Alcohol use spiked during the COVID-19 pandemic as the stressors of daily life and the absence of regular school and work routines drove many people to drink more than they had before. Now, however, a new study of alcohol-related deaths suggests that excessive drinking was a growing problem even before the pandemic hit.
Roughly 1 in 8 deaths among U.S. adults 20 to 64 years old were due to excessive drinking over the five-year period ending in 2019, according to a new study from the Centers for Disease Control and Prevention (CDC). During this same time frame, drinking caused about 1 in 5 deaths among younger adults 20 to 49 years old.
Several policy changes including higher alcohol taxes, tighter regulation of alcohol sales, and expanded screening and treatment for alcohol misuse could all help prevent these deaths, CDC researchers wrote in the study, published in JAMA Network Open.
“These premature deaths could be reduced through increased implementation of evidence-based alcohol policies,” the study team wrote.
Drinking has long been linked to several leading causes of premature death, including heart disease, liver disease, certain cancers, motor vehicle crashes, and other unintended injuries. However, many previous tallies of U.S. alcohol-related deaths have focused only on “fully alcohol-attributable causes” such as alcoholic liver disease, and not on causes like cancer that can be partially attributable to alcohol use.
For the new study, researchers used a CDC database that calculates the proportion of deaths from a wide variety of causes that may be fully or partially attributed to alcohol consumption. This allowed the new study to include fatalities that are only sometimes related to alcohol, such as drownings, falls, high blood pressure, stroke, and several types of cancer.
During the study period, about 90,000 deaths per year among adults 20 to 64 years old were due to excessive drinking, accounting for 12.9 percent of fatalities for this age group.
The proportion of deaths due to alcohol varied by state, from 9.3 percent in Mississippi to 21.7 percent in New Mexico, the study also found.
Alcohol was responsible for 15 percent of deaths each year in men, compared with 9.4 percent of fatalities for women. The leading causes of alcohol-related deaths were similar for men and women but varied slightly by age. For those 20 to 34 years old, the top three causes were poisonings, motor vehicle crashes, and homicides. In adults 35 to 49 years old, the top three causes were poisonings, alcoholic liver disease, and motor vehicle crashes.
One limitation of the study is that it may have underestimated the number of alcohol-related deaths, researchers note. That’s because they only had data on fatalities where alcohol-related conditions were identified as the underlying cause of death, and because they lacked data on fatalities among former drinkers who may have still died of alcohol-related causes.
The problem also got worse during the pandemic, a period not covered by the new study. Another study, by researchers at the National Institute on Alcohol Abuse and Alcoholism and published earlier this year in JAMA, found that alcohol-related deaths surged 26 percent between 2019 and 2020 — and provided preliminary data suggesting that these fatalities continued to climb in 2021.
To minimize the risk of these preventable deaths, adults who drink should do so in moderation, the CDC advises. U.S. dietary guidelines recommend no more than two daily drinks for men and one for women, and stress that less is better for health. One drink could be 12 ounces of beer, a 5-ounce glass of wine, 8 ounces of malt liquor, or a 1.5-ounce shot of spirits or liquor, according to the CDC.