Alcohol use among women has been increasing for years. It is unclear if this trend in increased consumption also includes increases in intensive binge drinking. This study looked at sex-based differences in heavy alcohol use using recent US survey data.
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The difference between women’s and men’s use of alcohol has been declining in the United States (US). Overall men drink more alcohol than women – an estimated 68% of men and 64% of women report drinking alcohol in the past year – but trends in national data show that this gender gap is narrowing. Between 2000 and 2016, yearly rates of alcohol use and binge alcohol use (i.e., reporting 4+/5+ drinks on a single occasion for women/men) increased by 6% and 14% among adult women but decreased by 2% and .5% for men. Evidence also shows that these changes in women’s alcohol use vary across the lifespan. Research shows that alcohol use among adolescents and young adults has been decreasing, but males are decreasing alcohol consumption faster than females. Furthermore, women in their 30s and 40s have been reporting increasing alcohol consumption and binge drinking.
With socio-cultural changes in many western societies including the United States during the past 60 years, women have gained more employment, economic independence, and empowerment, and simultaneously have been targeted by the alcohol industry as potential new alcohol consumers. Such changes have resulted in trends of increasing alcohol use among women that has correlated with numerous negative alcohol-related outcomes as women begin to catch up fast with men in terms of consequences. Arrests for driving under the influence of alcohol involving female drivers increased from 11% in 1989 to 24% in 2012. There is also evidence that emergency room department visits involving alcohol increased more for women than men. Data from 1999-2017 also shows that deaths related to alcohol-induced injuries and overdoses increased for young adult women but did not change for men. Compounding this increase in alcohol use among women is the “risk-severity paradox,” wherein women seem to suffer greater harms than men at lower levels of alcohol use. There is a critical need to continue to monitor the gender gap in alcohol use and to determine for which women alcohol use may be increasing. To this end, the current study sought to determine rates of alcohol use among women and men across multiple time points and compare rates of alcohol use across age groups.
This study analyzed data from the National Survey on Drug Use and Health (NSDUH). The NSDUH is an annual survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). The NSDUH provides nationally representative data on rates of substance use (i.e., alcohol, tobacco, and illicit drugs), substance use disorders, and receipt of substance use and mental health treatment. The NSDUH samples people living in the US who are: 1) aged 12 years or older, 2) non-institutionalized (e.g., not imprisoned), and 3) not active-duty military personnel. In addition, because of how the survey is conducted, respondents have a fixed address and can answer the questionnaire in English/Spanish.
For the present analysis, the authors included US adult (18+ years of age) respondents across 2 waves of the NSDUH: 2017-2019 and 2021-2023. The authors choose not to include data from collection period 2020 as in this year the NSDUH introduced web-based instruments, which were not comparable to measures used in other survey years. All NSDUH data were de-identified (anonymous) – the only demographic data reported were participants’ age and sex (i.e., assigned at birth).
The main outcome of the study was sex-differences in self-reported past month binge alcohol use (4+/5+ drinks for women/men on one occasion) and heavy drinking, (i.e., binge drinking on 5 or more days in the past month). Sex-differences were examined across age groups (18-25, 26-49, 50-64, and ≥65 years). The authors calculated time-period specific alcohol use rates per 100 persons – that is, they estimated the number of individuals who reported heavy/binge alcohol use per 100 persons, another way of reporting percentages. All analyses were stratified by respondents’ sex (male or female). Data were weighted to better reflect the US population (i.e., to reduce bias caused by overrepresentation of certain values within datasets due to sampling). All models adjusted for insurance status, poverty level, presence of children in the household, income level, education level, rurality, and employment status. Such statistical adjustments help to isolate the effect of interest – i.e., whether participants’ sex is independently related to their binge/heavy alcohol use.
This study had a sample of 267,843 people (128,319 from the 2017-2019 NSDUH survey waves and 139,524 from the 2021-2023 NSDUH survey waves). The sample was evenly split between women (51.5%) and men (49.5%). Most participants were between the ages of 36-49 years of age (40.5%).
Women reported less heavy alcohol use than men across all time points
Analyses showed that from 2017-2019 an estimated 5% of women reported past month heavy alcohol use compared to 8% for men. This was similar from 2021-2023 where, again, 5% of women and 8% of men were drinking heavily. Lower alcohol use among female respondents was consistent across ages – adult women reported lower heavy drinking levels than adult men across all age groups in data from 2017-2019 and 2021-2023.
Women reported less binge alcohol use than men from 2017-2019
Analyses estimated that 22% of women reported past month binge drinking compared to 29% of men. This lower reported alcohol use was also found among young adults (36% vs 38% women/men ages 18-25) although the margin was narrower.
Young adult women reported more binge alcohol use than men from 2021-2023
Overall, women reported less past month binge alcohol use from 2021-2023. Estimates showed that, overall, 22% of women reported binge alcohol use compared to 26% of men. However, as shown in the graph below, specifically among those 18-25, 32% of women reported binge drinking vs. 30% of men.
The results of this study show that overall adult women reported less binge and heavy alcohol use than their male peers. However, when the authors stratified the most recent data by age, they found that women ages 18-25 reported more past month binge alcohol use than same aged men.
The alcohol use differences between women and men in this study may be due to multiple changes in adults’ drinking behavior. For example, young adult (18-25 year old) women may appear to be binge drinking alcohol more than their male peers due to men reporting more rapid declines in binge drinking relative to women. Concurrently, the lack of difference between women and men overall may be due to the recent increases in alcohol use reported by adult women beginning to level off. This is speculative, and more research is needed, as it is beyond the scope of the present study to indicate why men and women’s alcohol use may be changing over time.
Overall women reported less heavy and binge alcohol use then men across time. However, the study also found that young adult women ages 18-25 reported more binge alcohol use than men in data from 2021-2023. It is unknown why this was found, but it may be that social/structural changes during the COVID-19 pandemic in 2020 catalyzed changes in the more established sex-specific alcohol use trends. This is speculative as the data do not allow for examining behavioral trends. Future research to understand the underlying reasons for the narrowing sex-gap in alcohol use is critical for developing public health interventions.
Shuey, B., Wen, H., Suda, K. J., Burnett, A., Wharam, J. F., Anderson, T. S., & Liebschutz, J. M. (2025). Sex-based differences in binge and heavy drinking among US adults. JAMA, 33(20), 1831-1833. doi: 10.1001/jama.2025.2726.
l
The difference between women’s and men’s use of alcohol has been declining in the United States (US). Overall men drink more alcohol than women – an estimated 68% of men and 64% of women report drinking alcohol in the past year – but trends in national data show that this gender gap is narrowing. Between 2000 and 2016, yearly rates of alcohol use and binge alcohol use (i.e., reporting 4+/5+ drinks on a single occasion for women/men) increased by 6% and 14% among adult women but decreased by 2% and .5% for men. Evidence also shows that these changes in women’s alcohol use vary across the lifespan. Research shows that alcohol use among adolescents and young adults has been decreasing, but males are decreasing alcohol consumption faster than females. Furthermore, women in their 30s and 40s have been reporting increasing alcohol consumption and binge drinking.
With socio-cultural changes in many western societies including the United States during the past 60 years, women have gained more employment, economic independence, and empowerment, and simultaneously have been targeted by the alcohol industry as potential new alcohol consumers. Such changes have resulted in trends of increasing alcohol use among women that has correlated with numerous negative alcohol-related outcomes as women begin to catch up fast with men in terms of consequences. Arrests for driving under the influence of alcohol involving female drivers increased from 11% in 1989 to 24% in 2012. There is also evidence that emergency room department visits involving alcohol increased more for women than men. Data from 1999-2017 also shows that deaths related to alcohol-induced injuries and overdoses increased for young adult women but did not change for men. Compounding this increase in alcohol use among women is the “risk-severity paradox,” wherein women seem to suffer greater harms than men at lower levels of alcohol use. There is a critical need to continue to monitor the gender gap in alcohol use and to determine for which women alcohol use may be increasing. To this end, the current study sought to determine rates of alcohol use among women and men across multiple time points and compare rates of alcohol use across age groups.
This study analyzed data from the National Survey on Drug Use and Health (NSDUH). The NSDUH is an annual survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). The NSDUH provides nationally representative data on rates of substance use (i.e., alcohol, tobacco, and illicit drugs), substance use disorders, and receipt of substance use and mental health treatment. The NSDUH samples people living in the US who are: 1) aged 12 years or older, 2) non-institutionalized (e.g., not imprisoned), and 3) not active-duty military personnel. In addition, because of how the survey is conducted, respondents have a fixed address and can answer the questionnaire in English/Spanish.
For the present analysis, the authors included US adult (18+ years of age) respondents across 2 waves of the NSDUH: 2017-2019 and 2021-2023. The authors choose not to include data from collection period 2020 as in this year the NSDUH introduced web-based instruments, which were not comparable to measures used in other survey years. All NSDUH data were de-identified (anonymous) – the only demographic data reported were participants’ age and sex (i.e., assigned at birth).
The main outcome of the study was sex-differences in self-reported past month binge alcohol use (4+/5+ drinks for women/men on one occasion) and heavy drinking, (i.e., binge drinking on 5 or more days in the past month). Sex-differences were examined across age groups (18-25, 26-49, 50-64, and ≥65 years). The authors calculated time-period specific alcohol use rates per 100 persons – that is, they estimated the number of individuals who reported heavy/binge alcohol use per 100 persons, another way of reporting percentages. All analyses were stratified by respondents’ sex (male or female). Data were weighted to better reflect the US population (i.e., to reduce bias caused by overrepresentation of certain values within datasets due to sampling). All models adjusted for insurance status, poverty level, presence of children in the household, income level, education level, rurality, and employment status. Such statistical adjustments help to isolate the effect of interest – i.e., whether participants’ sex is independently related to their binge/heavy alcohol use.
This study had a sample of 267,843 people (128,319 from the 2017-2019 NSDUH survey waves and 139,524 from the 2021-2023 NSDUH survey waves). The sample was evenly split between women (51.5%) and men (49.5%). Most participants were between the ages of 36-49 years of age (40.5%).
Women reported less heavy alcohol use than men across all time points
Analyses showed that from 2017-2019 an estimated 5% of women reported past month heavy alcohol use compared to 8% for men. This was similar from 2021-2023 where, again, 5% of women and 8% of men were drinking heavily. Lower alcohol use among female respondents was consistent across ages – adult women reported lower heavy drinking levels than adult men across all age groups in data from 2017-2019 and 2021-2023.
Women reported less binge alcohol use than men from 2017-2019
Analyses estimated that 22% of women reported past month binge drinking compared to 29% of men. This lower reported alcohol use was also found among young adults (36% vs 38% women/men ages 18-25) although the margin was narrower.
Young adult women reported more binge alcohol use than men from 2021-2023
Overall, women reported less past month binge alcohol use from 2021-2023. Estimates showed that, overall, 22% of women reported binge alcohol use compared to 26% of men. However, as shown in the graph below, specifically among those 18-25, 32% of women reported binge drinking vs. 30% of men.
The results of this study show that overall adult women reported less binge and heavy alcohol use than their male peers. However, when the authors stratified the most recent data by age, they found that women ages 18-25 reported more past month binge alcohol use than same aged men.
The alcohol use differences between women and men in this study may be due to multiple changes in adults’ drinking behavior. For example, young adult (18-25 year old) women may appear to be binge drinking alcohol more than their male peers due to men reporting more rapid declines in binge drinking relative to women. Concurrently, the lack of difference between women and men overall may be due to the recent increases in alcohol use reported by adult women beginning to level off. This is speculative, and more research is needed, as it is beyond the scope of the present study to indicate why men and women’s alcohol use may be changing over time.
Overall women reported less heavy and binge alcohol use then men across time. However, the study also found that young adult women ages 18-25 reported more binge alcohol use than men in data from 2021-2023. It is unknown why this was found, but it may be that social/structural changes during the COVID-19 pandemic in 2020 catalyzed changes in the more established sex-specific alcohol use trends. This is speculative as the data do not allow for examining behavioral trends. Future research to understand the underlying reasons for the narrowing sex-gap in alcohol use is critical for developing public health interventions.
Shuey, B., Wen, H., Suda, K. J., Burnett, A., Wharam, J. F., Anderson, T. S., & Liebschutz, J. M. (2025). Sex-based differences in binge and heavy drinking among US adults. JAMA, 33(20), 1831-1833. doi: 10.1001/jama.2025.2726.
l
The difference between women’s and men’s use of alcohol has been declining in the United States (US). Overall men drink more alcohol than women – an estimated 68% of men and 64% of women report drinking alcohol in the past year – but trends in national data show that this gender gap is narrowing. Between 2000 and 2016, yearly rates of alcohol use and binge alcohol use (i.e., reporting 4+/5+ drinks on a single occasion for women/men) increased by 6% and 14% among adult women but decreased by 2% and .5% for men. Evidence also shows that these changes in women’s alcohol use vary across the lifespan. Research shows that alcohol use among adolescents and young adults has been decreasing, but males are decreasing alcohol consumption faster than females. Furthermore, women in their 30s and 40s have been reporting increasing alcohol consumption and binge drinking.
With socio-cultural changes in many western societies including the United States during the past 60 years, women have gained more employment, economic independence, and empowerment, and simultaneously have been targeted by the alcohol industry as potential new alcohol consumers. Such changes have resulted in trends of increasing alcohol use among women that has correlated with numerous negative alcohol-related outcomes as women begin to catch up fast with men in terms of consequences. Arrests for driving under the influence of alcohol involving female drivers increased from 11% in 1989 to 24% in 2012. There is also evidence that emergency room department visits involving alcohol increased more for women than men. Data from 1999-2017 also shows that deaths related to alcohol-induced injuries and overdoses increased for young adult women but did not change for men. Compounding this increase in alcohol use among women is the “risk-severity paradox,” wherein women seem to suffer greater harms than men at lower levels of alcohol use. There is a critical need to continue to monitor the gender gap in alcohol use and to determine for which women alcohol use may be increasing. To this end, the current study sought to determine rates of alcohol use among women and men across multiple time points and compare rates of alcohol use across age groups.
This study analyzed data from the National Survey on Drug Use and Health (NSDUH). The NSDUH is an annual survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). The NSDUH provides nationally representative data on rates of substance use (i.e., alcohol, tobacco, and illicit drugs), substance use disorders, and receipt of substance use and mental health treatment. The NSDUH samples people living in the US who are: 1) aged 12 years or older, 2) non-institutionalized (e.g., not imprisoned), and 3) not active-duty military personnel. In addition, because of how the survey is conducted, respondents have a fixed address and can answer the questionnaire in English/Spanish.
For the present analysis, the authors included US adult (18+ years of age) respondents across 2 waves of the NSDUH: 2017-2019 and 2021-2023. The authors choose not to include data from collection period 2020 as in this year the NSDUH introduced web-based instruments, which were not comparable to measures used in other survey years. All NSDUH data were de-identified (anonymous) – the only demographic data reported were participants’ age and sex (i.e., assigned at birth).
The main outcome of the study was sex-differences in self-reported past month binge alcohol use (4+/5+ drinks for women/men on one occasion) and heavy drinking, (i.e., binge drinking on 5 or more days in the past month). Sex-differences were examined across age groups (18-25, 26-49, 50-64, and ≥65 years). The authors calculated time-period specific alcohol use rates per 100 persons – that is, they estimated the number of individuals who reported heavy/binge alcohol use per 100 persons, another way of reporting percentages. All analyses were stratified by respondents’ sex (male or female). Data were weighted to better reflect the US population (i.e., to reduce bias caused by overrepresentation of certain values within datasets due to sampling). All models adjusted for insurance status, poverty level, presence of children in the household, income level, education level, rurality, and employment status. Such statistical adjustments help to isolate the effect of interest – i.e., whether participants’ sex is independently related to their binge/heavy alcohol use.
This study had a sample of 267,843 people (128,319 from the 2017-2019 NSDUH survey waves and 139,524 from the 2021-2023 NSDUH survey waves). The sample was evenly split between women (51.5%) and men (49.5%). Most participants were between the ages of 36-49 years of age (40.5%).
Women reported less heavy alcohol use than men across all time points
Analyses showed that from 2017-2019 an estimated 5% of women reported past month heavy alcohol use compared to 8% for men. This was similar from 2021-2023 where, again, 5% of women and 8% of men were drinking heavily. Lower alcohol use among female respondents was consistent across ages – adult women reported lower heavy drinking levels than adult men across all age groups in data from 2017-2019 and 2021-2023.
Women reported less binge alcohol use than men from 2017-2019
Analyses estimated that 22% of women reported past month binge drinking compared to 29% of men. This lower reported alcohol use was also found among young adults (36% vs 38% women/men ages 18-25) although the margin was narrower.
Young adult women reported more binge alcohol use than men from 2021-2023
Overall, women reported less past month binge alcohol use from 2021-2023. Estimates showed that, overall, 22% of women reported binge alcohol use compared to 26% of men. However, as shown in the graph below, specifically among those 18-25, 32% of women reported binge drinking vs. 30% of men.
The results of this study show that overall adult women reported less binge and heavy alcohol use than their male peers. However, when the authors stratified the most recent data by age, they found that women ages 18-25 reported more past month binge alcohol use than same aged men.
The alcohol use differences between women and men in this study may be due to multiple changes in adults’ drinking behavior. For example, young adult (18-25 year old) women may appear to be binge drinking alcohol more than their male peers due to men reporting more rapid declines in binge drinking relative to women. Concurrently, the lack of difference between women and men overall may be due to the recent increases in alcohol use reported by adult women beginning to level off. This is speculative, and more research is needed, as it is beyond the scope of the present study to indicate why men and women’s alcohol use may be changing over time.
Overall women reported less heavy and binge alcohol use then men across time. However, the study also found that young adult women ages 18-25 reported more binge alcohol use than men in data from 2021-2023. It is unknown why this was found, but it may be that social/structural changes during the COVID-19 pandemic in 2020 catalyzed changes in the more established sex-specific alcohol use trends. This is speculative as the data do not allow for examining behavioral trends. Future research to understand the underlying reasons for the narrowing sex-gap in alcohol use is critical for developing public health interventions.
Shuey, B., Wen, H., Suda, K. J., Burnett, A., Wharam, J. F., Anderson, T. S., & Liebschutz, J. M. (2025). Sex-based differences in binge and heavy drinking among US adults. JAMA, 33(20), 1831-1833. doi: 10.1001/jama.2025.2726.
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