Although the NSDUH/NHSDA is the longest-running data source for estimates of binge drinking in a national sample, occasional design changes within the survey series prevent direct comparison of prevalence estimates across all years.24, 25 Hence, we focus on trends in the relative risk for binge drinking among youth, compared to young adults above the legal drinking age. Many of the design changes within the NSDUH series were introduced to decrease social desirability bias, thereby increasing honest reporting, and to increase response rates. Therefore, they are likely to influence prevalence estimates, with the general expectation that substance use estimates would be higher for more recent surveys. We proceed with the assumption that such design effects do not vary significantly with age, so that relative risk measures are less sensitive to design changes than are prevalence estimates. Our objective is accomplished by analyzing trends the relative odds for binge drinking by age and gender, with 24–34 year-old adults chosen as a reference group that is past the legal age for alcohol purchase and consumption. These groups are further stratified by student-status (for college aged subjects) and race/ethnicity.
