Heavy drinking among Americans ages 50 to 64 has jumped more than 36% since 2018, even as overall alcohol use in the United States has declined for the first time since the COVID-19 pandemic. A new study led by Dr. Brian P. Lee at Keck Medicine of the University of Southern California found that while younger generations are cutting back, middle-aged adults are moving in the opposite direction.

Researchers analyzed data from the National Health Interview Survey conducted from 2018 through 2024. The results, published in the Annals of Internal Medicine (September 2026), showed that heavy drinking rose by over one-third in adults 50 to 64, while alcohol use in this group increased by nearly 4%.

In contrast, Americans in other age groups have reduced their drinking habits. Gallup’s August 2026 poll found that only 54% of U.S. adults now drink alcohol, tying last year’s record low. Generation Z and millennials saw the largest drops, with Gen Z drinking down almost 6% and millennial heavy drinking falling by 17%.

The study defined heavy drinking as 15 or more drinks per week or five or more in a day for men, and eight or more a week or four or more in a day for women, matching standards from the Centers for Disease Control and Prevention. The researchers have not pinpointed exactly why heavy drinking is up among older adults, but they note that this group faces increased health risks, including higher rates of cirrhosis and alcohol-related cancers. As noted by Dr. Lee, “The encouraging national decline should not overshadow the fact that some groups continue to be at increased risk.”

Experts say several factors may contribute to these risks. The National Institute on Alcohol Abuse and Alcoholism reports that older adults have less body water and muscle, which means the same number of drinks leads to a higher blood alcohol level than in younger years. They are also more likely to take medications that can dangerously interact with alcohol and to have chronic health issues that alcohol can worsen.

The overall decline in drinking is seen as positive, but the rise among those aged 50 to 64 signals a need for targeted prevention and treatment efforts. Most people with alcohol use disorder do not receive treatment—in 2024, only 7.5% sought help, according to the National Survey on Drug Use and Health. Outpatient care, which can be scheduled around work and family, is now considered a practical option for many.

Looking ahead, health experts urge ongoing awareness and support for older adults at higher risk of alcohol-related harm. The study’s authors recommend that individuals discuss alcohol use with their healthcare providers, especially if they are taking other medications or managing chronic conditions.

Dickerman