Lena Savoie
Alcohol-related deaths have been on the rise in the US over the past two decades, with liver disease and alcohol-linked cancers doubling. Alcohol is a leading preventable cause of death in the country, with about 178,000 people dying from excessive drinking each year. While cancer deaths tied to alcohol are rising, with liver cancer being the most serious risk, especially for those 55 and older, the number of young people dying from alcohol-related causes is also increasing.
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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 is made from ethanol, which is broken down in the body into acetaldehyde, a known carcinogen. This means that alcohol can increase the risk of cancer in several ways, including by disrupting cell cycles, increasing chronic inflammation, and damaging DNA.
Alcohol is linked to an increased risk of cancers of the mouth, throat, voice box, and esophagus. Drinking alcohol and smoking together increases this risk many times more than drinking or smoking alone. This is because alcohol can help harmful chemicals in tobacco get inside the cells that line the mouth, throat, and esophagus. Alcohol might also limit how well these cells can repair damage to their DNA caused by tobacco chemicals.
Long-term alcohol use has also been linked to an increased risk of liver cancer. Regular, heavy alcohol use can damage the liver, leading to inflammation and scarring, which raises the risk of liver cancer. Liver disease deaths have roughly doubled over the course of 20 years, with a significant acceleration during and following the Covid pandemic.
Colon cancer has also seen a sharp rise in alcohol-linked cancer deaths, rising 32% from 4.92 to 6.5 alcohol-related cancer deaths per 100,000 people over a 30-year period. This could be linked to alcohol consumption, although it is falling in younger age groups. Studies suggest that people who develop colon cancer may have a less diverse microbiome, which raises the risk of inflammation and potentially cancer.
Breast cancer is the most common alcohol-associated cancer among women, with drinking even small amounts of alcohol increasing the risk. Alcohol can raise estrogen levels in the body, which plays a role in breast cancer development.
Overall, alcohol use accounts for about 5% of all cancers and 4% of all cancer deaths in the United States. In 2022, more than 538,000 alcohol-associated cancers occurred in the United States, including more than 160,000 among men and 378,000 among women. About 86% of new alcohol-associated cancers occur in people 50 or older.
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Alcohol-related liver disease
ARLD has various stages of severity, and symptoms may differ based on alcohol consumption patterns. The first stage is alcoholic fatty liver disease, which rarely causes symptoms but indicates harmful alcohol levels. This can progress to alcoholic hepatitis, a potentially serious condition caused by long-term alcohol misuse. At this stage, liver damage is usually reversible if alcohol consumption ceases. However, severe alcoholic hepatitis is life-threatening.
The next stage is cirrhosis, where the liver becomes significantly scarred. Even at this advanced stage, ARLD may not exhibit obvious symptoms. Cirrhosis is generally irreversible, but stopping alcohol consumption can prevent further damage and significantly improve life expectancy. There is no specific treatment for ARLD, and abstaining from alcohol is the primary form of management. In severe cases, a liver transplant may be required if the liver has stopped functioning and does not recover with abstinence.
ARLD is often diagnosed during tests for other conditions or at a stage of advanced liver damage. It is a preventable disease, and reducing or eliminating alcohol consumption can lower the risk of liver damage. While it is challenging to stop drinking for those dependent on alcohol, support, advice, and medical treatment are available through local alcohol addiction support services.
While the focus is on underage alcohol-related deaths, data on the specific number of deaths among minors due to ARLD is limited. However, it is known that 96.5% of teenagers who die from excessive alcohol use succumb to acute causes such as suicide or car accidents, while the remaining 3.5% may be attributed to chronic conditions, which could include ARLD. Additionally, 16.1% of all alcohol-related deaths are among those under 35, which could include some underage individuals.
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Alcohol-related car crashes
Alcohol abuse is a significant problem, and it is linked to a high number of deaths each year. While statistics on underage alcohol-related deaths are limited, car crashes are a leading cause of death for teens, and alcohol is often a contributing factor.
Alcohol is a substance that impairs the function of the brain, affecting thinking, reasoning, and muscle coordination—all critical abilities for operating a vehicle safely. As alcohol levels in the bloodstream rise, the negative impact on the central nervous system increases, and driving ability is compromised. Even a small amount of alcohol can affect a person's ability to drive, and the risk of crashing increases exponentially as Blood Alcohol Concentration (BAC) levels rise. For instance, at a BAC of 0.08 g/dL, a person is approximately four times more likely to crash than if they had not consumed alcohol.
In 2023, 12,429 people in the United States died in alcohol-impaired driving crashes, with about 34 people dying each day—that's one person every 42 minutes. These deaths are all preventable. The risk of crashing is even greater for young males. In 2023, 30% of young drivers aged 15 to 20 who were killed in crashes had BACs of 0.01 g/dL or higher.
The implementation of laws targeting underage drinking and drunk driving has had a positive impact on reducing alcohol-related crash fatalities. The two core underage drinking laws (purchase and possession) and the zero-tolerance law are estimated to save 732 lives each year. Additionally, minimum-drinking-age laws have saved 31,959 lives from 1975 to 2017. Since 1982, drunk driving fatalities have decreased by 41% nationally, and by 83% among those under 21.
Despite this progress, there is still work to be done to eliminate drunk driving. Hardcore drunk drivers continue to be a significant problem, accounting for nearly 70% of drunk driving fatalities. The presence of keg registration laws, contrary to expectations, has been associated with an increase in underage drinking-related fatal crashes. However, the nonrandom assignment of these laws across states may have influenced this counterintuitive result.
To further reduce alcohol-related car crashes, it is essential to enforce and expand upon existing underage drinking and traffic safety laws. These laws have proven effective in decreasing alcohol-impaired driving fatalities, and their continued implementation and enforcement can help save more lives.
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Alcohol poisoning
The symptoms of alcohol poisoning include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, pale or blue-tinged skin, clammy skin, dulled responses, and extremely low body temperature. It is important to seek immediate medical attention if alcohol poisoning is suspected, as it can lead to permanent brain damage or death. While waiting for emergency services, it is advised to stay with the affected person to ensure they do not choke on their vomit or stop breathing. If they are awake, they should be sat up or put in the recovery position if they have passed out, and their breathing should be monitored. It is important not to give them coffee or caffeinated drinks, as this can lead to dehydration, and to avoid cold showers or baths, as they may fall or lose consciousness in the water.
While I could not find specific statistics for underage alcohol-related deaths per year, some insights can be drawn from available data. For example, in Alabama, 3.94% of deaths from excessive alcohol use are among those under 21, and 71.5% are male. Additionally, 96.5% of teenagers who die from excessive alcohol use die from acute causes such as suicide or car accidents. Across the United States, 16.1% of people who die from alcohol-related causes are under 35, and 37.2% of those killed in alcohol-related car crashes are between 20 and 34 years old. These statistics highlight the dangers of alcohol, especially for younger individuals.
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Alcohol-related suicides
Alcohol is a depressant, and its consumption can have both stimulating and sedating effects on a person. The stimulating effects may include impulsivity and aggression, while the sedating effects may include feelings of sadness and despair. Alcohol can reduce a person's awareness of their negative emotions and impair their ability to use healthy coping skills to manage stressful situations. Both these effects can be harmful to someone experiencing suicidal thoughts by reducing their inhibition and increasing the risk of moving from suicidal ideation to an attempt.
Research has shown that acute use of alcohol (AUA) increases the risk of suicidal behaviour. AUA is associated with a rapid transition from acute suicidal impulse to action, suggesting that the role of AUA in promoting suicidal ideation and disinhibition is a mechanism of risk for suicidal behaviour. AUA can also increase the intensity of suicidal ideation and is linked to the use of firearms, the most common method of suicide in the United States.
Alcohol use disorder (AUD) is a potent risk factor for suicidal behaviour and is the second most commonly identified mental disorder among suicide decedents worldwide. Results from psychological autopsy investigations indicate that AUD is prevalent among individuals who die by suicide, with rates ranging from 7% in China to 61% in Estonia. AUD contributes to substance-induced depressive episodes, disruptions in interpersonal relationships, and repeated exposure to alcohol intoxication, all of which increase the risk of suicide.
The relationship between alcohol and suicide is complex, and understanding the factors that contribute to suicide risk is crucial for prevention. Suicide often results from a complex interplay of various factors, including mental health conditions, history of trauma or abuse, chronic illness or pain, social factors, and personal stressors. Alcohol use can influence these factors and increase suicide risk, especially when combined with other substances or medications.
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Frequently asked questions
It is difficult to provide a precise number as alcohol-related deaths are often caused by a combination of factors, and the primary cause of death may not be alcohol-related. However, according to the CDC, 3.94% of people in Alabama who die from excessive alcohol use are under the age of 21.
Excessive alcohol use leads to about 178,000 deaths in the US each year, a 29% increase from 2016-2017. Two-thirds of these deaths are from chronic conditions such as cancer, heart disease, liver disease, and alcohol use disorder. The remaining one-third of alcohol-related deaths are from binge drinking or drinking too much on one occasion, including car crashes, alcohol-involved drug overdoses, alcohol poisoning, and suicide.
New Mexico has the highest alcohol-related death rate per capita. Alabama has the third-highest rate of under-21 deaths related to excessive alcohol use. Washington, DC, has the highest rate of alcohol-related cancer deaths.
