The high school party days never really ended for a surprising number of middle-aged adults.

A University of Michigan study reveals that adults aged 35 to 60 are drinking at unprecedented rates, with a striking link between high school binge drinking and risky midlife alcohol consumption.

Women, in particular, seem to be experiencing a pronounced surge in risky drinking behaviors, according to the research published in Alcohol: Clinical and Experimental Research.

About 20% to 30% of midlife adults reported binge drinking—with four or more drinks for women, five for men—and 1 in 10 engaged in high-intensity drinking, having 8-10 drinks in a row.

Given the increased health risks associated with aging, the study signals a concerning pattern and highlights a critical need for targeted public health interventions.

“We found that people who reported binge drinking in high engaged in higher levels of alcohol use on a range of indicators decades later during midlife, compared to people who did not binge drink in high school,” said author Megan Patrick of U-M’s Institute for Social Research. “For example, among those who didn’t binge at age 18, only 20% reported binge drinking in midlife compared with 40% among those who did binge at age 18.”

Alcohol use is one of the biggest contributors to illness and death for all adults, and alcohol use conveys even more risk for adults in midlife, said Patrick and colleagues. Decreases in muscle mass and metabolism that are a part of the aging process may inhibit the body’s ability to process alcohol. People at this age more commonly have health conditions that are made worse by heavier drinking, such as diabetes, high blood pressure, cardiovascular disease and osteoporosis.

“While men drank more than women on all measures, the association between binge drinking in high school and high-intensity drinking in midlife was stronger for women,” Patrick said. “Women who reported binge drinking at age 18 were three times more likely to report high-intensity drinking in midlife; men were twice as likely to report high-intensity drinking if they binge drank at age 18. We noted that alcohol use among women in midlife has risen steadily in recent years, while alcohol use among men has not.”

Age and race/ethnicity were associated with drinking behaviors. Although alcohol use declined with age, among 60-year-olds, 1 in 5 still reported binge drinking in the past month. And the link between high school binge drinking and maximum drinks was stronger at age 60 than at age 35.

White participants reported higher typical and maximum drinks than other racial or ethnic groups. Previous studies have found that nonwhite drinkers may experience greater adverse outcomes from alcohol use, despite their lower rates of alcohol use frequency, quantity and alcohol use disorder compared to white drinkers.

Researchers analyzed data from more than 5,000 surveys of adults aged 35, 40, 45, 50, 55 and 60. These participants had been part of a national longitudinal study, the Monitoring the Future Panel study, since the 12th grade. The aim was to explore if there were long-term links between binge drinking in adolescence and alcohol use in midlife.

Respondents in midlife were asked about their drinking habits in the past 30 days. Specifically, they reported the typical number and the maximum number of drinks they consumed on the days they drank.

“Adolescent alcohol use is a predictor of health and well-being in midlife. This provides strong evidence for thinking about prevention and intervention in adolescence for long-term impacts,” Patrick said. “At the same time, many of the people who were binge drinking in high school are no longer engaging in high-risk alcohol use in midlife. We need to continue to examine how and for whom adolescent behaviors pose risks for later health and when protective factors can mitigate negative outcomes.”

The research was funded by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse.