A Generational Change in Drinking Habits with Akhil Anand, MD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

When it comes to college kids and alcohol consumption, most of us have a vision shaped by the rowdy Delta frat in “Animal House.” Well, got some news for you. That idea may be as dated as the classic movie. Research shows that the Generation Z crowd is drinking far less alcohol than previous generations. So what's behind this trend? Does that mean alcohol and drug use worries are disappearing?

Addiction psychiatrist, Akhil Anand is with us today to break the topic down. Dr. Anand is one of the many experts at Cleveland Clinic who visit our weekly podcast to explore health topics. So with that, let's see what this younger generation is doing differently and what it might mean in the long run.

Welcome back to the podcast, Dr. Anand. I appreciate you stopping by to chat.

Dr. Akhil Anand:

Great to be back, and I'm excited about this topic, young adults.

John Horton:

Yeah. Well, yes. And I have to tell you, when we first talked about doing a show on younger people on alcohol use, we all kind of assumed what direction things were going to go. And I have to say, I was a little surprised with what I found when I started doing research.

Dr. Akhil Anand:

Right. It's interesting. The national average of alcohol use … in fact, they've done surveys, and about 62% of Americans 12 and older drink alcohol, have drank in the last year. What we've actually noticed, though, younger adults — particularly the Gen Z population — there's a reduction in alcohol use and it's been for a while. This is not just a blip, we're talking two decades, we've seen a decrease in their alcohol use.

Interesting, too, is we've seen an uptick in our elderly population, so that's why the number hasn't changed. But yet the younger adults are drinking less alcohol. I'm glad you guys caught onto that.

John Horton:

Well, and I was shocked, and here I have a couple of, like I said, from the research I did, a few studies. One showed that Generation Z — and that would be people born after 1997 — are drinking 20% less alcohol than Millennials, the generation right before them. And there was another group that found that 28% to 30% of young adults in that age group just simply abstained from alcohol. What's driving these numbers and these trends?

Dr. Akhil Anand:

There's a lot of theories out there. The answer is, we don't really know. But there are a lot of theories. One of the theories is that there's more awareness now about mental health and the association with alcohol use in mental health. There's now more data and more awareness about the harms of alcohol on health, and the Gen Z population seems to be more focused on health, which is great.

There's been some studies on weight, and people have been surveyed about that in this population, and that's one of the reasons why they don't like to drink. There's been other surveys that have shown that they don't like to have hangovers, which is great. There's also theories about-

John Horton:

…None of us do.

Dr. Akhil Anand:

Right.

John Horton:

They're actually doing something about it, though.

Dr. Akhil Anand:

Yeah. But they're mentioning that in their surveys, they're identifying that, which is interesting. And then, there is this also idea of, are they using other drugs, like cannabis and other drugs rather than alcohol? There's a lot of theories.

Another theory, it's a very simple one, is the American demographic population is changing, the race population is changing. So there are more mixed ethnicities and an increase in Black and Hispanic population, which tend to drink less than the white population. So that's another reason why the numbers are decreasing in the Gen Z population. There's a lot of theories. It's probably a combination of everything.

John Horton:

Well, and it usually is, it's all these forces coming together. Is there even some thought that it's years and years and years of this alcohol education that's been out there and that it's finally taken hold a little bit or sticking?

Dr. Akhil Anand:

I think so. There's a lot more awareness now than I can remember. And I think you're right, I think because of the access, I think the government has done a lot of great stuff. There's a lot of public health policies — we talk about Dry January, for example — so there's a lot of increased awareness, and Gen Z folks are listening.

John Horton:

Well, and that's where I feel like it almost is a cultural movement that you're seeing. You had mentioned Dry January, which I don't think any of us had ever really heard about until within the last few years. This whole notion of just … you're giving up alcohol for the first month of the year. And even when you go to restaurants and bars, it seems like they have so many more mocktails and nonalcoholic options. So you kind of see the world adjusting to this.

Dr. Akhil Anand:

Yeah. I know Dry January, which has been around, I think you said a few years, which is interesting because it's been around longer than that. Came from Britain and I moved here. People have really enjoyed it. I talk to folks all the time, my friends and family members, and they love doing it.

And studies have shown even one month of sobriety can really enhance a person's sleep architecture, can help them reduce weight. It shows substantial reduction in cholesterol and triglycerides, even with one month, and people notice it. It's really fascinating. If someone stops drinking for a month, they definitely will tell you that they feel better, they're more energetic, their mood is better.

And yeah, the nonalcoholic industry, it's huge now. I see it everywhere, every grocery store, every convenience store. It's great, it's wonderful.

John Horton:

Well, and then, you do start to wonder, once people kind of adjust and you kind of take alcohol out of your system and then you put it back in and you sometimes that bad feeling that you get, you can see why you just start opting not to do it as much.

Dr. Akhil Anand:

Yeah. So that's another part of Dry January, where they've noticed that folks that really follow through or try it, it gives them a lot of self-awareness about a) they can enjoy their lives without alcohol, and then b) when they reintroduce alcohol, the adverse effects of it, that they're not sleeping as well as anymore, they're having those hangovers again, they feel guilty again. They just don't like the feelings, what they're doing to their stomach, their stomachs are more upset. So they have found that doing something like Dry January over a month, it leads to — for a subset of the population — a reduction in total alcohol consumption over the rest of the year.

John Horton:

Well, obviously, we're seeing a positive trend and we're seeing those numbers drop, but I'm guessing that there still are issues with alcohol abuse and overdoing it. And binge drinking, I'm assuming, has not just disappeared among younger folks and college students.

Dr. Akhil Anand:

Yeah, John. In fact, binge drinking, the most common population to binge drink is the young adults. And you're right, binge drinking does not mean that you have an alcohol addiction, but binge drinking can be extremely harmful to the body and to the brain. Binge drinking increases the risk of violence, of impulsive, reckless behavior, motor vehicle accidents, rise in STDs and abuse. Binge drinking can lead to blackout drunks, it can lead to falls. It is very scary.

And there is a trend of increased binge drinking in certain younger populations, which is leading to more strain on the liver. And we're developing a rise in something called alcoholic hepatitis, which is the most severe form of liver disease, acute liver disease from alcohol. And we have seen an uptick, specifically after the pandemic, with this in the younger adult population, specifically the younger female population.

John Horton:

Wow. It's so surprising. You kind of have both ends, the extremes, where you're seeing increases. I guess that's the way our world's going with a lot, though.

Dr. Akhil Anand:

Yeah, and that's the thing — it's that moderation — it’s really hard with alcohol. And oftentimes, people are using alcohol for reasons that are not for enjoyment per se. They're using it to cope with stress and anxiety, and we're seeing that after COVID. And so, yeah, it's a tricky, slippery slope. I hope we can find some kind of middle ground.

John Horton:

You mentioned this earlier, when we were talking about the decrease in alcohol consumption. But is some of this drop connected to the use of marijuana or other sort of drugs? Is that going up and alcohol is dropping in response?

Dr. Akhil Anand:

I think so. I think there's an element of that. We are seeing the Gen Z population is using more marijuana than any other population. I think 46% of them, in recent surveys, use marijuana regularly. So we're seeing a huge rise in marijuana use, and there’s multiple reasons.

One is access has increased. People have a lower risk perception of marijuana than they've ever had before. And the government is ... the deregulating of marijuana, so it's all become OK. And folks are using marijuana more than alcohol.

They're also using other drugs more than alcohol. We're seeing a lot of other things like hallucinogens being used by the younger adult population, higher than we've ever seen it been used before. So we are seeing definitely more drug use, maybe less alcohol use.

John Horton:

Is this just a case of one substance being traded for another?

Dr. Akhil Anand:

I don't know. Maybe. That's a great question, John. The answer is, I don't know, but they are addictive, right? Marijuana is an addictive substance. If you use it regularly, people do get dependent. And I have seen in my practice, people come in with marijuana withdrawals. So people do develop a use disorder from it, so that could possibly be it.

Oftentimes, people are using marijuana to cope with stress, just like they were using for alcohol. Some people are using it to cope with their depression, just like they're using it for alcohol. So there are harmful use patterns with marijuana as there are with alcohol.

John Horton:

In looking specifically then just at alcohol, which is kind of what we've been focused on, where do you see this trend regarding consumption going? Do you see us entering a period where just increased moderation just becomes the norm?

Dr. Akhil Anand:

No. I generally don't know, but I don't think so. Alcohol is everywhere. In this country, it's very culturally acceptable to drink. I have friends that are not doctors that work in different … like finance, and they tell me that there's alcohol at work, there's alcohol at bar mitzvahs, there's alcohol at baby showers, there's alcohol at weddings and funerals. It's just part of the essence. And like I mentioned very early on in the interview, 62% of adults are still drinking. It's just now we're having older folks.

It's nice to see that there is more awareness about alcohol use. But then you look at it — we talked about the extremes — we're seeing a rise in young adults developing alcoholic hepatitis. Alcoholic hepatitis is very severe. It's a 50% mortality in the first three months.

John Horton:

Wow. Yeah.

Dr. Akhil Anand:

Yeah. It's a whole mess. It goes back to, should it ever have been legal? Moderation. So the answer is, I don't know … some of these things are very cyclical, so things become trendy and then they change again. We'll see. Hopefully, we'll have an interview in 10 years and talk about it.

John Horton:

Well, and we can do that. We can book that now. Dr. Anand, it's always a fascinating conversation when you come in here and you join us, and I could keep doing this with you all day, but I know that you have patients waiting. So before we kind of part ways, is there anything else that you'd like to add on this topic and where we're going?

Dr. Akhil Anand:

It's a great topic. I feel there's a lot to explore with this new landscape of drug use in young adults. If you know someone, if you, yourself, are struggling with addiction, whether it be alcohol or marijuana or anything, know that there's help available. You can go to your primary care doctor, you can go to family and friends. There are plenty of self-help groups. Often, folks that struggle with addiction, they do it alone. But they get better with community and family and friends. So always ask for help. If you know someone, do your best to help them find help as well. Speak up.

John Horton:

Dr. Anand, you always have a wonderful way of wording everything and just driving the point home, so thank you very much for joining us, and I look forward to having you back.

Dr. Akhil Anand:

Thanks, John. Thanks for having me. Bye.

John Horton:

Concerns about young adults and teens abusing alcohol date way back. And truth be told, those worries will never go away. But this new generation seems to be making better choices when it comes to beer and booze. Maybe they can even teach us a thing or two. Till next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.