Monitoring the Future 2019: Alcohol and Drug Use Among Adults Age 18-60

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Since 1975, the National Institutes of Health (NIH) and the National Institute on Drug Abuse (NIDA) have funded a comprehensive nationwide survey on drug and alcohol use among high school students, college students, and young adults in the U.S. This survey – called Monitoring the Future (MTF) – is designed and administrated by public health researchers at the University of Michigan. The Michigan team distributes, receives, and assesses detailed questionnaires from over fifty-thousand college students and young adults each year about their drug and alcohol use. In recent years, researchers added questions designed to gather information on the attitudes and personal opinions of these age groups about alcohol and drug use.

The most recently published MTF, which offers data for 2019, expands the sections on personal attitudes and opinions, and includes and a set of questions on the perceived harm of alcohol and drug use. The goal of the new questions is to generate an evidence-based snapshot of what young adults think about alcohol and drug use. To paraphrase, the new MTF asks questions like:

Do you think…

…trying marijuana once or twice is harmful?

…having one or two alcoholic beverages a day is harmful?

…smoking marijuana every day is harmful?

…drinking more than five alcoholic beverages two nights each weekend is harmful?

These questions help MTF researchers gauge – among other things – the effect of awareness campaigns and public health initiatives around alcohol and drug use among young adults. Data on these topics – i.e. how people think and feel about alcohol and drug use – is relevant in light of recent developments in the public sphere such as the opioid crisis, the trend toward legalized cannabis, and changing sentiments around treatment for alcohol and substance use disorder.

The 2019 MTF Survey: Specific Data for Adults

We’ll dedicate a separate article to a discussion of evolving attitudes around alcohol and drug use. This article addresses another change in the MTF data for 2019. For the first time, the statisticians reported detailed data for adults age 19-30 and specific data for adults age 31 and over. In previous years, data for people age 18 + appeared in age ranges, such as 18-25, 26-35, 35-54, 55-64, and 65 +. This year, the MTF team published MTF 2019 – Volume 2: College Students & Adults Ages 19-60. In this iteration of the report, the MTF team shares and analyzes data for the following age groups:

  • 19-20
  • 21-22
  • 23-24
  • 25-26
  • 27-28
  • 29-30

In addition, researchers sent follow-up surveys to previous respondents who are now the following ages:

  • 35
  • 40
  • 45
  • 55
  • 60

These new reporting categories give us more precise insight, compared to previous reports, into prevalence trends and changing opinions on alcohol and drug use. We’ll look at the key findings for young adults and discuss notable trends in older adults.

We’ll start with a general data breakdown, then move on to specific sets that merit attention for young adults age 19-30, and finish with data for adults age 35 and over.

Long-Term Trends Are Good – Recent Trends Are Mixed

The prevalence of illicit drug use among all age groups has decreased since 1976, with some notable exceptions. Daily and past-month marijuana use increased among several young adult categories, and past-month marijuana use increased among adults age 35, 40, 45, and 55. In addition, prevalence of vaping marijuana increased in every age category. While this vaping data is easily explained by the two facts – vaping marijuana is a new phenomenon, and recreational marijuana is now legal in several states – it’s something public health officials are keeping a close eye on.

The overall marijuana use data is also something we should all understand, for those same two reasons. Vaping is a relatively recent phenomenon, the consequence of which no one fully understands yet because there’s no long-term data on its health consequences. We likewise don’t have extensive data on marijuana prevalence in this new era of legalization, since the trend towards legalization of recreational marijuana use also began relatively recently, in Washington and Colorado in 2012.

However, we do have notable figures among young adults in several areas: binge drinking, past-month marijuana use, and vaping marijuana. Although we offered reasons for the increases in marijuana use – vaping and otherwise – we include the data here so can see the figures for yourself.

Alcohol Use, Marijuana Use, and Vaping Marijuana: Young Adults

Alcohol Use

  • Between 2017-2019, the prevalence of consuming more than five drinks in a row in the two weeks before answering the survey increased for the following age groups:
    • Age 23-24:
      • 2017: 31.2%
      • 2019: 34.2%
    • Age 25-26:
      • 2017: 33.8%
      • 2019: 37.5%
    • Age 27-28:
      • 2017: 31.4%
      • 2019: 33.0%
    • Age 29-30:
      • 2017: 28.7%
      • 2019: 31.6

Marijuana Use

  • Between 2015-2019, the prevalence of smoking marijuana at least once in the month before answering the survey increased for the following age groups:
    • Age 19-20
      • 2015: 22.6%
      • 2019: 26.5%
    • Age 21-22
      • 2015: 21.2%
      • 2019: 30.5%
    • Age 25-26
      • 2015: 20.7%
      • 2019: 25.3%
    • Age 27-28
      • 2015: 15.4%
      • 2019: 25.6%
    • Age 29-30
      • 2015: 13.2%
      • 2019: 24.5%
  • Between 2017-2019, the prevalence of smoking marijuana daily at least once in the month before answering the survey increased for the following age groups:
      • Age 21-22
        • 2015: 6.3%
        • 2019: 10.8%
      • Age 25-26
        • 2015: 7.0%
        • 2019: 9.7%
      • Age 27-28
        • 2015: 5.5%
        • 2019: 9.6%
      • Age 29-30
        • 2015: 4.7%
        • 2019: 8.3%

Vaping Marijuana

  • Between 2017-2019, the prevalence of vaping marijuana at least once in the month before answering the survey increased for the following age groups:
    • Age 18:
      • 2017: 4.9%
      • 2019: 14.0%
    • Age 19-20
      • 2017: 6.0%
      • 2019: 14.3%
    • Age 21-22
      • 2017: 6.1%
      • 2019: 14.7%
    • Age 23-24
      • 2017: 8.4%
      • 2019: 11.3%
    • Age 25-26
      • 2017: 4.6%
      • 2019: 11.4%
    • Age 27-28
      • 2017: 7.4%
      • 2019: 12.1%
    • Age 29-30
      • 2015: 4.1%
      • 2019: 14.3%

As you read through this data, keep in mind that all these figures are pre-COVID, so COVID-related stress is not related to any of these increases. Of the data above, the most notable increases are in binge drinking in people between age 23-30 and marijuana use – particularly vaping – in almost all groups age 18-30. The binge drinking numbers are unexpected, because binge drinking is typically associated with college-age people age 18-22, but these numbers show binge drinking on the rise for people in their mid- to late-20s.

The marijuana use numbers jumped for both smoking marijuana and vaping. Smoking marijuana increased significantly for all age groups 18-30, with daily use almost doubling in several categories. Vaping is the area where the increase in prevalence was most pronounced. Between 2017-2019, vaping almost tripled for 18-year-olds, more than tripled for age 29-30, and more than doubled for age 19-20, age 21-22, and age 25-26.

Whether these marijuana numbers are attributable to the novelty of vaping and the move toward legalization for recreational use remains to be seen: research efforts to answer these questions is underway, and we’ll report the data when it becomes available.

Now, we’ll look at prevalence trends in alcohol and drug use in older adults.

Alcohol and Drugs: Adults Age 35-60

The MTF survey broke out the data for older adults of specific ages: 35, 40, 45, 50, and 60. In almost all of these ages, past-month marijuana use, past-month daily marijuana use, and past two-week binge drinking increased.

Binge Drinking and Marijuana Use: Older Adults

Binge Drinking

  • Between 2015-2019, the prevalence of consuming more than five drinks in a row in the two weeks before answering the survey increased for the following ages:
    • 40:
      • 2015: 20.3%
      • 2019: 23.1%
    • 45:
      • 2015: 20.5%
      • 2019: 23.5%
    • 50:
      • 2015: 22.0%
      • 2019: 24.6%
    • 55:
      • 2015: 18.9%
      • 2019: 22.2%

Marijuana Use

  • Between 2015-2019, the prevalence of smoking marijuana at least once in the month before answering the survey increased for the following ages:
    • 35:
      • 2015: 13.2%
      • 2019: 16.0%
    • 40:
      • 2015: 8.8%
      • 2019: 16.4%
    • 45:
      • 2015: 7.8%
      • 2019: 10.2%
    • 50:
      • 2015: 8.0%
      • 2019: 10.3%
    • 55:
      • 2015: 8.6%
      • 2019: 10.9%

The overall increase in binge drinking among older adults is of significant concern. Five or more drinks in a row within two weeks of answering the survey does not prove that these older adults binge drink frequently, but it does cause professionals working in addiction and addiction recovery to think about this development. To help raise awareness, they can spread the word to their peers in other medical areas, such as general practitioners and family doctors. This appears to be a rising trend, and it’s best to arrest developments like this earlier, rather than later. The same is true for marijuana use: rates almost doubled for 45-year-olds and increased by 20-25% for all other ages in this group.

Prevent Stigma Through Awareness and Early Intervention

The MTF survey serves a critical role in how we understand alcohol and substance use disorder in the U.S. Physicians, therapists, counselors, and mental health professionals use the data to get a clear, fact-based idea of exactly what’s going on in the country with regards to alcohol and drug use. When they see upward trends in young adults – especially trends around daily use of substances and binge drinking – it prepares them for an expected increase in people seeking treatment for alcohol and substance use disorder.

Policymakers at all levels – federal, state, and local – use this data to allocate resources to at-risk populations or population of increasing- or near-risk. The right resources at the right time can prevent negative consequences for everyone. An upward trend for teens would precipitate an increase in resources for high schools and colleges. An upward trend for young adults would precipitate an increase in non-school related community resources. And an upward trend for older adults places a responsibility on new groups of people: family members and family physicians. Family members should keep an eye on family members 35 and older, and ask relevant questions related to alcohol use. Family physicians can screen for alcohol use disorder when adults 35 and over appear for regularly scheduled wellness checks and routine lab work.

Together, families, medical professionals, and policymakers can coordinate awareness and resources in order to take proactive steps to spread the word about evidence-based treatment for alcohol and substance use disorder: treatment works – and the sooner someone in need of support gets the support they need, the better their chances of achieving sustained recovery.