Americans are drinking less for the first time since the pandemic, although alcohol use remains above levels recorded before 2020. The findings come from a study published Monday in the journal Annals of Internal Medicine.

The overall decline was modest, at roughly 1%, but it followed a sharp rise in heavy alcohol use during the pandemic. Senior study author Dr. Brian P. Lee, a liver transplant doctor at Keck Medicine of USC in Los Angeles, called the decrease welcome news.

The shift was not shared equally across the population. Lee cautioned that “these trends haven’t been even across the board.”

Both heavy and occasional drinking declined among Gen Z and millennials from 2022 to 2024. During the same period, however, alcohol use increased among adults ages 50 to 64.

The researchers used data from the National Health Interview Survey conducted by the Centers for Disease Control and Prevention. Lee and his team examined survey findings from four years: 2018, 2020, 2022 and 2024.

From 2022 to 2024, men reported a larger overall decline in drinking than women, at 2.4% compared with 1.1%. Heavy drinking fell by 9% among women and by 7.7% among men.

The survey defined heavy drinking differently for men and women. For men, it meant five or more drinks per day or at least 15 per week, while for women it meant four drinks per day or eight per week.

Gen Z adults recorded the largest overall decrease in drinking between 2022 and 2024, with a drop of more than 5%. Millennials showed the steepest decline in heavy drinking during that period, with a 17% reduction.

Despite those recent improvements, drinking or heavy drinking among both younger groups remained slightly above 2018 levels. The results suggest the pandemic era increase has not been completely reversed.

Lee said the most concerning result involved adults ages 50 to 64, whose heavy drinking has climbed steadily since 2018. About 2% more people in that age group reported heavy drinking in 2024 than in 2022, while the number has risen by more than one third since 2018.

“This 30% increase, that’s about a million people drinking heavily in that age group alone,” Lee said. He also warned that older adults are more vulnerable to the physical damage caused by alcohol.

Drinking raises the risk of high blood pressure, stroke and digestive problems. Liver disease related to alcohol is now the leading cause of liver transplants in the United States, while yearly cancer deaths linked to alcohol have doubled during the past three decades.

“The average age of developing cirrhosis is in the 50s, and we know someone with a 50-year-old liver is more likely to develop liver scarring with the same quantity of alcohol as a 20-year-old liver,” Lee said. “The risk with alcohol isn’t the same across all age groups, and this middle-aged group is exactly the group we are worried about.”

Adults in their 50s and 60s who currently drink heavily have probably been drinking for years, further worsening their risk of health complications linked to alcohol, said Dr. Michael Siegel. Siegel is a professor of public health and community medicine at Tufts University School of Medicine in Boston.

“We’re talking about a substantial amount of alcohol consumption that is probably going to have health effects at that level, and to see that those trends over time have not really decreased is worrisome,” Siegel said.

Alcohol consumption had been rising since around 2000, following a decline in the late 1980s and 1990s, according to Priscilla Martinez-Matyszczyk, deputy scientific director of the nonprofit Alcohol Research Group. Drinking peaked in 2020, when heavy use rose 20% and any alcohol use increased 4% compared with 2018.

Martinez-Matyszczyk said similar spikes have followed traumatic events affecting broad populations, including the 9/11 terrorist attacks. She said drinking can decline after such a surge but may eventually return to its previous direction, which was already upward before the pandemic.