developing AUD later in life. Adults who first started drinking before they were 15 years old have a significantly increased risk of developing AUD as adults (more than three times higher) than those who waited until they were 21 years old to start drinking. 

Health Risks of Alcohol Abuse

Alcohol abuse poses the risk of significant adverse health effects. Many vital organs in the body are impacted by alcohol. 

People who abuse alcohol are at increased risk of many diseases, including liver and heart disease, depression, stroke, and stomach bleeding. Alcohol abuse also increases the risk of certain cancers, including cancer of the mouth, esophagus, larynx, pharynx, liver, colon, and rectum. 

An increase in risky sexual behaviors, which exposes individuals to a range of health concerns, is also associated with alcohol abuse. 

Data published in 2022 shows that nearly half of all deaths related to liver disease involved alcohol. In males, over 50% of liver disease deaths involved alcohol, with 42.8% of liver disease deaths in women involving alcohol. 

Studies have also found an association between alcohol use and increased risk of physical injury due to violence, falling, car crashes, and drowning. 

Deaths Related to Alcohol Abuse

Alcohol is involved in many fatal accidents. Since 2020, fatal car accidents involving alcohol have increased. 

From 2020 to 2021, fatalities involving alcohol-impaired drivers increased by 14%. In 2021, 31% of driving fatalities were caused by alcohol-impaired drivers. 

Alcohol abuse is also associated with causing many fatal diseases. Chronic conditions attributed to alcohol abuse include liver disease, cardiovascular disease, cancer, and AUD. Of people who die by suicide, approximately one in four people have AUD and approximately 21% of people who die by suicide have a blood alcohol concentration of 0.1% or higher, shares the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Binge Drinking

Binge drinking is a particularly risky form of alcohol abuse, as it can raise the blood alcohol content to dangerously high levels. People who binge drink, defined as five or more drinks at once for men and four or more drinks at one time for women, are not necessarily dependent on alcohol, though they are still abusing it. 

Binge drinking increases the risk of disease, serious injury, and AUD. One in six adults in the U.S. report binge drinking. Of those adults, a quarter binge drink weekly. 

Of adults who drink excessively, over 90% report binge drinking. Binge drinking can cause alcohol poisoning, which results in an estimated 2,300 deaths per year. 

Alcohol Abuse & COVID

A rise in alcohol abuse was observed throughout the COVID-19 pandemic. Once the U.S. declared COVID-19 a public health emergency in January 2020, alcohol-related deaths in people ages 16 and older in the U.S. began to rise. 

From 2019 to 2020, deaths involving alcohol increased by 25.5%. They continued to increase throughout the spring of 2020, as many people experienced new levels of isolation. The number of deaths related to alcohol abuse remained high throughout the first half of 2021 as well. 

During the first year of the COVID-19 pandemic, alcohol sales increased by 2.9%, which is the greatest annual increase seen in over 50 years. Stress, anxiety, and previous alcohol misuse are likely factors that contributed to increased drinking and alcohol-related deaths. 

Increased drinking throughout the pandemic also resulted in a greater number of transplants for alcohol-related liver diseases and visits to emergency rooms for alcohol poisoning and withdrawal. 

Alcohol Abuse Among Young Adults

According to the 2021 NSDUH, nearly half (49.7%) of young adults ages 18 to 25 reported drinking alcohol in the past month. Over 29% percent of the same age group reported binge drinking in the past month, with 7.2% of individuals who are 18 to 25 years old reporting past-month heavy alcohol use. NIAAA estimates that over 1,500 college students and over 2,500 people ages 18 to 24 die each year due to alcohol abuse and related accidental injuries. 

Males in this age range were more likely to drink heavily, at 7.7%, while females were at 6.5%. Of the young adults who reported heavy alcohol use, 9% were white, 5.7% were Black, 4.4% were Asian, and 4.5% were Hispanic or Latino.

Underage Drinking 

According to the most recent data collected by the NSDUH, over 13 million, or 34.4% of, adolescents and young adults ages 12 to 20 have tried alcohol at least once. Over 11 million people in this age range reported drinking in the past year, with 8.2% of this age group binge drinking in the past month, and 1.6% of young people ages 12 to 20 reporting heavy alcohol use in the past month. 

About 1.7% of males in this age range reported heavy alcohol use in the past month, compared to 1.5% of females. Regarding 12 to 20-year-olds who reported binge drinking, 10.1% were white, 7.5% were Hispanic or Latino, 5.5% were Black, and 2.5% were Asian.

While most alcohol use trends have increased across the U.S. in recent years, the 2021 NSDUH revealed a drop in underage drinking. From 2002 to 2021, adolescents ages 16 to 17 reported a 58.3% decrease in alcohol consumption. Adolescents ages 14 to 15 reported a 69.1% decrease, with a 52.8% decrease reported by 12 to 13-year-olds. 

Alcohol Abuse & Pregnancy 

The rate of alcohol use during pregnancy has increased in recent years. From 2011 to 2018, current drinking, defined as at least one drink in the past 30 days, among pregnant women increased from 9.2% to 11.3%. 

Women with frequent mental health problems and those without a regular healthcare provider were most likely to use alcohol while pregnant. As of 2020, approximately one in seven pregnant women reported drinking alcohol, with approximately one in 20 reporting binge drinking. 

Drinking during pregnancy exposes babies to fetal alcohol spectrum disorders (FASDs), which can cause physical and developmental disabilities. The Centers for Disease Control and Prevention (CDC) estimates that one in 1,000 babies are born with fetal alcohol syndrome (FAS), the most involved type of FASD. Children with FAS can experience significant disabilities, with the total cost of care over the lifetime estimated at $2 million. 

Top States for Alcohol Abuse

Alcohol abuse is a widespread problem across the country, though some states are more heavily impacted than others. Almost 17% of U.S. adults report binge drinking, and 6% report drinking heavily. Except for a few states, the Midwest tends to see the highest rates of alcohol abuse.

According to the most recent data from the Behavioral Risk Factor Surveillance System, states with the highest rates of binge drinking among adults ages 18 and older, include:

  • Wisconsin (23.5%)
  • Montana (22.9%)
  • Iowa (21.8%)
  • North Dakota (21.7%)
  • South Dakota (21.1%)
  • Nebraska (20.8%)
  • District of Columbia (20.7%)
  • Colorado (19.5%)
  • Vermont (19.2%)
  • Minnesota (19.3%)
  • Kansas and Rhode Island (18.9%)
  • Ohio (18.5%)
  • Louisiana (18.3%)
  • Missouri (18.1%)
  • Maine (17.8%)

Alcohol Abuse Treatment

Evidence-based treatments are available to help individuals recover from alcohol abuse. Treatment should be customized to the needs of each individual in treatment, so the intensity of care will vary greatly depending on the severity of the person’s alcohol abuse. 

There are currently three medications approved by the U.S. Food and Drug Administration (FDA) to help people quit drinking and avoid relapse. A combination of medication, behavioral therapy, and participation in support groups is considered the most effective treatment approach, explains NIAAA.

Studies show that less than 10% of people with AUD seek treatment services. Men are more likely to seek help for an AUD than women, and white people are more likely to utilize addiction treatment services than Black or Hispanic people. 

Alcohol abuse is a growing public health concern throughout the country. It is the third cause of preventable death in the U.S., and it costs the country an estimated $250 billion per year. 

Of individuals who enter treatment for a substance use disorder, 40% to 60% are likely to relapse at some point. However, relapse is not a failure. It can provide valuable information to guide future treatment planning. 

Recovery is a complex process, and care must be frequently updated to meet the individual’s evolving needs. The more accessible and effective treatment becomes, the more people will benefit from services that start them on their path to recovery. 

Updated August 18, 2023
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  2. Alcohol and Young Adults. (2023). National Institute on Alcohol Abuse and Alcoholism.
  3. Alcohol-Related Deaths During the COVID-19 Pandemic. (May 2022). Journal of the American Medical Association.
  4. Alcohol-Related Emergencies and Deaths in the United States. (2023). National Institute on Alcohol Abuse and Alcoholism.
  5. Binge Drinking. (November 2022). Centers for Disease Control and Prevention.
  6. Data and Statistics on FASDs. (January 2023). Centers for Disease Control and Prevention.
  7. Data on Excessive Drinking. (November 2022). Centers for Disease Control and Prevention.
  8. Deaths Involving Alcohol Increased During the COVID-19 Pandemic. (June 2022). National Institute on Alcohol Abuse and Alcoholism.
  9. Epidemiology of Recovery from Alcohol Use Disorder. (November 2020). Alcohol Research.
  10. Overview of Motor Vehicle Traffic Crashes in 2021. (April 2023). National Highway Traffic Safety Administration.
  11. Treatment and Recovery. (July 2020). National Institute on Drug Abuse.
  12. Underage Drinking in the United States (Ages 12 to 20). (2023). National Institute on Alcohol Abuse and Alcoholism.
  13. Understanding Alcohol Use Disorder. (April 2023). National Institute on Alcohol Abuse and Alcoholism.
  14. Relapse Prevention and the Five Rules of Recovery. (September 2015). Yale Journal of Biology and Medicine.
  15. Relapse Prevention. (February 2018). Indian Journal of Psychiatry.
  16. Advances in the Science and Treatment of Alcohol Use Disorder. (September 2019). Science Advances.
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