You consider yourself a light-to-moderate drinker, having the occasional cocktail or glass of wine with dinner and only tossing back a few extra glasses of liquid refreshment at social gatherings on weekends. By most standards, you'd be right — because drinking is typically tracked as an average over the week.
"This leaves many drinkers mistakenly assuming that a moderate average level of consumption is safe, regardless of drinking pattern," said Rudolf Moos, professor emeritus of psychiatry and behavioral sciences at Stanford University School of Medicine, in a statement.
Moos is the coauthor of a recent study that found many moderate drinkers above age 30 actually end up binging on the weekend — defined as five or more drinks in a row or within a short period of time.
People who binged were about five times more likely to experience multiple alcohol problems, such as "getting hurt, emotional or psychological problems from alcohol, having to use more alcohol to get the same effect, and experiencing effects of alcohol at work, school or caring for children," said study coauthor Charles Holahan, professor of psychology at the University of Texas at Austin, in an email.
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"What this means is that an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner, even though their average drinking level is the same," Holahan said.
Adult binge drinking
Most past research on binge drinking has focused on the younger generation, typically teens and college students. Consuming multiple drinks at one sitting is widespread in this population segment. But statistics show a good many adults over 30 are binge drinkers, and the problem is on the rise, especially among women and adults over 65.
Yet levels of binge drinking among adults may escape "public health scrutiny, because it occurs among individuals who drink at a moderate average level," Holahan said. "At present, binge drinking among moderate drinkers is largely undetected in primary care settings."
Women are especially sensitive to the effects of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related problems appear sooner and at lower drinking levels than in men, the NIAA said.
Women are more susceptible to alcohol-related brain damage and heart disease than men, and studies show women who have one drink a day increase their risk of breast cancer by 5% to 9% compared with women who abstain.
For both men and women over 65 years of age, the increase "is of particular concern because many older adults use medications that can interact with alcohol, have health conditions that can be exacerbated by alcohol, and may be more susceptible to alcohol-related falls and other accidental injuries," the NIAA stated.
Drinkers who binged were about five times more likely to experience multiple alcohol problems, according to new research.
An 'overlooked' pattern
The new study, published in the American Journal of Preventative Medicine, used survey data collected as part of the Midlife Development in the United States study, which has been following a national sample of Americans between the ages of 25 and 74 since 1995.
The study analyzed nearly 1,300 drinkers over nine years and found most cases of binge drinking — and of multiple alcohol problems — occurred among individuals who were average moderate drinkers.
"An average moderate drinker of, for example, one drink a day might achieve that average by a daily drink with dinner or seven drinks on Saturday night," Holahan said.
While that behavior would not necessarily lead to alcoholism, Holahan said, the study found drinking an average of more than one drink a day for women and two drinks a day for men — or five or more drinks on the same occasion — was linked to alcohol problems nine years later.
"These findings point to a need for alcohol interventions targeting moderate average level drinkers in addition to conventional strategies focusing on the higher risk, but smaller, population of habitually high-level drinkers," Holahan said.
Is your drinking a problem?
How do you know if your use of alcohol has become a problem? One telltale sign is when drinking is beginning to interfere with your ability to go through your daily life, experts say.
"Alcohol use disorder is defined as compulsively using alcohol despite having negative consequences from your use, such as an impact on your relationships, your ability to function in your job or in whatever roles you have in your community," Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Mass General Brigham told CNN in a prior interview.
Be wary if you continue drinking despite negative impacts on your physical or mental health. And it doesn't have to be calling in sick or working with a hangover, Dr. Leena Mittal, chief of the women's mental health division in the department of psychiatry at Brigham and Women's Hospital in Boston, told CNN previously.
"Don't forget relationships. Are you having more disagreements? Are people in your life expressing concern or noting that you're different? Hiding your drinking, or lying about it, these too are concerning behaviors," Mittal said.
Here's a red flag: You're pouring big drinks without realizing it. Current American Heart Association guidelines call for no more than two standard drinks a day for men and one for women and anyone 65 and older.
What is a standard drink? It's 12 ounces of regular beer, 4 ounces of regular wine or 1.5 ounces of liquor, according to US standards.
"Yet people may be pouring a huge goblet of wine and not realize that it's actually two or three servings of wine and not just one," Wakeman said.
"We know that millions of Americans drink above those levels, even in pre-pandemic times," Wakeman said. "In 2019, some 66 million Americans had episodes where they were drinking higher than those recommended limits."
If you (or a loved one) appears to be struggling with alcohol, don't hesitate to reach out for help, experts stress. There are many different support groups that can assist, such as 12-step programs and individual therapy.
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How alcohol-related deaths have changed in every state over the past two decades
How alcohol-related deaths have changed in every state over the past two decades
Over the last 20 years, a disturbing trend emerged: All 50 states have seen a significant increase in alcohol-related deaths. Only Washington D.C. saw a decrease in death rates.
Besides more obvious alcohol-related deaths like alcohol poisoning or drunk-driving accidents, prolonged heavy alcohol use can cause a range of health problems, which can lead to death. Liver cirrhosis, which develops over years, is a common condition among those who drink heavily. Excessive drinking causes damage to the liver, which causes a buildup of scar tissue, rather than living tissue, in the organ. The effects of cirrhosis are largely irreversible and can lead to liver failure and death.
Alcohol use can also raise the risk of developing cancer. The most common alcohol-related cancers are throat and mouth, liver, esophagus, breast, colon, and rectum. When the body breaks down alcohol, it becomes a chemical called acetaldehyde. This chemical can damage DNA, which can lead to cells growing out of control, resulting in the creation of a tumor. Some alcoholic drinks may also contain carcinogens like asbestos fibers, hydrocarbons, and nitrosamines.
To slow the increasing number of deaths, the CDC created a state funding program to build public health infrastructures aimed at preventing excessive alcohol use. The CDC also partnered with health care networks to improve alcohol screenings and interventions.
To determine how alcohol-related deaths have changed in every state over 20 years, Zinnia Health examined data between 2000 and 2020 from the Centers for Disease Control and Prevention. The CDC considers alcohol-induced deaths as any reported deaths caused by alcohol use—whether dependent or non-dependent—and accidental alcohol poisonings. For every state, 2020 statistics are provided, including the number of alcohol-related deaths, how this figure compares per 100,000 people, the state population that year according to the U.S. Census Bureau, and the 20-year percent change for all three of these statistics.

Alabama
2020 alcohol-related death stats:
- 569 deaths (up 139.1% from 2000)
- 11.6 deaths per 100,000 people (up 114.8% from 2000)
- 2020 state population: 4,921,532 (up 10.7% from 2000)
Alaska
2020 alcohol-related death stats:
- 242 deaths (up 137.3% from 2000)
- 33.1 deaths per 100,000 people (up 103.1% from 2000)
- 2020 state population: 731,158 (up 16.6% from 2000)
Arizona
2020 alcohol-related death stats:
- 1,578 deaths (up 234.3% from 2000)
- 21.3 deaths per 100,000 people (up 131.5% from 2000)
- 2020 state population: 7,421,401 (up 44.6% from 2000)
Arkansas
2020 alcohol-related death stats:
- 382 deaths (up 238.1% from 2000)
- 12.6 deaths per 100,000 people (up 200.0% from 2000)
- 2020 state population: 3,030,522 (up 13.4% from 2000)
California
2020 alcohol-related death stats:
- 6,193 deaths (up 81.8% from 2000)
- 15.7 deaths per 100,000 people (up 55.4% from 2000)
- 2020 state population: 39,368,078 (up 16.2% from 2000)
Colorado
2020 alcohol-related death stats:
- 1,568 deaths (up 251.6% from 2000)
- 27.0 deaths per 100,000 people (up 159.6% from 2000)
- 2020 state population: 5,807,719 (up 35.0% from 2000)
Connecticut
2020 alcohol-related death stats:
- 552 deaths (up 183.1% from 2000)
- 15.5 deaths per 100,000 people (up 171.9% from 2000)
- 2020 state population: 3,557,006 (up 4.4% from 2000)
Delaware
2020 alcohol-related death stats:
- 133 deaths (up 160.8% from 2000)
- 13.5 deaths per 100,000 people (up 107.7% from 2000)
- 2020 state population: 986,809 (up 25.9% from 2000)
Florida
2020 alcohol-related death stats:
- 3,419 deaths (up 155.0% from 2000)
- 15.7 deaths per 100,000 people (up 86.9% from 2000)
- 2020 state population: 21,733,312 (up 36.0% from 2000)
Georgia
2020 alcohol-related death stats:
- 1,186 deaths (up 142.5% from 2000)
- 11.1 deaths per 100,000 people (up 85.0% from 2000)
- 2020 state population: 10,710,017 (up 30.8% from 2000)
Hawaii
2020 alcohol-related death stats:
- 131 deaths (up 244.7% from 2000)
- 9.3 deaths per 100,000 people (up 200.0% from 2000)
- 2020 state population: 1,407,006 (up 16.1% from 2000)
Idaho
2020 alcohol-related death stats:
- 349 deaths (up 232.4% from 2000)
- 19.1 deaths per 100,000 people (up 135.8% from 2000)
- 2020 state population: 1,826,913 (up 41.2% from 2000)
Illinois
2020 alcohol-related death stats:
- 1,543 deaths (up 174.1% from 2000)
- 12.3 deaths per 100,000 people (up 173.3% from 2000)
- 2020 state population: 12,587,530 (up 1.4% from 2000)
Indiana
2020 alcohol-related death stats:
- 1,027 deaths (up 196.0% from 2000)
- 15.2 deaths per 100,000 people (up 166.7% from 2000)
- 2020 state population: 6,754,953 (up 11.1% from 2000)
Iowa
2020 alcohol-related death stats:
- 524 deaths (up 288.1% from 2000)
- 16.6 deaths per 100,000 people (up 260.9% from 2000)
- 2020 state population: 3,163,561 (up 8.1% from 2000)
Kansas
2020 alcohol-related death stats:
- 489 deaths (up 256.9% from 2000)
- 16.8 deaths per 100,000 people (up 229.4% from 2000)
- 2020 state population: 2,913,805 (up 8.4% from 2000)
Kentucky
2020 alcohol-related death stats:
- 738 deaths (up 180.6% from 2000)
- 16.5 deaths per 100,000 people (up 153.8% from 2000)
- 2020 state population: 4,477,251 (up 10.8% from 2000)
Louisiana
2020 alcohol-related death stats:
- 443 deaths (up 98.7% from 2000)
- 9.5 deaths per 100,000 people (up 90.0% from 2000)
- 2020 state population: 4,645,318 (up 3.9% from 2000)
Maine
2020 alcohol-related death stats:
- 286 deaths (up 194.8% from 2000)
- 21.2 deaths per 100,000 people (up 178.9% from 2000)
- 2020 state population: 1,350,141 (up 5.9% from 2000)
Maryland
2020 alcohol-related death stats:
- 600 deaths (up 104.1% from 2000)
- 9.9 deaths per 100,000 people (up 76.8% from 2000)
- 2020 state population: 6,055,802 (up 14.3% from 2000)
Massachusetts
2020 alcohol-related death stats:
- 1,006 deaths (up 195.0% from 2000)
- 14.6 deaths per 100,000 people (up 170.4% from 2000)
- 2020 state population: 6,893,574 (up 8.6% from 2000)
Michigan
2020 alcohol-related death stats:
- 1,610 deaths (up 137.1% from 2000)
- 16.2 deaths per 100,000 people (up 138.2% from 2000)
- 2020 state population: 9,966,555 (up 0.3% from 2000)
Minnesota
2020 alcohol-related death stats:
- 1,065 deaths (up 232.8% from 2000)
- 18.8 deaths per 100,000 people (up 189.2% from 2000)
- 2020 state population: 5,657,342 (up 15.0% from 2000)
Mississippi
2020 alcohol-related death stats:
- 395 deaths (up 135.1% from 2000)
- 13.3 deaths per 100,000 people (up 125.4% from 2000)
- 2020 state population: 2,966,786 (up 4.3% from 2000)
Missouri
2020 alcohol-related death stats:
- 791 deaths (up 141.2% from 2000)
- 12.9 deaths per 100,000 people (up 118.6% from 2000)
- 2020 state population: 6,151,548 (up 9.9% from 2000)
Montana
2020 alcohol-related death stats:
- 299 deaths (up 273.8% from 2000)
- 27.7 deaths per 100,000 people (up 211.2% from 2000)
- 2020 state population: 1,080,577 (up 19.8% from 2000)
Nebraska
2020 alcohol-related death stats:
- 383 deaths (up 447.1% from 2000)
- 19.8 deaths per 100,000 people (up 382.9% from 2000)
- 2020 state population: 1,937,552 (up 13.2% from 2000)
Nevada
2020 alcohol-related death stats:
- 714 deaths (up 229.0% from 2000)
- 22.8 deaths per 100,000 people (up 109.2% from 2000)
- 2020 state population: 3,138,259 (up 57.0% from 2000)
New Hampshire
2020 alcohol-related death stats:
- 226 deaths (up 148.4% from 2000)
- 16.5 deaths per 100,000 people (up 123.0% from 2000)
- 2020 state population: 1,366,275 (up 10.6% from 2000)
New Jersey
2020 alcohol-related death stats:
- 861 deaths (up 68.8% from 2000)
- 9.7 deaths per 100,000 people (up 59.0% from 2000)
- 2020 state population: 8,882,371 (up 5.6% from 2000)
New Mexico
2020 alcohol-related death stats:
- 925 deaths (up 170.5% from 2000)
- 43.9 deaths per 100,000 people (up 133.5% from 2000)
- 2020 state population: 2,106,319 (up 15.8% from 2000)
New York
2020 alcohol-related death stats:
- 1,883 deaths (up 62.5% from 2000)
- 9.7 deaths per 100,000 people (up 59.0% from 2000)
- 2020 state population: 19,336,776 (up 1.9% from 2000)
North Carolina
2020 alcohol-related death stats:
- 1,392 deaths (up 100.3% from 2000)
- 13.1 deaths per 100,000 people (up 52.3% from 2000)
- 2020 state population: 10,600,823 (up 31.7% from 2000)
North Dakota
2020 alcohol-related death stats:
- 178 deaths (up 263.3% from 2000)
- 23.3 deaths per 100,000 people (up 206.6% from 2000)
- 2020 state population: 765,309 (up 19.2% from 2000)
Ohio
2020 alcohol-related death stats:
- 1,599 deaths (up 173.3% from 2000)
- 13.7 deaths per 100,000 people (up 163.5% from 2000)
- 2020 state population: 11,693,217 (up 3.0% from 2000)
Oklahoma
2020 alcohol-related death stats:
- 737 deaths (up 216.3% from 2000)
- 18.5 deaths per 100,000 people (up 172.1% from 2000)
- 2020 state population: 3,980,783 (up 15.4% from 2000)
Oregon
2020 alcohol-related death stats:
- 1,134 deaths (up 263.5% from 2000)
- 26.7 deaths per 100,000 people (up 193.4% from 2000)
- 2020 state population: 4,241,507 (up 24.0% from 2000)
Pennsylvania
2020 alcohol-related death stats:
- 1,272 deaths (up 170.1% from 2000)
- 10.0 deaths per 100,000 people (up 163.2% from 2000)
- 2020 state population: 12,783,254 (up 4.1% from 2000)
Rhode Island
2020 alcohol-related death stats:
- 205 deaths (up 166.2% from 2000)
- 19.4 deaths per 100,000 people (up 165.8% from 2000)
- 2020 state population: 1,057,125 (up 0.8% from 2000)
South Carolina
2020 alcohol-related death stats:
- 878 deaths (up 90.5% from 2000)
- 16.8 deaths per 100,000 people (up 46.1% from 2000)
- 2020 state population: 5,218,040 (up 30.1% from 2000)
South Dakota
2020 alcohol-related death stats:
- 271 deaths (up 292.8% from 2000)
- 30.4 deaths per 100,000 people (up 234.1% from 2000)
- 2020 state population: 892,717 (up 18.3% from 2000)
Tennessee
2020 alcohol-related death stats:
- 1,250 deaths (up 221.3% from 2000)
- 18.2 deaths per 100,000 people (up 167.6% from 2000)
- 2020 state population: 6,886,834 (up 21.0% from 2000)
Texas
2020 alcohol-related death stats:
- 3,298 deaths (up 176.9% from 2000)
- 11.2 deaths per 100,000 people (up 96.5% from 2000)
- 2020 state population: 29,360,759 (up 40.8% from 2000)
Utah
2020 alcohol-related death stats:
- 414 deaths (up 266.4% from 2000)
- 12.7 deaths per 100,000 people (up 149.0% from 2000)
- 2020 state population: 3,249,879 (up 45.5% from 2000)
Vermont
2020 alcohol-related death stats:
- 126 deaths (up 231.6% from 2000)
- 20.2 deaths per 100,000 people (up 225.8% from 2000)
- 2020 state population: 623,347 (up 2.4% from 2000)
Virginia
2020 alcohol-related death stats:
- 996 deaths (up 178.2% from 2000)
- 11.6 deaths per 100,000 people (up 127.5% from 2000)
- 2020 state population: 8,590,563 (up 21.4% from 2000)
Washington
2020 alcohol-related death stats:
- 1,506 deaths (up 187.4% from 2000)
- 19.6 deaths per 100,000 people (up 120.2% from 2000)
- 2020 state population: 7,693,612 (up 30.5% from 2000)
Washington D.C.
2020 alcohol-related death stats:
- 87 deaths (down 23.0% from 2000)
- 12.2 deaths per 100,000 people (down 38.4% from 2000)
West Virginia
2020 alcohol-related death stats:
- 304 deaths (up 108.2% from 2000)
- 17.0 deaths per 100,000 people (up 109.9% from 2000)
- 2020 state population: 1,784,787 (down 1.3% from 2000)
Wisconsin
2020 alcohol-related death stats:
- 1,077 deaths (up 172.7% from 2000)
- 18.5 deaths per 100,000 people (up 150.0% from 2000)
- 2020 state population: 5,832,655 (up 8.7% from 2000)
Wyoming
2020 alcohol-related death stats:
- 227 deaths (up 254.7% from 2000)
- 39.0 deaths per 100,000 people (up 200.0% from 2000)
- 2020 state population: 582,328 (up 17.9% from 2000)
This story originally appeared on Zinnia Health and was produced and distributed in partnership with Stacker Studio.
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