Yes, alcoholism is on the rise in the United States by nearly every measure. Alcohol-related deaths jumped 29% between 2016 and 2021, climbing from roughly 138,000 per year to 178,000. Heavy drinking increased during the COVID-19 pandemic and, critically, has not returned to pre-pandemic levels.
The Numbers Behind the Increase
The CDC tracked deaths from excessive alcohol use across three periods: 2016–2017, 2018–2019, and 2020–2021. Between the first two periods, deaths rose a modest 5.3%. Then the increase accelerated sharply, jumping nearly 23% from 2018–2019 to 2020–2021. That acceleration was roughly four times the pace of the earlier rise, adding more than 40,000 deaths per year in just a few years.
These numbers include deaths fully caused by alcohol (like alcoholic liver disease) and deaths where alcohol played a contributing role (like certain cancers and injuries). The age-adjusted death rate rose from about 38 per 100,000 people to nearly 48 per 100,000, meaning the increase isn’t simply a reflection of population growth.
The Pandemic Made It Worse, and It Stuck
A nationally representative study published in the Annals of Internal Medicine compared alcohol use in 2018, 2020, and 2022 to determine whether pandemic drinking habits faded once lockdowns ended. They didn’t. Any alcohol use rose about 2.7 percentage points between 2018 and 2020, and by 2022 it had actually ticked slightly higher, up about 3 percentage points from pre-pandemic levels. Heavy drinking followed the same pattern: a 20% relative increase that held steady two years after the pandemic’s peak.
This matters because many experts initially expected a temporary spike. Instead, the data suggest that millions of people adopted heavier drinking habits during the pandemic and kept them.
Women Are Driving Much of the Change
One of the most striking trends is how much faster drinking has increased among women compared to men. Among adults in their late 20s through mid-30s, binge drinking among women climbed from about 21% to 26%, while rates among men barely budged (45.7% to 46.1%). In the 45-to-64 age range, binge drinking among women rose from 9.5% to 13%, while men’s rates stayed essentially flat.
Multiple national surveys confirm the same pattern across age groups. In adulthood, many studies found decreases or no change in men’s drinking over time, but steady, significant increases among women. Between 2000 and 2015, women saw rises in overall alcohol use, binge drinking, high-risk drinking, and diagnosed alcohol use disorder, while rates among men did not change. Among older adults, binge drinking has only significantly increased among women, not men. The gender gap in problem drinking, once enormous, is narrowing fast.
Young Adults Are Getting Sicker Sooner
The health consequences are showing up earlier in life than previous generations experienced. Hospitalizations for alcohol-related liver disease among young adults (ages 20 to 44) are rising at more than twice the rate of older adults: 4.48% per year compared to 1.78%. Among young adults, those in their 30s account for the largest share of the increase. Advanced liver scarring, the kind that used to be associated with decades of heavy drinking, has risen most steeply in the 20-to-29 age group.
Rates among young adults climbed from about 107 hospitalizations per 100,000 to 145 per 100,000. These are people developing serious organ damage in what should be some of the healthiest years of their lives.
Older Adults Face Growing Risk
At the other end of the age spectrum, drinking among people 65 and older is expanding rapidly. The percentage of older adults who drink monthly increased 16% between 2002 and 2019. But because the Baby Boomer generation is so large, the actual number of drinkers in that age group grew by 80% over the same period.
The consequences are severe. In 2022 and 2023, people 65 and older accounted for nearly 41% of all alcohol-attributable deaths, according to the CDC. Older bodies process alcohol more slowly, and drinking interacts dangerously with the medications many older adults take daily. A level of drinking that felt manageable at 50 can become genuinely hazardous at 70.
One Bright Spot: Teenagers Are Drinking Less
The one age group moving decisively in the right direction is adolescents. Binge drinking among boys dropped from 28.4% in 2008 to 18.5% in 2017, a 35% decline. Among girls, it fell from 21.3% to 14.6% over the same period. Young adults aged 18 to 20 also showed declines, though the decreases were larger among men than women. Gen Z appears to be approaching alcohol differently than previous generations, though whether this carries into their 30s and 40s remains to be seen.
The Global Picture Varies Widely
Globally, the trends depend heavily on region. South Asia saw the most dramatic increase in per capita alcohol consumption between 2000 and 2020, rising roughly 149% from 1.6 liters of pure alcohol per person per year to 3.9 liters. East Asia (up 57%) and Southeast Asia (up 46%) also saw large jumps. Meanwhile, Eastern Europe, historically one of the heaviest-drinking regions on earth, saw consumption drop 21%, from about 12.9 liters per person to 10.1. Parts of Sub-Saharan Africa also declined significantly. The global story is not a uniform rise but a geographic shift, with consumption climbing in Asia while falling in several regions that previously had the highest rates.
Most People With a Problem Never Get Help
Despite rising rates of heavy drinking and alcohol-related harm, the vast majority of people who develop a drinking problem never receive treatment. A global meta-analysis found that only about 17% of people with alcohol use disorder seek any type of help, whether through formal healthcare, support groups, or other settings. In high-income countries in Europe and North America, fewer than 10% of people who meet the diagnostic criteria receive formal treatment. One U.S. estimate put the past-year treatment rate at just 7.7%.
Alcohol use disorder is diagnosed when someone meets at least 2 of 11 criteria within a 12-month period. These include drinking more than intended, unsuccessful attempts to cut back, spending a lot of time drinking or recovering from it, craving alcohol, giving up activities to drink, and continuing despite worsening physical or mental health. Meeting 2 to 3 criteria indicates a mild disorder; 4 to 5 is moderate; 6 or more is severe. Many people who would qualify for a diagnosis don’t recognize their drinking as a problem, in part because heavy consumption has become so normalized.
That normalization, combined with a treatment gap this wide, helps explain why alcohol-related deaths keep climbing even as awareness of the risks grows. More people are drinking heavily, fewer demographic groups are exempt from the trend, and the system designed to help is reaching only a small fraction of those who need it.