Key Points

  • National heavy drinking declined more than 8% from 2022 to 2024, the first reduction since the start of the pandemic, driven largely by Gen Z and millennial adults cutting back.
  • Adults ages 50 to 64 were the only age group where heavy drinking kept climbing: any drinking rose nearly 4% and heavy drinking climbed more than 36% since 2018.
  • Alcoholic cirrhosis most often emerges around age 52, making the heavy drinking surge in the 50-to-64 age group a serious clinical concern even as national headlines turn positive.
  • More than one in five adults ages 62 to 85 takes a medication combination that carries the potential for a major drug interaction; muscle relaxants are the fastest-growing contributor to those dangerous combinations.
  • Benzodiazepine interactions in older adults dropped sharply over the study period, but muscle relaxant regimens nearly doubled, a trend researchers say may be contributing to unintentional overdose deaths.
  • A new commentary in the American Journal of Psychiatry proposes that every benzodiazepine prescription carry a named near-term goal (maintain, reduce, defer, or discontinue) along with a scheduled revisit date.

Addiction News Weekly Episode 1.19

In This Episode:

Episode Transcript

Welcome to Addiction News Weekly by Rehab.com, where we break down the biggest stories in addiction, recovery, and public health. This week, Americans are drinking less except for one age group where heavy drinking is up more than a third, more than one in five older adults takes a combination of medications that could interact badly, and psychiatrists make the case that benzodiazepine prescriptions should come with a plan for ending it. Now, let’s get into it.

Alcohol Use Falls Nationally, but Climbs for Adults Ages 50 to 64

We start with drinking. A study published this week in Annals of Internal Medicine looked at survey responses from more than 114,000 American adults collected by the CDC across four years: 2018, 2020, 2022, and 2024. The overall news is good.1

Any drinking fell about two percent between 2022 and 2024, and heavy drinking fell about eight percent. That is the first decline since the pandemic began. But that decline came almost entirely from younger adults.1

Gen Z and millennials cut back on both. Adults 65 and older stayed roughly flat. Adults between 50 and 64 went the other direction. Any drinking in that group rose nearly four percent since 2018, and heavy drinking rose more than 36 percent. They were the only age group where heavy drinking kept climbing.1 Lead author Dr. Brian Lee, a liver transplant specialist at Keck Medicine of USC, said the national decline should not overshadow the group still at increased risk. Alcoholic cirrhosis, he noted, most often shows up around age 52.

Here is Rehab.com Chief Medical Officer Dr. Sylvie Stacy with her take on the matter. Alcohol-related mortality really accelerated during COVID. So when we’re seeing this decline now in both all drinking and heavy drinking in the data from this study, this is genuinely a great thing, but we’re not back to pre-pandemic baselines yet. There’s still ground to cover. And of course, the high-level trend kind of masks the populations moving in the other direction, particularly adults in their 50s and 60s, where heavy alcohol consumption climbed by over 36 percent.

When I see younger populations of patients in my practice, the downward alcohol trends seen in this study align with what I’m seeing. I certainly evaluate a higher volume of the older adults for alcohol use disorder, whereas the younger generations are often bringing in different substance use issues, specifically problematic cannabis use. And there’s been a steady climb in kratom and 7-OH use, also a heavy reliance on nicotine products like pouches.

So substance trends, they’re constantly shifting, and that is definitely due in part to aggressive marketing and social media channels that young people receive differently than older people. In this study, it does suggest in its conclusions that we have targeted interventions for higher-risk groups, specifically for older adults and for females. And the advantage of that targeted outreach is efficiency and clinical precision. We can deploy screening tools, for example, directly to primary care settings or clinics that are geared toward older adults, where these specific populations already receive their routine care. A drawback is, though, that very hyper-focused campaigns might miss broader cultural changes and shifts, and they can potentially stigmatize specific demographics of people. So I think that effective care really requires keeping our screening broad while also knowing exactly where the highest risks lie.

One in Five Older Adults Faces a Potentially Major Drug Interaction

Our second story is about everything else in the medicine cabinet. A research letter published in JAMA this week, led by Dima Mazen Qato at the University of Southern California, compared medication use among adults aged 62 to 85 surveyed in 2015 and 2016 against a second group surveyed from 2021 to 2023. Polypharmacy is up.2

Taking five or more prescription medications at once rose from 31% to about 36%. Doing the same with dietary supplements rose from about 13% to roughly 17%. The headline number has improved, though. Regimens carrying the potential for a major drug interaction fell from 25.7% to 22.3%. That is still more than one in five older adults, however.2

What changed is the composition. Interacting combinations involving opioids declined. Combinations involving benzodiazepines dropped sharply, from about 2% to under 1%, which the authors credit to years of deprescribing pressure on both drug classes. Muscle relaxants went the other way. Their share of interacting regimens nearly doubled, and the authors say that rise may be contributing to unintentional overdose deaths among older adults.2 Antidepressants remained the single most common ingredient in a risky combination.

Now here is the key takeaway. You should bring every prescription, every supplement, and every over-the-counter product to your doctor’s appointment, written down. Ask for an interaction check, and be sure to mention alcohol because it belongs on that list as well.

A Four-Goal Framework for Benzodiazepine Prescribing

And our final story is about the prescriptions themselves. A commentary in the September issue of the American Journal of Psychiatry by Apurva Parikh, Geoffrey Russell, and Mark Olfson is titled “Defining Near-Term Treatment Goals for Benzodiazepine Use in Clinical Practice.”3

Their observation is that benzodiazepines often get continued because a patient seems stable, revisited only during a crisis, or tapered reactively rather than by plan. Over time, it stops being clear whether the prescription reflects a decision or just inertia. What they propose is that at every visit, including the first one, the prescriber names which of these four goals applies.3

Maintain, where the benefit is real and continuing is an active choice. Reduce, lowering the dose while keeping the person stable. Defer, where stopping makes sense in principle but not right now. Or discontinue, tapering with support in place.

Now it’s important to be careful about that last one. Stopping is not automatically the safer path, and for some patients it has been linked to worse outcomes, so it should be planned rather than assumed.

So here’s the question worth asking: which of those four is the goal right now, and when does it get revisited? And whatever the answer, never stop abruptly on your own. Benzodiazepine withdrawal, like alcohol withdrawal, can be life-threatening, and a gradual taper under medical supervision is the safest route.

Conclusion

Three stories and one list underneath all of them. What a person drinks, what they’re prescribed, what they picked up over the counter, and what they take to sleep. No prescriber sees that whole list unless somebody brings it in, so be sure to bring it written down to your next appointment, for yourself or for the person you’re going with.

If you or someone you love is looking for treatment, Rehab.com lists thousands of verified centers across the country, and free, confidential support is available anytime through the SAMHSA National Helpline at 1-800-662-4357. And if you are in crisis, you can call or text 988 at any time.

Those are the top stories in the news. For more, visit Rehab.com. I’m Kay, we will be back next week, and thank you for listening.

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Sources in This Episode

  1. Lee BP, Chhatwal J, et al. Alcohol Use Between 2018 and 2024: A National Cross-Sectional Study. Ann Intern Med. Published September 22, 2026. doi:10.7326/ANNALS-26-01824. Accessed October 6, 2026.
  2. Qato DM, et al. Polypharmacy and Drug-Drug Interactions Among Older Adults. JAMA. Published September 24, 2026. doi:10.1001/jama.2026.17268. https://jamanetwork.com/journals/jama/article-abstract/2854478. Accessed October 6, 2026.
  3. Parikh A, Russell G, Olfson M. Defining Near-Term Treatment Goals for Benzodiazepine Use in Clinical Practice. Am J Psychiatry. September 2026.