By Jeffrey L. Reynolds, Ph.D
Bet you didn’t know that April is Alcohol Awareness Month.
That’s not surprising, because, for the past two decades, the opioid epidemic has commanded — justifiably — the laser-focused attention of public health officials, lawmakers, and advocates like me. We have buried too many people after fatal overdoses, fought too hard for funding, and watched too many families destroyed to look away. But somewhere in that sustained, necessary focus, another crisis kept quietly compounding. We never stopped drinking. We just stopped paying as much attention to it.
Alcohol remains the most widely used substance in America. According to the 2024 National Survey on Drug Use and Health, about 179 million Americans drank in the past year. More than 9 million young adults between the ages of 18 and 25 reported binge drinking in the past month alone. Excessive alcohol use now contributes to approximately 178,000 American deaths annually — more than twice the number killed by opioids in a typical year. Alcohol also plays a part in roughly 30% of all traffic fatalities.
The numbers among young people are somewhat encouraging, but complicated. Thankfully, teen drinking has declined steadily over the past three decades. Consumption among high school seniors over the past year has dropped 44% since 2000, and binge drinking has reached record lows across middle and high school students. The communities, educators, and prevention specialists who drove those public health gains deserve credit.
But we’re not done. Nearly 9.3 million young adults between 18 and 25 still self-reported binge drinking in the past month, and the transition from high school to college — and from college to early adulthood — remains among the most dangerous windows for developing a lifelong problematic relationship with alcohol.
Alcohol disrupts neurodevelopment in the brain’s prefrontal cortex, the region that regulates attention, learning, mood, and impulse control and the damage done in those formative years sometimes doesn’t show up until much later in life.
Among adults, the picture is starker. Alcohol-induced deaths increased by 89% from 1999 to 2024, with the largest relative increases among adults aged 25 to 34 — 255% among women, 188% among men. The COVID-19 pandemic accelerated what was already a troubling trend and we still aren’t back to baseline. We are living with the long tail of a surge that has not fully receded.
Perhaps most concerning is what is happening among women. While men still account for more alcohol-related deaths overall, heavy drinking among women is rising, driven by stress, cultural shifts, and biological vulnerability — alcohol-related liver and heart damage can occur at lower consumption levels in women than in men. This narrowing gap is one of the least discussed trends in American public health — as is the now solid connection between alcohol use and several cancers.
None of this means the opioid crisis deserves less attention. Both crises are real, both are killing our loved ones and neighbors, and both demand sustained public health investments.
Alcohol Awareness Month is a reminder that some of our deadliest health threats don’t arrive with press conferences, emergency legislation, or a steady drumbeat of flashy headlines. They just keep running quietly and largely ignored while we focus on whatever crisis has our attention for the moment.
That’s exactly when they do the most damage.
Dr. Jeffrey L. Reynolds is the President/CEO of Family and Children’s Association (FCA), one of Long Island’s oldest and largest nonprofits providing addiction prevention, treatment and recovery support services.