Is alcohol consumption in the United States (U.S.) decreasing or increasing?

From the Guidelines

Alcohol consumption in the U.S. is actually declining, with a gradual decrease in per capita consumption since the early 2000s, particularly among younger generations. According to the American Cancer Society guideline for diet and physical activity for cancer prevention 1, approximately 50.7% of the US population aged ≥12 years reported current alcohol consumption in 2016, with about 6% being heavy alcohol drinkers and 24.2% being binge drinkers.

Key Findings

• The guideline recommends that it is best not to drink alcohol, and those who do choose to drink should limit their consumption to no more than 1 drink per day for women and 2 drinks per day for men 1.
• Alcohol consumption is an established cause of at least 7 types of cancer, including cancers of the upper aerodigestive tract, liver, colorectal, and female breast cancers 1.
• The carcinogenic effects of ethanol found in alcoholic beverages and acetaldehyde involve DNA and protein damage and alterations, oxidative stress, inhibition of DNA repair and cell death, increased cell proliferation, nutritional malabsorption, changes in DNA methylation, and, for breast cancer, increased estrogen levels 1.

Trends in Alcohol Consumption

• The percentage of adults who abstain from alcohol has increased, while heavy drinking rates have decreased slightly.
• The "sober curious" movement has contributed to this shift by normalizing reduced consumption and alcohol-free alternatives.
• Economic factors, such as financial pressures faced by younger generations, also play a role in the decline of alcohol consumption.

Demographic Variations

• While overall consumption is down, certain demographic groups still maintain higher drinking rates.
• Pandemic-related increases in consumption were observed temporarily but appear to be returning to the longer-term downward trend.

From the Research

Alcohol Consumption Trends in the U.S.

• There is no direct evidence in the provided studies to suggest that alcohol consumption in the U.S. is declining or increasing 2, 3, 4, 5, 6.
• The studies focus on the effectiveness of various treatments for alcohol use disorder, such as Alcoholics Anonymous and 12-Step Facilitation interventions 3, 5, and the management of alcohol withdrawal in outpatient settings 6.
• One study examines the relationship between alcohol craving and withdrawal symptoms and alcohol use outcomes during outpatient treatment 4.
• Another study discusses the implementation of outpatient alcohol withdrawal management in a substance use disorder bridge clinic and short-term clinical outcomes 6.

Treatment Outcomes and Effectiveness

• Manualized AA/TSF interventions are more effective than other established treatments, such as CBT, for increasing abstinence 3, 5.
• Non-manualized AA/TSF may perform as well as other established treatments for alcohol-related outcomes 3.
• AA/TSF interventions produce similar benefits to other treatments on all drinking-related outcomes except for continuous abstinence and remission, where AA/TSF is superior 5.
• Outpatient alcohol withdrawal management in a bridge clinic provides an opportunity to engage patients from marginalized groups and improve treatment outcomes 6.

Healthcare Cost Savings

• AA/TSF interventions demonstrate higher healthcare cost savings than other AUD treatments 3, 5.
• One study found that total medical care costs decreased for participants attending CBT, MET, and AA/TSF treatment, with AA/TSF having higher potential cost savings than MET for participants with worse prognostic characteristics 3.