People in their 40s have the highest rates of hospital admissions for drug and alcohol abuse, a review says.
More than half a million people were admitted to hospital as an emergency in the last three years with serious health problems related to drink or drug use, health performance experts Dr Foster said.
Of the 533,302 admitted since 2010, more than 120,000 were in their 40s.
Of those, 60,738 were 40 to 44, the Guardian said, while 60,083 were between 45 and 49.
Almost one in five people in their 40s admitted to hospital for any reason in 2012/13 were classed by the NHS as "emergency admissions due to a known drug/alcohol issue", the report said.
Experts warned of a generation that is gambling with its long-term health through heavy drinking and drug taking.
Roger Taylor, co-founder of Dr Foster, told the BBC the figures suggested there was a particular issue among people born in the 1960s.
He said: "The bulk of the problem is in this age group. It seems they are the ones that have used drinks and drugs more than previous generations and it is now catching up with them in middle age."
The data, collated for Dr Foster's annual Hospital Guide, which is released today, also revealed that alcohol and drug abuse problems cost the NHS £607million a year.
While drinking problems were spread across all socio-economic groups, the poorest were most likely to end up in hospital.
Some 192,014 (36%) of the total admissions since 2010 were of people in the most deprived income group, compared with 45,957 (8.6%) of people in the wealthiest 20%.
The figures also showed an alarming number of children and teenagers were admitted to hospital for drink and drug problems.
More than 1,000 children between 10 and 14 were hospitalised each year - 3,013 over the three-year period - and 24,101 teenagers between 15 and 19 years old.
Some 15% of drink or drug-related admissions were among those aged 30 to 34, 18% between 35 and 39, and 16% for 50 to 54-year-olds.
And the figures uncovered a geographical divide in the numbers of patients admitted because of drink or drugs, with higher rates in the north of England, the Guardian said.
Matt Tee, chief operating officer of the NHS Confederation, which represents hospitals, told the Guardian the hidden problem of middle-age drinking to excess was more harmful than binge-drinking.
He told the newspaper: "It's all too easy to dupe ourselves that binge-drinking teenagers or stag and hen parties in their 20s are the cause of alcohol-related pressures on the health service.
"Today's news puts this myth firmly back in its place and makes it even more important that as a society we seriously examine the impact our drinking habits have on our health - and on our health service."
The British Medical Association warned that the burden from alcohol on the NHS was unsustainable.
A spokesman said: "It is vital that we take more action to tackle the impact of excessive alcohol consumption on the UK's population and the NHS.
"As the Dr Foster research highlights, this is a problem that affects large numbers of people across all age groups and as a result places serious strain on a number of already overstretched NHS services. "