Vivian Marlowe
Alcohol is a major cause of death worldwide, with about 178,000 people dying from excessive drinking each year in the US alone. Alcohol-related deaths have been rising over the past two decades, with liver disease, cancer, heart disease, and stroke being common causes. In the UK, men are twice as likely to die from alcohol-specific causes than women, with a rate of 22 deaths per 100,000 people. Drunk driving is also a significant issue, causing hundreds of deaths each year in the USA, including those of children. With alcohol being the most common substance used by people aged 12 and older in the US, the impact of excessive drinking on public health is a growing concern.
| Characteristics | Values |
|---|---|
| Number of deaths per year in the US | 178,000 |
| Number of deaths per year in the UK | 10,473 |
| Number of deaths per year among young people (under 21) in the US | 4,000 |
| Number of deaths per year of children (0-14) in the US due to drunk driving accidents | 229 |
| Number of deaths per 100,000 people in the UK | 16 |
| Number of deaths per 100,000 people in the US | 12.5 |
| Number of deaths per 100,000 men in the UK | 22 |
| Number of deaths per 100,000 women in the UK | 10 |
| Number of deaths per 100,000 people in London | 12 |
| Number of deaths per 100,000 people in Islington, London | 16.9 |
| Number of deaths per 100,000 people in Barnet, London | 6.9 |
| Number of deaths due to alcohol-related cancer in the US in 2021 | 23,207 |
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What You'll Learn
Alcohol-related cancer
Alcohol consumption is linked to an increased risk of developing several types of cancer. Alcohol use accounts for about 5% of all cancers and 4% of all cancer deaths in the United States. 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.
Alcohol can increase the risk of cancer in several ways. Firstly, it can disrupt cell cycles, increase chronic inflammation, and damage DNA. DNA is the cell's "instruction manual," and when it is damaged, a cell can grow out of control and become cancerous. Alcohol can also increase estrogen levels, which is a known risk factor for breast cancer development. Additionally, alcohol makes it easier for the cells in the mouth, throat, and oesophagus to absorb carcinogens, or cancer-causing chemicals, especially when used in combination with tobacco.
Long-term alcohol use has been linked to an increased risk of liver cancer. Regular and heavy alcohol consumption can lead to liver inflammation and scarring, increasing the risk of liver cancer. Alcohol use is also associated with a higher risk of cancers of the colon, rectum, and pancreas. In fact, colorectal cancer is the most common alcohol-associated cancer among men.
The risk of developing alcohol-related cancers increases with the amount of alcohol consumed over time. While drinking in moderation is often recommended, studies have shown that even small amounts of alcohol can increase the risk of certain cancers, such as breast cancer. The type of alcohol consumed is less important than the amount, as all alcoholic drinks contain ethanol, which is the main contributor to increased cancer risk.
The number of alcohol-related cancer deaths has been on the rise, particularly among older adults and women. In the United States, the number of deaths from alcohol-linked cancer doubled from 11,896 in 1990 to 23,207 in 2021. Similarly, in the UK, alcohol-related deaths have been increasing, with a record number of deaths reported for four consecutive years. While liver disease is a significant contributor to alcohol-related deaths, cancer caused by alcohol consumption is also a growing concern.
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Liver disease
Alcohol-related liver disease (ARLD) is a spectrum of disorders caused by excess alcohol intake. The liver is a highly resilient organ, capable of regenerating itself, but prolonged alcohol misuse over many years can reduce its ability to regenerate, leading to serious and permanent damage. ARLD is often asymptomatic until the liver has been severely damaged, and it is one of the most common underlying causes of alcohol-induced deaths.
Alcoholic liver disease progresses through several stages, each with varying levels of severity and associated symptoms. The first stage is alcoholic fatty liver disease, which affects about 90% of people who regularly consume excessive amounts of alcohol. This stage is usually reversible if the person stops drinking, but if they continue, it can progress to the next stage, alcoholic hepatitis. This stage is characterised by inflammation and swelling of the liver, which impairs its ability to function. Alcoholic hepatitis can be caused by long-term alcohol misuse or binge drinking over a shorter period. While mild cases are usually reversible if the person stops drinking, severe alcoholic hepatitis is a serious and life-threatening condition.
The final stage of alcoholic liver disease is alcoholic cirrhosis, which is irreversible. Cirrhosis is the result of scarring of the liver, and it is this stage that often requires a liver transplant. Between 1999 and 2019 in the United States, there was a greater-than-threefold increase in deaths from alcoholic cirrhosis, with the largest increase seen in the 24-35 age group. In 2019, alcohol-related liver disease resulted in approximately 37,000 deaths in the US, and the number of 25-34-year-olds dying annually from alcohol-related liver disease nearly tripled between 1999 and 2016.
The best treatment for alcohol-related liver disease is abstinence from alcohol, and many patients can recover if they stop drinking early enough. However, this requires a multidisciplinary approach, and specific treatments are available to help people remain abstinent and reduce liver inflammation. Public health interventions, such as strategic taxation of alcoholic beverages and counselling, can also play a role in addressing the problem by deterring consumption.
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Drunk driving accidents
Drunk driving is a serious issue that affects the entire country, and it continues to happen across the United States. Driving while intoxicated is illegal in every state, yet people still choose to get behind the wheel while impaired. This puts not only themselves at risk but also endangers the lives of others on the road.
According to the National Highway Traffic Safety Administration (NHTSA), drunk driving fatalities accounted for 32% of total vehicle traffic fatalities in 2022, with an estimated 13,524 people killed in crashes involving a driver with an illegal blood alcohol concentration (BAC) of .08 or greater. This means that about 11,000 people die every year in drunk-driving crashes, with 12,429 deaths reported in 2023. The risk of crashing is even higher for young males, with a staggering statistic showing that one person was killed in a drunk-driving crash every 42 minutes in the United States in 2023.
The impact of drunk driving extends beyond the immediate physical harm caused in crashes. When drunk drivers cause accidents resulting in injuries or fatalities, they face severe legal consequences, including vehicular manslaughter charges, which can carry long prison sentences. Additionally, the financial toll of impaired driving crashes is significant. Based on 2019 numbers, these crashes cost the United States approximately $68.9 billion annually.
Ignition interlock devices are one measure implemented to prevent drunk driving. These devices are connected to a vehicle's ignition, requiring the driver to blow into them before starting the vehicle. If the driver's BAC is above a pre-set low limit, usually .02 g/dL, the vehicle will not start. While this technology is effective in keeping drunk drivers off the road, the responsibility to avoid drunk driving rests with individuals. It is essential to plan a safe ride home before consuming alcohol, whether by choosing a designated driver, calling a taxi, or arranging a sober ride.
Despite the overall decline in drunk driving fatalities since 1982, there is still much work to be done. Hardcore drunk drivers continue to be a persistent problem, accounting for nearly 70% of drunk driving fatalities. To eliminate drunk driving, a combination of education, stricter laws, and proven solutions is necessary.
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Alcohol poisoning
Alcohol is a leading cause of preventable death, with alcohol-related fatalities on the rise in the US and UK. In 2023, the UK recorded 10,473 alcohol-related deaths, while the US saw 23,207 alcohol-associated cancer deaths in 2021. These numbers underscore the urgent need for enhanced prevention and public health strategies.
The signs and symptoms of alcohol poisoning can vary among individuals but generally include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, pale or blue-tinged skin, and extremely low body temperature. It is important to note that continuing to drink despite displaying these signs of impairment can result in an alcohol overdose.
If you suspect someone is experiencing alcohol poisoning, do not drive them to the hospital yourself. Instead, call emergency services and follow their advice. It is important to stay with the person to ensure they don't choke on their vomit or stop breathing. Place them in the recovery position if they are unconscious and monitor their breathing. Do not give them caffeine or put them in a cold shower or bath, as this can worsen their condition.
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Alcohol use disorder
Alcohol misuse is a growing problem, with a record number of alcohol-related deaths reported in the UK in 2023. Alcohol-related deaths in the US have also been on the rise over the past two decades. Alcohol use disorder (AUD) is a medical condition characterised by a person's impaired ability to stop or control their alcohol use, despite adverse consequences. AUD can be mild, moderate, or severe, and is considered a brain disorder.
The risk factors for developing AUD include the amount, frequency, and speed of alcohol consumption. Binge drinking and heavy alcohol use are forms of alcohol misuse and increase the risk of AUD. Drinking at an early age is another risk factor, with those who start drinking before the age of 15 being more likely to develop AUD. Genetics and family history also play a role, with hereditability accounting for approximately 60%. Mental health conditions and a history of trauma are also associated with AUD.
The severity of AUD is assessed by healthcare professionals using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Severity is classified as mild, moderate, or severe, based on the number of criteria met. Treatment for AUD includes behavioural therapies, mutual-support groups, and medications such as naltrexone, acamprosate, and disulfiram. These medications are non-addictive and can be used alone or in combination with behavioural treatments.
The effects of alcohol consumption on the body can be cumulative over a lifetime, increasing the risk of cancer, heart disease, liver disease, and high blood pressure. Alcohol-related liver disease deaths have surged in recent years, and liver cancer cases linked to alcohol have jumped by 117%. Alcohol consumption can also lead to blood sugar issues and worsen high blood pressure.
The problem of alcohol misuse is widespread, with men in the UK twice as likely to die from alcohol-specific causes than women. In the US, liver disease deaths have doubled over the past 20 years, with a significant acceleration during and after the Covid pandemic. Washington DC has the highest rate of alcohol-related cancer deaths, while Utah has the lowest.
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Frequently asked questions
About 178,000 people die from excessive drinking each year in the US.
In 2023, 10,473 people died from alcohol-related causes in the UK.
Alcohol-related deaths can occur from drinking alcohol over several years or drinking too much on one occasion. Chronic conditions caused by drinking alcohol over time include cancer, heart disease, liver disease, and alcohol use disorder. Binge drinking can lead to motor vehicle crashes, drug overdoses, alcohol poisoning, and suicide.
