Alcohol Use Is Down, But the Health Toll Is Rising — Here’s Why That Matters

As alcohol use among younger Americans hits record lows, the health consequences tied to drinking are paradoxically on the rise. The reason? According to Dr. Amy Swift, Deputy Chief Medical Officer at Silver Hill Hospital, we’re only now witnessing the delayed fallout from decades of sustained alcohol use in older populations.

“When we look at the consequences of heavy alcohol use, we have to look at a timeline that extends beyond the immediate years we’re observing,” says Dr. Swift. “What we’re seeing now are the effects of alcohol use over the last 15 to 20 years. Heavy use doesn’t always manifest right away — it often shows up later in life as organ damage.”

September marks National Recovery Month, a timely reminder that the conversation around alcohol use must extend beyond statistics. Dr. Swift points to the widening disconnect between drinking trends and the current health toll. While younger generations may be drinking less, the damage from long-term consumption, especially to the brain and liver, is just coming into focus.

The Hidden Damage

“In the short term, alcohol causes disinhibition,” explains Dr. Swift. “It opens the door to behavior changes where people may put themselves in risky situations, interact with others in ways they typically wouldn’t, or use other substances. These are largely psychosocial effects.”

But the long-term effects are more insidious and often overlooked. “With continuous exposure, we often see cognitive decline — memory impairment is a common symptom,” she says. “Interestingly, when individuals stop drinking, some of that memory function can improve.”

Even so-called “moderate” drinking isn’t without consequences. The language itself, Dr. Swift believes, is part of the problem.

“Moderate drinking still carries risk. Anytime someone exceeds four drinks a week for women, or five drinks for men, they’re entering riskier territory. The term ‘moderation’ is part of the problem — we really should be saying alcohol should be used ‘sparingly’ instead of in moderation.”

Alcohol’s Day-After Effects

While public conversations often fixate on how long alcohol stays in your system, Dr. Swift urges people to consider the cognitive and emotional aftermath.

“It’s important to understand that while the acute effects of alcohol last only a few hours, the next day is just as important,” she says. “People often report feeling depressed or anxious after drinking and rarely connect that back to their alcohol use.”

This lack of awareness has real consequences. “Alcohol isn’t just a night-of issue, it affects your brain chemistry well into the next day and, as mentioned, can have long-term brain implications as well.”

Stigma and the Biology of Addiction

Perhaps the most dangerous misconception? That addiction is simply a matter of choice or willpower.

“There’s also the persistent belief that addiction is a choice,” says Dr. Swift. “Initially, people may choose to drink, but over time, the part of the brain responsible for decision-making shifts. Once someone is using consistently, especially when they feel worse without the substance, their brain moves from logical decision-making to being driven by emotion and impulse. At that point, it’s no longer about willpower, it’s about biology.”

Stigma, she notes, hits hardest among those society expects to “have it together,” such as mothers, police officers, and first responders. “That stigma creates enormous barriers to treatment. These are people we depend on, and yet we make it harder for them to get help.”

A Message of Hope for Recovery Month

Younger generations are certainly drinking less, but that doesn’t mean the problem is going away. 

“There’s an entire industry behind it that isn’t going anywhere,” says Dr. Swift.

Instead, what we’re seeing is what she calls a “telescoping of illness.” As casual or social drinking declines, the smaller group that continues to drink may be progressing more quickly toward serious health consequences like organ damage. “So while fewer may be drinking, those who are could be sicker and need help sooner.”

Despite the statistics, Dr. Swift emphasizes that recovery is always possible, even for those who’ve relapsed before.

“Even if you’ve tried before and it didn’t work out, it’s always worth another try,” she says. “I’ve seen people speak at recovery meetings who say, ‘This was my 50th time in rehab,’ and now they’ve been sober for 10 years. With the right care at the right time, that can be you.”

And treatment today isn’t what it used to be. “There are virtual options, outpatient programs, and a wide range of services that are more accessible than ever,” she says. “I encourage people to explore their options before they’re in crisis — or for loved ones to quietly prepare in the background. That way, when someone says, ‘I’m ready,’ the path is already there.”

Spotting the Signs

For families and loved ones, early intervention can be lifesaving. Dr. Swift advises paying attention to a loss of control over drinking habits. “If someone says in the morning they’re not going to drink, but they have a drink in hand by evening, that’s a red flag.”

Other warning signs include missed responsibilities, risky behavior, or drinking in inappropriate settings. In those cases, Dr. Swift says, “The most supportive thing you can say is, ‘I know this isn’t who you are. Let me help you.’”

The Role of Primary Care

One key opportunity to catch harmful drinking patterns early lies in the primary care setting. 

“There’s very little stigma about seeing your primary care doctor once a year, which makes them the perfect person to start this conversation,” says Dr. Swift.

“They can ask simple, nonjudgmental questions like, ‘What is your relationship with alcohol or cannabis?’ When providers ask these questions in a casual, supportive way, patients are more likely to respond honestly. And those answers open the door to follow-up conversations, support, and potentially life-changing care.”

For more information, visit https://silverhillhospital.org.