Mason Delacroix
Alcohol-related deaths in the United States have increased over the past two decades, with nearly 100,000 annual deaths attributable to alcohol abuse. Alcoholic liver disease is the leading cause of alcohol-related deaths, followed by alcohol poisoning, which accounts for 32% of acute alcohol-related deaths. Alcohol-induced chronic conditions, such as pancreatitis and liver disease, are also significant contributors to alcohol-related mortality. The COVID-19 pandemic and associated lockdowns have been linked to increased alcohol consumption and a rise in alcohol-related deaths, particularly between 2019 and 2020. Alcohol-related deaths among women have more than doubled from 1999 to 2020, and certain states like Washington, D.C., Texas, and Tennessee have seen a sharp rise in alcohol-linked cancer deaths.
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What You'll Learn
- Alcohol-related deaths increased during the pandemic
- Alcoholic liver disease is the leading cause of alcohol-related deaths
- Alcohol-related deaths among women more than doubled from 1999 to 2020
- Alcohol-related cancer deaths are highest in Washington DC
- Alcohol abuse statistics indicate some inequalities may be due to social conditioning
Alcohol-related deaths increased during the pandemic
Alcohol-related deaths in the US increased during the COVID-19 pandemic, particularly from 2019 to 2020. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol-related deaths among individuals aged 16 and older increased by 25.5% between 2019 and 2020, the first year of the pandemic. The total number of deaths increased by another 10% between 2020 and 2021. This trend is reflected in the data from the Centers for Disease Control and Prevention (CDC), which shows a 29.3% increase in the average annual number of deaths from excessive alcohol use during the same period.
The increase in alcohol-related deaths is attributed to a rise in alcohol consumption during the pandemic. Alcohol sales in the US increased by 2.9% in 2020, the largest annual increase in over 50 years. Research suggests that people increased their alcohol intake to cope with pandemic-related stress and anxiety, especially those with pre-existing mental health issues and alcohol misuse struggles. The rise in alcohol consumption led to a widespread increase in alcohol-related harms, including liver disease, alcohol withdrawal, and drug overdoses.
The impact of increased alcohol consumption during the pandemic was also observed in emergency departments, with a rise in visits related to acute alcohol consumption and alcohol withdrawal. Alcohol-related hospitalizations also increased, particularly for women, raising concerns about future liver-related diseases and the need for timely interventions to prevent high-risk drinking from progressing to alcohol use disorder or alcoholic liver disease.
To address the rise in alcohol-related deaths and harms, public health interventions, alcohol policy and regulation changes, and improved health services are necessary. Implementing evidence-based policies that reduce alcohol availability and accessibility and increase prices can help reduce excessive alcohol use and related deaths. These strategies have been effective in other countries, such as Canada, which experienced a 24% increase in alcohol-related deaths during the pandemic.
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Alcoholic liver disease is the leading cause of alcohol-related deaths
Alcoholic liver disease is a condition that occurs when the liver is damaged by excessive alcohol consumption, typically over several years. The disease progresses through three stages: alcohol-related fatty liver disease, alcohol-related hepatitis, and alcohol-related cirrhosis. Fatty liver disease, the first stage, is characterized by a buildup of lipids or fats in the liver, impairing its function. This stage can often be reversed by abstaining from alcohol consumption. However, if left untreated, it can progress to alcohol-related hepatitis, which is characterized by inflammation and swelling of the liver, leading to degeneration and impaired function. The final stage, alcohol-related cirrhosis, is a life-threatening condition that is the leading indication for liver transplantation in the US.
The number of deaths due to alcohol-related liver disease has been increasing, particularly in younger age groups (25-34 years). This trend is expected to continue, with cirrhosis-associated mortality projected to rise further. Excessive alcohol consumption remains the primary cause of alcohol-related liver disease and its complications. Even an average of two drinks or fewer per day can contribute to the progression of liver fibrosis.
In addition to liver disease, alcohol use is associated with various other adverse health outcomes, including an increased risk of cancer, heart disease, and high blood pressure. It is classified as a Group 1 carcinogen by the International Agency for Research on Cancer. Alcohol-induced deaths also include acute pancreatitis and mental and behavioral disorders due to alcohol use. Understanding trends in alcohol-induced mortality can help identify groups particularly affected by alcohol-related causes and guide the implementation of effective prevention strategies.
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Alcohol-related deaths among women more than doubled from 1999 to 2020
Alcohol-related deaths in the United States have nearly doubled from 19,356 to 48,870 between 1999 and 2020, with the mortality rate increasing from 10.7 per 100,000 to 21.6 per 100,000 during this period. This surge is attributed to a range of factors, including the toxic and dependence-producing nature of alcohol, which has been classified as a Group 1 carcinogen.
While men consistently had higher overall death rates, the largest proportional increase was among women, with alcohol-related deaths more than doubling from 4.8 per 100,000 in 1999 to 12 per 100,000 in 2020. This trend may reflect changing social norms and the alcohol industry's increased targeting of women through marketing campaigns.
The rise in alcohol-related deaths among women is particularly concerning given that women are biologically more vulnerable to the effects of alcohol. Women have lower levels of alcohol dehydrogenase (ADH), an enzyme that helps break down alcohol, which means they are more susceptible to alcohol-related health issues in the liver, heart, and brain. As a result, women are at greater risk of cirrhosis, alcohol-related liver diseases, congestive heart failure, heart attack, and stroke. Furthermore, chronic alcohol consumption increases the risk of various cancers, including breast cancer and cancers of the mouth, throat, oesophagus, liver, and colon.
The COVID-19 pandemic may have also played a role in the increase in alcohol-related deaths among women, as per-capita alcohol sales and emergency department visits associated with acute alcohol use rose during this time. The implementation of evidence-based policies that reduce alcohol availability and increase its price could help mitigate this growing public health issue.
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Alcohol-related cancer deaths are highest in Washington DC
Alcohol is a toxic, psychoactive, and dependence-producing substance. It has been classified as a Group 1 carcinogen, which is the highest-risk category, by the International Agency for Research on Cancer. Alcohol causes at least seven types of cancer, including some of the most common types, such as bowel cancer and female breast cancer. According to the World Health Organization (WHO), there is no safe amount of alcohol consumption when it comes to health.
In the United States, deaths from causes fully attributable to alcohol use have increased over the past two decades, particularly during the COVID-19 pandemic. This includes a rise in alcohol-related cancer deaths, which have doubled from just under 12,000 per year in 1990 to over 23,000 per year in 2021. The percentages of cancer deaths related to alcohol increased from 2.5% to 4.2% for men and from 1.46% to 1.85% for women during this period.
On a state level, Washington, D.C., had the highest alcohol-related cancer mortality rate across both sexes, according to an analysis of data from the Global Burden of Disease (GBD) database. In contrast, Utah had the lowest rate. In Washington, D.C., the alcohol-related cancer mortality rate was higher than in any other state, indicating a significant impact of alcohol consumption on cancer deaths in the district.
The high rate of alcohol-related cancer deaths in Washington, D.C., could be attributed to various factors, including social and economic factors, as well as access to healthcare and preventive services. Disadvantaged and vulnerable populations, including those with lower economic status, often have higher rates of alcohol-related deaths and hospitalizations due to the higher harms associated with a given amount and pattern of drinking. Additionally, the district's specific demographics and cultural norms may play a role in the high rate of alcohol-related cancer deaths.
To address the high rate of alcohol-related cancer deaths in Washington, D.C., comprehensive prevention strategies and public health initiatives are necessary. This includes implementing evidence-based policies that reduce the availability and accessibility of alcohol, increasing its price, and improving health literacy and awareness about the link between alcohol and cancer risk. By addressing the underlying factors contributing to high alcohol consumption and providing resources for harm reduction, Washington, D.C., can work towards reducing the burden of alcohol-related cancer deaths.
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Alcohol abuse statistics indicate some inequalities may be due to social conditioning
Alcohol is a toxic, psychoactive, and dependence-producing substance. It is a leading cause of death in the US, with excessive alcohol use causing a 29.3% increase in deaths between 2016–2017 and 2020–2021. Alcohol-related deaths in the US are strongly linked to social inequalities, with disadvantaged and vulnerable populations experiencing higher rates of alcohol-related death and hospitalization. This trend is also seen globally, with the WHO European Region having the highest alcohol consumption level and the highest proportion of drinkers in the population.
Social learning theory suggests that alcohol abuse may be influenced by social conditioning. This theory posits that individuals learn behaviours by observing others, particularly those closest to them, such as family and peers. As alcohol is often a central feature of social venues, individuals may observe others using alcohol to relax, have fun, and reduce stress, leading them to associate alcohol with positive outcomes. This is especially true if they do not have healthier examples of stress relief or social interaction. As addiction progresses, the addict's social circle may become exclusively composed of other addicts, further reinforcing the behaviour.
Media representations of alcohol consumption can also contribute to social conditioning. Individuals may observe and learn from media models without directly engaging in drinking themselves, forming expectations of how alcohol affects individuals. This can shape their behaviour when they decide to consume alcohol.
To address alcohol-related harm and reduce alcohol-related deaths, policies should aim to decrease the availability and accessibility of alcohol and increase its price. Additionally, public health initiatives should focus on raising awareness of the risks associated with alcohol consumption, including its carcinogenic effects, through health information messages on alcoholic beverage labels and health education by trained professionals.
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Frequently asked questions
Nearly 100,000 people die each year in the US due to alcohol-related causes.
Alcoholic liver disease is the leading cause, responsible for 19.1% of all alcohol-related deaths. Alcohol poisoning is another leading cause, responsible for 32% of acute alcohol-related deaths.
The COVID-19 pandemic has had a significant impact on alcohol consumption in the US, with rates of alcohol-related deaths increasing from 2019 to 2020.
Men are three times more likely to die from alcohol-related causes than women, and adults aged 35 or older account for the majority of alcohol-related deaths. However, alcohol use and binge drinking have been increasing among women, leading to a rise in alcohol-related health consequences and deaths.
Washington DC has the highest rate of alcohol-related cancer deaths, followed by Texas and Hawaii. Montana also has a high rate of alcohol-related deaths, with a significant proportion of adults aged 35 and older dying from excessive alcohol use. Alabama has the third-highest rate of under-21 deaths related to alcohol use.
