Epidemiology of Alcohol Use and Alcohol Problems

Part 1. Prevalence Rates: National Survey on Drug Use and Health

Although the Monitoring the Future Project is the best source of epidemiological data on adolescents, it is limited by the age range it covers and by the exclusion of students not attending school. The most comprehensive source of epidemiological data on alcohol and drug use among both young people and adults is the National Survey on Drug Use and Health (NSDUH). This is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older that is based on face-to-face interviews in a representative sample of U.S. households. Prior to 2002, the survey was called the National Household Survey on Drug Abuse (NHSDA). Unfortunately, data from earlier years are no longer comparable to data collected since 2002 because of important changes in methodology. Most notably, respondents in the 2002-2010 NSDUH surveys, unlike earlier respondents, were paid $30 for their participation. This financial incentive improved the response rate for interviews and increased prevalence estimates for alcohol and drug use. However, improvements like this came at the cost of comparability with earlier surveys.

NSDUH collects information from residents of households, noninstitutional group quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases ages 12 and over. Persons excluded from the survey include homeless persons who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. The graph below presents results for men and women from the 2010 NSDUH survey, which completed usable interviews with 68,487 respondents, aged 12 and over. It depicts the prevalence of three types of drinking by age for the noninstitutionalized U.S. population.

The NSDUH survey includes questions about the recency and frequency of consumption of alcoholic beverages, such as beer, wine, whiskey, brandy, and mixed drinks. An extensive list of examples of the kinds of beverages covered is given to respondents prior to the question administration. A "drink" is defined as a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. Times when the respondent only had a sip or two from a drink are not considered as consumption. Estimates for the prevalence of alcohol use are reported primarily at three levels defined for both males and females and for all ages as follows:

  • Current use - At least one drink in the past 30 days (includes binge and heavy use).

  • Binge use - Five or more drinks on the same occasion at least once in the past 30 days (includes heavy use).

  • Heavy use - Five or more drinks on the same occasion on at least 5 different days in the past 30 days.

Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2010 survey (51.8 percent). This translates to an estimated 131.3 million people, which was similar to the 2009 estimate of 130.6 million people (51.9 percent). In general, the overall rate of alcohol use and number of drinkers in the United States has changed very little over the past few years.

Nearly one quarter (23.1 percent) of persons aged 12 or older participated in binge drinking at least once in the 30 days prior to the survey in 2010. This translates to about 58.6 million people. The rate in 2010 was similar to the rate in 2009 (23.7 percent).

Finally, heavy drinking was reported by 6.7 percent of the population aged 12 or older, or 16.9 million people in 2010. This percentage was similar to the rate of heavy drinking in 2009 (6.8 percent).

Rates of alcohol use and heavy drinking vary markedly by age. As shown in the graph below, the prevalence of current (thirty-day) alcohol use in 2010 increased from 3.1 percent at aged 12 or 13 to 70.0 percent of persons 21-25 years old. Among older age groups, the prevalence of alcohol use decreased with increasing age, from 65.3 percent among 26 to 29 year olds to 51.6 percent among 60 to 64 year olds and 38.2 percent among people aged 65 or older. The rate of "binge drinking" was 40.6 percent for young adults aged 18 to 25 in 2010. Heavy alcohol use was reported by 13.6 percent of persons aged 18 to 25. Whereas illegal drug use peaks in the 18-20 age category, the early 20s are the "prime time" for heavy drinking in the United States.

NSDUH 2010 Alcohol by Age

Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age

Source: 2010 National Survey on Drug Use and Health
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