Virginia Via Research Day Book 2026

Medical Graduate Student Research Public Health

02 ALCOHOL USE BEHAVIORS IN THE UNITED STATES BEFORE AND AFTER THE COVID-19 PANDEMIC: A SECONDARY ANALYSIS OF NSDUH DATA (2019–2022)

Sara Bannwart, Laura Hungerford, DVM, NREMT, MPH, PhD, CPH, FNAP Corresponding author: sarabannwart@vt.edu

Virginia Tech, Blacksburg, Virginia

Alcohol consumption patterns in the United States may have shifted in recent years, potentially due to unavoidable stressors such as the COVID-19 pandemic, but evidence is still emerging. Understanding national trends in alcohol use and related behaviors can help identify emerging public health needs. This study examined changes in alcohol-related behaviors in 2022 compared to 2019, using secondary data from the National Survey on Drug Use and Health (NSDUH). The primary objective of this study was to determine whether alcohol use behaviors, including frequency of drinking and heavy drinking, differed between 2019 and 2022, controlling for demographic factors, using secondary analysis of NSDUH data. NSDUH datasets from both years included participants from across the United States, aged 12 and older. Key variables that were considered in this analysis included heavy drinking recorded in the past month, general alcohol use recorded in the past month, and self-reported alcohol abuse and disorder based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). In this dataset, the same method for classifying cases of alcohol use disorder was not available for both years, however, the variable for the average number of reported drinks in the past month was.

Participants with missing data regarding alcohol use were not included in analysis. The association between gender and alcohol use disorder prevalence in 2019 and 2022 was examined by using a stratified analysis of contingency tables. The association between 2019 and 2022 and the median days of drinking per month were examined using a non-parametric Wilcoxon rank sum test. All analyses were conducted using OpenEpi and R-Studio. The datasets used in analysis included deidentified participants through public-use data under the provisions of the NSDUH agreement with the IRB. In 2019, 622 out of 29,348 (2.12%) of female respondents reported alcohol abuse, compared to 931 out of 26,788 (3.48%) of male participants. Females had a significantly lower of alcohol abuse than males (RR=0.61, 95% CI of 0.55, 0.67, (p<0.0001) with a risk difference of -1.36% (95% CI of -1.63, -1.08). In 2022, 3005 of 15,543 (19.33%) of female participants reported alcohol use disorder, compared to 3210 of 13,085 (24.53%) of male participants. The risk ratio was 0.79 (95% CI of 0.75, 0.82, p<0.001), and the risk difference was -5.20% (95% CI -6.16, -4.24), indicating a similar pattern from 2019 of a lower risk among females. Because of these differences, recorded drinks per month were analyzed by gender. For men,

the median number of drinking days remained at 5 per month from 2019 to 2022, but the Wilcoxon test indicated a small yet statistically significant shift in the overall distribution (p = 0.027), likely reflecting increased drinking in the upper tail. For women, the median stayed at 4 days per month, and the distribution did not change significantly (p = 0.555). Future investigations will elaborate on these findings using a comprehensive multivariable approach to incorporate confounding and effect modifying variables and, to refine the interpretation of alcohol consumption patterns. Overall, this study supports the conclusion that men tend to exhibit more alcohol-related behaviors compared to women and that drinking among men may have increased in the post COVID period. These findings address the question by identifying demographic patterns associated with alcohol use behaviors, highlighting how patterns have changed over time.

Table of Contents

36 Edward Via College of Osteopathic Medicine (VCOM)