Young women now binge drink more than young men

By Dr. Jay-Sheree Allen Akambase

Young women ages 18 to 25 in the United States are now binge drinking more than their male peers, a reversal of prior trends, according to a new research letter published Wednesday.

Binge drinking is defined as a man having five or more alcoholic drinks or a woman having four or more alcoholic drinks in one sitting, or within two to three hours. Heavy drinking refers to men having 15 or more drinks per week and women having eight or more drinks per week, according to the U.S. Substance Abuse and Mental Health Services Administration.

Using data from the National Survey on Drug Use and Health, researchers found that women ages 18 to 25 reported higher rates of binge drinking than men in the same age group from 2021 to 2023, a reversal of patterns seen in 2017 to 2019.

While men in older age groups still drink more heavily overall, this shift among young adult women is raising alarms in the medical community.

"That has big implications just for health down the line … [including] the progression to alcohol related liver disease," said Dr. Bryant Shuey, lead author of the study, which was published in JAMA, and a physician at the University of Pittsburgh.

STOCK PHOTO/Monkeybusinessimages/iStockphoto/Getty Images

Stock photo of a group of women enjoying cocktails.

According to the Centers for Disease Control and Prevention, over time, drinking alcohol has been linked to several types of cancers, and excessive alcohol use can lead to heart disease, liver disease and alcohol use disorder.

One standard drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits. But Shuey said even the same amount of alcohol could affect women differently than men.

"We need more education around the harms of alcohol use and how the same amount can pose greater health risks for women than men," Shuey said.

The study only looked at two snapshots in time and didn't follow the same people over time, so they can't say whether these results are due to faster declines in drinking among young men or increasing rates among women, but Shuey pointed to several possibilities, including cultural changes around alcohol use, the likelihood of drinking among the young professional workforce and targeted alcohol marketing toward women.

Still, the overall picture is clear: The gender gap in risky alcohol use is narrowing and in the case of young women is flipping.

The findings underscore the need for better screening and intervention strategies, said Shuey. He noted that brief counseling interventions during routine medical visits can reduce alcohol consumption by up to 30% in a six to 12-month period. But many patients are never asked about their drinking.

"Screening should be a standardized process in all clinical encounters for risky alcohol use," Shuey said. He noted that asking about alcohol is already recommended in federal medical guidance, but not enough doctors ask the question.

Beyond screening, doctors can connect people to treatment, whether that's therapy, mutual support groups, or medications.

As for next steps, Shuey said he hopes this research prompts not just clinical action, but public awareness. "There needs to be more education around the harms related to alcohol use, the normalization and the kind of heightened risk that alcohol has specifically to females relative to males," he said.

Dr. Jay-Sheree Allen Akambase is a family medicine and preventive medicine physician at the Mayo Clinic and a member of the ABC News Medical Unit.

If you or someone close to you needs help for a substance use disorder, call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) or visit FindTreatment.gov, SAMHSA's Behavioral Health Treatment Services Locator.