3. Alcohol Use

A number of measures of alcohol use are available from the National Survey on Drug Use and Health (NSDUH). This chapter discusses past month alcohol use, past month binge alcohol use, and the perceived risk of binge alcohol use. Binge alcohol use is defined as drinking five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey. Alcohol is the most commonly used substance in the United States. Nationally, the past month use of alcohol rate was stable between 2002 (51.0 percent) and 2003 (50.1 percent) (Office of Applied Studies [OAS], 2004c, Table 2.45B).

3.1. Alcohol

For the combined 2002–2003 time period, about half of Americans aged 12 or older reported having had a drink in the past month (50.5 percent). The States in the top fifth for past month use of alcohol among persons aged 12 or older were primarily Northeastern (six States). The other four States in the top fifth were either Midwestern or Western. Among persons aged 12 or older, all of the States in the lowest fifth were from the South, except for Utah (West region). Utah had the lowest rate for all age groups (10.2 percent for 12 to 17 year olds, 35.7 percent for 18 to 25 year olds, 31.4 percent for persons aged 26 or older, and 29.6 percent for persons aged 12 or older) (Table B.8, Figure 3.1).

New Hampshire had the highest rate in the 12 or older population (59.8 percent) as well as in the 26 or older population (63.2 percent). The highest rate of past month use of alcohol for the 18 to 25 age group was in Rhode Island (76.1 percent), and North Dakota had the highest rate among youths aged 12 to 17 (25.2 percent). Rhode Island, Massachusetts, New Hampshire, Vermont, and Wisconsin ranked in the top fifth for all three age groups (12 to 17, 18 to 25, and 26 or older) (Table B.8, Figures 3.1 to 3.4).

3.2. Binge Alcohol

Nationally, almost a quarter (22.8 percent) of all persons aged 12 or older participated in binge use of alcohol in the past month in 2002–2003. In addition to having the lowest rate in the Nation for past month use of alcohol (29.6 percent), Utah had the lowest rate for past month binge use of alcohol among all persons aged 12 or older (15.9 percent). North Dakota had the highest rate among all persons aged 12 or older (31.4 percent) and among persons aged 26 or older (28.4 percent). Most of the States in the top fifth for past month binge use of alcohol for persons aged 12 or older were from the Midwest (six States) (Table s B.8 and B.9, Figure 3.5).

Although there is a high correlation between State prevalence rates for past month alcohol use and binge use of alcohol, only six States in the top fifth for use of alcohol among persons aged 12 or older also were in the top fifth for binge alcohol use. Similarly, eight States ranked in the lowest fifth for past month alcohol use in that age group also were ranked in the lowest fifth for binge use of alcohol (Figures 3.1 and 3.5).

3.3. Perceptions of Risk of Binge Alcohol Use

People's perceptions of the risk of binge drinking were moderately related to their actual rates of binge drinking at the State level in 2002–2003. Eight of the States (Iowa, Massachusetts, Minnesota, Montana, North Dakota, Rhode Island, South Dakota, and Wisconsin) with the highest rates of binge use of alcohol in 2002–2003 also were States with the lowest perceived risk of binge drinking for the population aged 12 or older. Similarly Utah, the State with the lowest rate of binge use of alcohol among persons aged 12 or older (15.9 percent), also had the highest rate of perceived risk of that behavior (50.9 percent) (Table s B.9 and B.10, Figures 3.5 and 3.9).

The District of Columbia had a somewhat different relationship for these two measures among persons aged 26 or older. It ranked in the highest fifth for perception of great risk of binge drinking among persons aged 26 or older (47.2 percent) as well as in the highest fifth for actual binge use of alcohol in the same age group (24.4 percent) (Table s B.9 and B.10, Figures 3.8 and 3.12).