Alcohol-Related Deaths Still Climbing

It turns out the pandemic was worse than we thought. The U.S. Centers for Disease Control and Prevention (CDC) just published a new study that reveals alcohol-related deaths spiked nearly 30 percent between 2017 and 2021. In the darkest days of the pandemic, the CDC estimates that 488 Americans died every day from excessive alcohol use.

The report, appearing in the CDC’s latest Morbidity and Mortality Weekly Report, shows that “deaths from excessive drinking among males increased approximately 27 percent, from 94,362 per year to 119,606, and among females [it] increased approximately 35 percent, from 43,565 per year to 58,701.”

CDC Research Expands the Scope

Alcohol-related fatalities have been climbing in the United States for more than two decades. But researchers saw a notable increase in 2019-2020, coinciding with the onset of the COVID pandemic.

The increase in deaths also dovetails with alcohol sales, which have been climbing for years, despite a sizable dip in 2020. Sales have already surged past pre-pandemic levels to $37.7 billion in 2023. The report also showed that emergency room visits because of acute alcohol use surged in this period.

But it’s worth noting that earlier studies tracked only deaths that researchers could tie directly to alcohol, such as alcoholic liver disease and alcohol use disorder. But this latest CDC research includes deaths the authors could link indirectly to alcohol. This includes fatal injuries and alcohol-related cancers.

The jump in excessive alcohol deaths ignored age differences. And while more men died during this period, the rate of deaths among women saw a larger increase – 35% during the 2016-17 to 2020-22 time periods. Heart disease and stroke proved the most fatal to women.

On the other hand, deaths among men rose nearly 27% in that same time frame. Most died from chronic conditions tied to alcohol.

Methodology

CDC researchers examined data from the National Vital Statistics System and organized them into three different periods: 2016–2017, 2018–2019, and 2020–2021.

The researchers classified deaths based on the 58 alcohol-related conditions in the CDC’s Alcohol-Related Disease Impact application. For every cause of death, the scientists assigned a fractional value based on the extent to which alcohol played a role.

“For the 15 fully alcohol-attributable conditions, the alcohol-attributable fraction is 1.0,” the study explains. “Fully alcohol-attributable conditions include the 100% alcohol-attributable chronic causes as well as the 100% alcohol-attributable acute causes (i.e., alcohol poisonings that are a subset of deaths in the alcohol-related poisonings category and deaths from suicide by exposure to alcohol that is a subset of the suicide category).”

Partially alcohol-attributable conditions earned fractional scores. For most of the partially alcohol-related chronic conditions, population-attributable fractions were estimated using relative risks from published meta-analyses and adjusted prevalence estimates of low, medium, and high average daily alcohol use among U.S. adults.

Notably, the nearly 23% spike in excessive alcohol deaths that occurred from 2018–2019 to 2020–2021 was roughly four times as high as the earlier 5% jump from 2016–2017 to 2018–2019.

Policy Recommendations

Aside from a leap in binge drinking – which hit a peak higher in 2022 among 35 to 50-year-olds than at any other time over the last 10 years – researchers pointed to multiple factors that emerged from the pandemic. Those include:

• Expanded alcohol carryout and home delivery options.
• More places started selling alcohol for off-premise consumption (such as liquor stores) because they’d earned “essential business” status in multiple states, which allowed them to remain open.
• General delays in seeking medical attention, including avoidance of ER visits for alcohol-related conditions.
• Increased stress, loneliness, and social isolation.

Finally, the CDC researchers proposed some public policy ideas to address this growing crisis.

“States and communities can discourage excessive alcohol use and reverse recent increases in alcohol-attributable deaths by implementing comprehensive strategies, including evidence-based alcohol policies that reduce the availability and accessibility of alcohol and increase its price (e.g., policies that reduce the number and concentration of places selling alcohol and increase alcohol taxes),” the authors wrote. “Also, CDC’s electronic screening and brief intervention can be used in primary and acute care, or nonclinical, settings to allow adults to check their alcohol use, receive personalized feedback, and create a plan for drinking less alcohol.”

Further Reading

Patients With Alcohol Use Disorder Co-Occurring With Depression and Anxiety Symptoms

Alcohol Use Disorder Treatment in Sexually and Gender Diverse Patients

The Moderating Effect of Emotion Regulation Between Fear of COVID-19 and Quality of Life