Alcohol's Deadly Toll: Annual Global Deaths

Alcohol is a leading cause of preventable deaths in the United States, second only to tobacco. Alcohol-related deaths have been on the rise in the US over the past two decades, with liver disease deaths and alcohol-linked cancer deaths doubling. In 2021, cancer deaths linked to alcohol rose to more than 23,000 a year, with liver disease deaths doubling over 20 years. Alcohol-impaired crash fatalities accounted for 28% of all crash fatalities, with 10,142 people dying in drunk-driving crashes in 2019. Overall, alcohol is estimated to cause about 88,000 deaths in the US each year, with Native Americans having the highest prevalence of heavy drinking.

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Alcohol-related cancer

Alcohol consumption is a leading preventable cause of death in the United States. Alcohol-related deaths have been on the rise in the US over the past two decades, with liver disease deaths doubling over 20 years and a significant acceleration during and after the COVID-19 pandemic.

Alcohol use is linked to an increased risk of several types of cancer, including mouth, throat, voice box, and esophageal cancer. Drinking even small amounts of alcohol can increase the risk of breast cancer in women, with alcohol consumption increasing estrogen levels in the body, which plays a role in breast cancer development. Alcohol use is also linked to an increased risk of colorectal cancer, with colorectal cancer being the most common alcohol-associated cancer among men. Long-term alcohol use has also been linked to an increased risk of liver cancer.

Alcohol may increase cancer risk in several ways. Firstly, alcohol can disrupt cell cycles, increase chronic inflammation, and damage DNA. When DNA is damaged, a cell can grow out of control and become cancerous. Secondly, alcohol can increase the absorption of carcinogens from tobacco, making it easier for the cells in the mouth to absorb these cancer-causing chemicals. Thirdly, alcohol might limit the ability of cells in the mouth, throat, and esophagus to repair damage caused by the chemicals in tobacco. Finally, alcohol use increases levels of hormones such as estrogen, which are linked to an increased risk of certain cancers.

According to the National Institutes of Health (NIH), about 5.5% of all new cancer diagnoses and 5.8% of all cancer deaths are attributed to alcohol consumption. This equates to approximately 20,000 alcohol-associated cancer deaths per year in the United States, with more than 538,000 alcohol-associated cancers occurring in the US in 2022. Alcohol use accounts for about 5% of all cancers and 4% of all cancer deaths in the country.

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Liver disease

Alcohol misuse is now one of the most common causes of death in the UK and the US, along with smoking and high blood pressure. Alcohol-induced deaths include International Classification of Diseases, 10th Revision (ICD–10) underlying cause-of-death codes, such as alcoholic liver disease. Alcoholic liver disease was the most frequent cause of alcohol-induced death in the US in 2019 and 2020, with the rate of deaths increasing by 23% from 2019 to 2020.

Alcohol-related liver disease (ARLD) refers to liver damage caused by excess alcohol intake. The liver breaks down alcohol, and if you consume more than the liver can process, it can become seriously damaged. As the liver breaks down the alcohol, the chemical reaction releases a toxin that damages liver cells. If too much alcohol is ingested repeatedly over time, even without getting drunk, liver damage can silently begin. Typically, it takes several years of unhealthy drinking to develop alcohol-related liver disease, but fatty liver disease can occur after drinking excessive amounts of alcohol for as little as two weeks. The liver is very resilient and capable of regenerating itself, but prolonged alcohol misuse over many years can reduce its ability to regenerate, resulting in serious and permanent damage to the liver.

There are three stages of alcohol-related liver disease: fatty liver disease, alcohol-related hepatitis, and alcohol-related cirrhosis. Fatty liver disease is reversible if a person stops drinking alcohol for several months or years. Alcoholic hepatitis is a potentially serious condition that can be caused by alcohol misuse over a long period, or by binge drinking a large amount of alcohol in a short period of time. The liver damage associated with mild alcoholic hepatitis is reversible if the person stops drinking permanently. However, severe alcoholic hepatitis is a serious and life-threatening illness that causes many deaths in the UK each year. Alcohol-related cirrhosis occurs when the liver has become permanently damaged by alcohol, to the point where scar tissue replaces healthy tissue, causing the liver to shrink and harden. This type of damage cannot usually be reversed, and it can lead to liver failure.

The signs and symptoms of ARLD vary depending on the severity of the liver damage. Patients with fatty liver disease usually do not have any symptoms, but symptoms for hepatitis and cirrhosis may include the appearance of red blood vessels on the skin’s surface that resemble a spider web. Diagnosis usually begins with a medical history and physical exam, and other tests may include blood tests, liver biopsies, ultrasounds, and CT scans. The best treatment for ARLD is abstinence from alcohol, and getting help through an alcohol use disorder treatment program can improve the likelihood of favourable outcomes.

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Heart disease

Alcohol is a major cause of preventable deaths worldwide. In 2019, around 2.6 million deaths were caused by alcohol consumption globally, with 1.6 million of these being from noncommunicable diseases, including heart disease. Alcohol-related deaths in the United States alone increased by 29% from 2016-2017 to 2020-2021, with a total of 178,000 alcohol-related deaths in the latter period. Of these, about 117,000 were from chronic conditions that develop from drinking alcohol over time, such as heart disease.

Excessive alcohol intake is a well-known risk factor for heart disease. Heavy drinking is linked to high blood pressure, heart failure, and stroke. It can also contribute to cardiomyopathy, a disorder that affects the heart muscle. Alcohol-induced cardiomyopathy is a condition where the heart changes shape due to long-term heavy alcohol use. The heart muscles stretch and weaken, reducing the heart's ability to pump blood effectively and disrupting the body's oxygen supply. This condition can lead to severe problems and even heart failure.

The Centers for Disease Control and Prevention (CDC) defines heavy alcohol use as more than eight drinks per week for women and more than 15 drinks per week for men. Alcohol-related cardiomyopathy is a type of dilated cardiomyopathy, where the heart muscles stretch and weaken due to excessive alcohol consumption. The muscles that control the lower chambers of the heart, the left and right ventricles, are particularly susceptible to this kind of stretching.

In addition to the direct impact on heart health, alcohol consumption can also contribute to obesity and associated health problems. Alcohol is a source of excess calories and can cause weight gain, which can further increase the risk of heart disease. Additionally, alcohol can have a toxic effect on the heart, leading to the formation of scar tissue.

While alcohol consumption can have detrimental effects on heart health, it's important to note that individual genetic factors also play a role in the development of alcohol-induced cardiomyopathy. This condition is relatively uncommon, occurring in about 1% to 2% of people who consume more than the recommended amount of alcohol. However, limiting alcohol intake can help lower the risk of alcohol-related heart problems.

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Accidents and injuries

Alcohol is a major factor in a significant number of accidents and injuries each year, leading to disability and death. The World Health Organization (WHO) estimates that globally, 3 million people die each year as a result of harmful alcohol use, with accidents and injuries being a leading cause.

Road Traffic Accidents

Alcohol impairs judgement, reaction time, coordination, and vision, making driving under the influence extremely dangerous. According to the WHO, alcohol is a factor in about one-third of all traffic-related deaths, with an estimated 340,000 annual deaths attributed to alcohol-related crashes worldwide. Studies have shown that even at low blood alcohol concentrations (BAC), the risk of being involved in a crash significantly increases.

Alcohol poisoning

Alcohol is the most common substance used by people aged 12 and older in the United States. Excessive alcohol use is a leading preventable cause of death in the country. Binge drinking is the most common way that people drink alcohol excessively. In 2021, an estimated 23,207 people died from cancer caused by alcohol in the US, a significant increase from 11,896 deaths in 1990.

The symptoms of alcohol poisoning include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, pale or blue-tinged skin, and extremely low body temperature. These symptoms indicate that the areas of the brain controlling basic life-support functions, such as breathing, heart rate, and temperature control, are beginning to shut down. Alcohol poisoning can lead to permanent brain damage or even death if left untreated.

If you suspect someone is experiencing alcohol poisoning, it is important to call for emergency medical assistance immediately. Do not drive the person to the hospital yourself, as their condition may deteriorate rapidly. Stay with the person and follow the advice provided by the emergency services. Place them in the recovery position if they are unconscious and monitor their breathing. Do not give them coffee or caffeinated drinks, as this can dehydrate them further. It is also important to not put them in a cold shower or bath, as their body temperature is already dangerously low.

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