Research Summary

National Survey: Young Adult Women Now Outpace Men in Binge Drinking

Kate Young

Key Highlights:

  • From 2021–2023, young adult women (18-25 years) had significantly higher past-month binge drinking rates than men.
  • Sex-based differences in heavy drinking narrowed, with women showing significantly lower rates in both 2017-2019 and 2021-2023.
  • The previously higher male-heavy drinking prevalence decreased over time, but young women’s binge drinking increased.

In recent years, sex-based disparities in alcohol consumption patterns have changed, particularly among younger adults. This study found that in 2021 to 2023, women aged 18 to 25 had significantly higher rates of past-month binge drinking than men in the same age range, a reversal from prior patterns. However, women overall continued to have lower levels of heavy drinking than men across all time periods.

Sex-based differences in alcohol use have historically favored lower use among women, but recent public health data signal a shift. The need to understand whether these patterns have narrowed, especially among young and middle-aged adults, is critical, given disproportionate increases in alcohol-related liver disease and mortality among females since 2020.

Using data from the National Survey on Drug Use and Health (NSDUH), researchers conducted cross-sectional analyses of adults aged 18 and older during two time periods: 2017 to 2019 and 2021 to 2023. They used logistic regression modeling to compare sex-based differences in binge drinking (defined as ≥ 5 drinks for men, ≥ 4 for women on the same occasion) and heavy drinking (≥ 5 days of binge drinking in the past 30 days), stratified by age groups (18 to 25, 26 to 49, ≥ 65 years).

The study included 267,843 respondents. In 2017 to 2019, women had significantly lower binge drinking levels than men (6.6 vs. 9.5 per 100 persons). By 2021 to 2023, binge drinking among women aged 18 to 25 surpassed that of men (21.8 vs. 19.9 per 100 persons), indicating a narrowing and reversal of the historical gap. Women aged 26 to 49 and 65 years of age or older also had significantly lower binge drinking rates than men, but the differences were smaller or not statistically significant. In heavy drinking, men had higher rates in both periods (4.5 vs. 3.8 per 100 persons in 2017 to 2019; 5.0 vs. 3.2 per 100 persons in 2021 to 2023), with a persistent but narrowing gap.

“Our findings may be due to more rapid decreases in binge drinking over time among young adult males relative to females, or plateauing or increases in binge drinking among females,” the study authors wrote. “Further investigation using other nationally representative surveys is needed to elucidate these explanations.”

Reference:

Shuey B, Wen H, Suda KJ, et al. Sex-Based Differences in Binge and Heavy Drinking Among US Adults. JAMA. 2025;333(20):1831-1833. doi:10.1001/jama.2025.2726