What you probably already know: Younger women are binge drinking more than men, a disturbing trend that coincides with recent reports that excessive drinking is raising the mortality rate among women. A JAMA report, “Sex-based differences in binge and heavy drinking among U.S. adults,” notes that women between the ages of 18 and 25 report higher levels of binge drinking than their male peers, with 31.6% saying they consumed four or more drinks at least five times across a 30-day period. The report, which examined drinking across gender and age between 2021 and 2023, finds that women’s binge drinking has remained consistent with data compiled between 2017 and 2019, though binge drinking among men declined from 36% to about 30%.
Why it matters: “The recent findings mark a notable change in longstanding alcohol use patterns,” says Dr. Ash Bhatt, an addiction medicine specialist at Legacy Healing Centers, which serves patients in about 60 U.S. cities. “At the same time, it is important to recognize that these conclusions are based on self-reported alcohol consumption, which can introduce underreporting or recall bias. Even with that limitation, the trend is concerning.” Binge drinking is defined as four or more drinks on one occasion for women. It’s five drinks for men.
What it means: It’s worth noting that women still report lower heavy and binge drinking than men in all other age groups, but the differences are much less pronounced in young women. JAMA notes that alcohol-related liver disease and mortality are increasing faster among women than men, a finding that correlates with data from the Centers for Disease Control and Prevention and other reports. Women — with lower body water content that leads to higher blood alcohol concentration — metabolize alcohol differently than men. Women tend to experience greater organ damage, even at lower levels of consumption. Most substance-abuse research has historically focused on men.
What happens next: Researchers suggest that clinicians should screen women, especially young adults, for binge drinking, and prevention efforts should increasingly target women “to mitigate downstream alcohol-related impacts.” Legacy Healing says several early-life and psychological factors can lead to excessive alcohol consumption, including a family history of drinking, alcohol use that begins during adolescence and underlying anxiety, depression or other mental health concerns. “One of the challenges in interpreting this development is that research into the predictors of alcohol misuse has historically not been conducted with a strong gender-specific lens,” Bhatt says. “More recent research shows that women with substance-abuse disorders are more likely to experience co-occurring anxiety, mood or eating disorders, as well as higher rates of trauma exposure and complex family or relationship dynamics.”
