Objective: Research with college populations suggests that elevated levels of heavy drinking do not generally persist into later adulthood for most individuals. The aims of this study were to determine whether this pattern applies to the population as a whole and to identify those for whom heavy drinking in early adulthood does lead to continued high levels of consumption throughout the life course. Method: Patterns of heavy drinking were assessed, and a mixture model was used to evaluate relationships between psychological profiles and trajectories of heavy drinking in early to middle adulthood for race-gender groups. Subjects (N = 5,115; 55% women) were drawn from the longitudinal study of Coronary Artery Risk Development in Young Adults (CARDIA) conducted in four major U.S. cities from 1985 to 1995. Results: Patterns of heavy drinking differed by race and gender, with higher rates observed among whites and men. Heavy drinking was generally most common in the early 20s and dropped sharply thereafter. For a subset with psychological profiles characterized by elevated levels of hostility, anxiety, and depressive symptoms, high rates of heavy drinking persisted into later adulthood; 20% of whites and 50% of blacks in the overall sample were in this subset. Rates of heavy drinking in this group were similar for blacks and whites. Conclusions: At a population level, heavy drinking in early adulthood tends not to continue into later life. For a subset of psychologically vulnerable individuals, however, early adult heavy drinking persists into the middle adulthood years.