For age at first treatment utilization, generation X individuals (HR = 1.64; p < .001) and millennials were more likely than boomers to utilize treatment (HR = 1.64; p < .001) and females age 30 and under were less likely than males to utilize treatment than males of the same age, regardless of generation (HR = .69; p < .001). For the transition from first AUD onset to treatment utilization, generation X males were more likely than boomer males to utilize treatment (HR = 1.90; p < .001) and millennial males six years or less post-onset were more likely to utilize treatment than boomer males (HR = 2.41; p < .001); among females there were no generational differences in treatment utilization for this transition.