Americans appear to be moderating — at least when it comes to alcohol.
The number of people who drink in a way that crosses the line into a medical disorder decreased substantially over a five-year period in the United States, according to new federal data.
The National Survey on Drug Use and Health, released late last month, found that the share of people 12 and older who qualified for a diagnosis of alcohol use disorder fell to 8.9 percent in 2025 from 10.6 percent in 2021 — or by about 4 million people.
The methodology of the annual survey, conducted by the Substance Abuse and Mental Health Services Administration, was updated during the pandemic, so its results cannot be compared to years before 2021, the agency said.
But Katherine Keyes, a professor of epidemiology at Columbia University, said the decline was credible, in part because a Gallup survey and a long-running University of Michigan study also show fewer Americans are drinking.
“This is the direction we want to see the data going, and the fact that we’re seeing it across multiple samples is also a very encouraging sign,” she said.
The decline comes even as the federal government has retreated from alcohol as a public health concern, loosening its dietary guidance on drinking and shedding scientists who track alcohol’s toll.
Alcohol use disorder is a diagnosis for drinking that a person cannot fully control, even as it undermines their work, health and relationships. “You can define a use disorder as continued use despite consequences,” said Alexis Ritvo, an addiction psychiatrist at the University of Colorado School of Medicine, who has treated thousands of such patients.
The diagnosis also reflects advances in the understanding of alcohol dependency, which scientists no longer see as a binary division between those who can control their drinking and those who can’t, but as a spectrum.
To assess patients, clinicians usually ask about 11 symptoms, including cravings, drinking more or for longer than intended, and unsuccessful attempts to cut back. Two or three symptoms count as a mild disorder; four or five as moderate; and six or more as severe.
The federal data suggest that the decline has been chiefly among people with a mild form of the disorder, who constitute a majority of problem drinkers and whose numbers fell by nearly a fifth, or almost three million people. There was less of a decrease in the share of people with moderate and severe alcohol use disorder.
Even a decline confined to milder cases is consequential, because those cases are so numerous. “It’s a massive public health gain,” said John Kelly, the director of the Recovery Research Institute at Mass General Brigham.
The distinction between milder and more severe forms of the disorder matters for treatment, said Marissa Esser, a public health consultant and a former director of the alcohol program at the Centers for Disease Control and Prevention. People with severe alcohol disorder may benefit from effective but underused medications like naltrexone, while those with milder cases “can generally reduce their drinking on their own,” she said, without specialized addiction treatment.
Asked to explain the decline, Dr. Kelly pointed to converging cultural forces rather than any single cause. Since the early 2000s, successive generations of young people have been drinking less, and are now carrying those habits into adulthood. A growing share of Americans are aware of alcohol’s health risks, including its role in causing cancers of the breast, throat and esophagus, the subject of a Surgeon General’s advisory in January 2025. Some drinkers may also be turning to cannabis.
“Many people who would previously have met criteria for mild alcohol use disorder may never progress that far because of these changing social norms, greater health awareness and alternative recreational activities,” Dr. Kelly said. If current trends continue, he added, declines in moderate and severe disorder might eventually follow.
Studies have shown that semaglutide, the compound in the popular weight-loss drugs Ozempic and Wegovy, can also curb cravings for alcohol, and about 1 in 8 American adults now takes semaglutide or a similar drug, according to a survey by the health research group KFF.
But Christian Hendershot, a professor at the University of Southern California who led the first randomized trial of semaglutide’s effects on drinking, said he was hesitant to attribute the decline in alcohol use disorder to the medications. Their effects on alcohol consumption are “most pronounced in the heaviest drinkers,” he wrote, yet severe cases are where the numbers have moved least.
For people who recognize that alcohol is affecting their daily life, Dr. Ritvo recommended raising the issue with a primary care doctor, who can offer counseling, medication or a referral. She said she often points patients to Rethinking Drinking, a website from the National Institute on Alcohol Abuse and Alcoholism that helps people take stock of their drinking habits.
Whether the national decline in alcohol use disorder continues will likely depend on more than individual choices. In January, the federal government’s updated dietary guidelines dropped the recommendation that men limit their consumption to two drinks a day and women to one, advising Americans simply to limit their intake. Experts said the eventual impact of this change was uncertain, but guidance that was more vague could sow confusion just as public awareness was growing.
“Progress could stall if we don’t have greater investment in prevention,” Dr. Esser said, whether from government, philanthropy or other private funders.
Instead, the public health infrastructure is shrinking, she added, as she knows firsthand. Last year the C.D.C.’s alcohol program — along with her job — was eliminated in the federal government’s mass reduction in force. Similar cuts have thinned alcohol expertise across the federal government, she said, including at SAMHSA.
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