January 14, 2020

Alcohol-related deaths  increased by more than twofold between 1999 and 2017, reflecting an increase in alcohol consumption among all U.S. adults, according to a study published Tuesday in the journal Alcoholism: Clinical and Experimental Research.

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Key findings

For the study, researchers from the National Institute on Alcohol Abuse and Alcoholism reviewed death certificates of people ages 16 and older between 1999 and 2017.

The researchers found that the number of alcohol-related deaths more than doubled during the study period, from 35,914 deaths in 1999 to 72,558 deaths in 2017. Over the same time period, the rate of alcohol-related deaths increased 50.9%, from 16.9 per 100,000 in 1999 to 25.5 in 2017.

In tallying the increase in alcohol-related deaths, the study did not account for population increases.

Overall, alcohol contributed to nearly one million deaths during the study period and almost 3% of deaths in 2017 alone, the researchers said. In 2017, about 50% of alcohol-related deaths resulted in liver disease or a fatal alcohol-related overdose. Specifically, the researchers said 31% of alcohol-related deaths were due to liver disease and 18% were due to alcohol-related overdoses that did and did not involve other substances.

The researchers found the rates of alcohol-related deaths were higher among certain demographic groups. Death rates were highest among men, but the increase in deaths during the study period was higher among women, at 85%, than men, at 35%. By ethnicity, the alcohol-related death rates were highest among non-Hispanic American Indians and Alaska natives.

The death rate was also highest among people ages 45 to 74, while the biggest increase over time occurred among people ages 25 to 34.

Further, the researchers said because "death certificates often fail to indicate the contribution of alcohol," the actual number of alcohol-related deaths is probably higher than the figures in the study.

What could be behind the increase?

The researchers concluded that alcohol-related deaths are on the rise because U.S. adults are drinking more alcohol.

According to the Center for Behavioral Health Statistics and Quality, about 70% of Americans consumed alcohol in 2017, and most people averaged about two drinks per day. A meta-analysis of six national surveys found that alcohol use among U.S. adults between 2000 and 2016 increased by more than 4% while binge drinking, or drinking between four and five drinks per day, increased by almost 8%.

But why are rates higher among certain demographics? 

The researchers said deaths may be increasing among women because women reach higher blood alcohol levels than men of similar weights after drinking the same amount. "Women are at greater risk than men at comparable levels of alcohol exposure for alcohol-related cardiovascular diseases, certain cancers, alcohol-related liver disease and acute liver failure due to excessive drinking," the researchers write.

NIAAA Director George Koob said, "Alcohol is not a benign substance and there are many ways it can contribute to mortality." He added, "The report is a wakeup call to the growing threat alcohol poses to public health" (Pesce, MarketWatch, 1/9; NIH release, 1/8; Budryk, The Hill, 1/8).

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