Alcohol consumption among young adults ages 18-24 in the United States: results from the 2001-2002 NESARC Survey

The high prevalence of drinking in young adults is a serious public health concern. Alcohol use among young adults often is associated with a wide variety of risky behaviors and both immediate and long-term negative consequences. The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) presents a unique opportunity to examine young adult drinking because it has an excellent response rate, oversamples young adults ages 18-24, and includes college-related group housing. According to the NESARC data, in 2001-2002 over three-quarters of young adults ages 21-24 were current drinkers, as were nearly two-thirds of those ages 18-20, despite the fact that the legal drinking age is 21. More than half of young adult men exceeded the recommended daily drinking limit, as did two-fifths of young adult women. Although the prevalence of exceeding the daily limit is higher for those ages 21-24 than for those ages 18-20, it also is substantial for those ages 18-20. Because drinking more than the recommended per-occasion maximum is likely to impair mental and physical performance, the increase over the past decade in the prevalence among young adults of drinking five or more drinks 12 or more times per year may help explain the increased risk of injury and other acute negative consequences commonly observed among college students ages 18-24. KEY WORDS: young adult; undergraduate student; underage drinking; National Epidemiologic Survey on Alcohol and Related Conditions (NESARC); heavy drinking; binge drinking; AOD (alcohol and other drug) use pattern; AOD use frequency; amount of AOD use; AOD intake per occasion; AOD use frequency; individual AOD consumption; aggregate AOD consumption; gender differences; ethnic differences; racial differences ********** Over the life course, drinkers in the United States tend to have the highest level of alcohol consumption in their late teens and early twenties (Naimi et al. 2003; Fillmore et al. 1991). According to the National Survey on Drug Use and Health (NSDUH), the prevalences of both binge drinking (i.e., consuming five or more [5+] drinks in a row at least once in the past month) and heavy drinking (i.e., consuming 5+ drinks in a row on at least five occasions in the past month) in 2003 were highest among young adults ages 18 to 25, peaking at age 21 (Substance Abuse and Mental Health Services Administration [SAMHSA] 2004). And according to the Monitoring the Future Survey, the prevalence of drinking and heavy drinking (i.e., consuming 5+ drinks in a row at least once in the prior 2-week period) among young adults changed relatively little between 1993 and 2003 after declining noticeably from 1980 to 1993 (Johnston et al. 2004). The high prevalence of drinking in young adults is a serious public health concern because alcohol use by this age group often is associated with a wide variety of risky behaviors and various negative consequences. Many of these consequences are immediate and tragic (Hingson et al. 2005)--most notably alcohol-related traffic fatalities (Yi et al. 2004). College students continue to stand out from other young adults because of their relatively high rates of heavy drinking, even though their average daily alcohol consumption generally is lower than that of their noncollege peers (Johnston et al. 2004). Until recently, however, college students have been a difficult population to study. In general, they are not well represented in normal household surveys, which typically exclude group housing, such as dormitories, fraternities, and sororities. In addition, group-housing-based samples of college students must be quite large in order to attain accurate national representation because there is great heterogeneity in the types of student populations served in these institutions. Finally, the drinking behavior of young adults, particularly college students, often is characterized by episodic drinking, which may be more difficult to capture adequately on surveys that rely only on the measure of average alcohol consumption over a short period of time. …