Alcohol Use Is Getting Deadlier in the United States

When I read the recent Centers for Disease Control and Prevention (CDC) report on the rising death rate from excessive alcohol use in the United States, my thoughts immediately turned to our addiction treatment clinic here in Jacksonville, Florida, where I am the chief medical officer.

That’s because one of the ways that people are dying is from liver disease, and we’re seeing that condition at the facility. (Thank goodness no one has died under our care.)

Here’s the really scary part. In the past year, we treated several women in their 30s with advanced liver failure. Some were sent to us by way of a medical referral: To qualify for a liver transplant, they had to get and stay sober. So they came to us.

Their young age matches with the CDC finding that although liver disease death rates remain highest in men and women aged 50 to 64, the rate is increasing more quickly among younger adults—including women.

One of the challenges is that in the early stages of liver disease, there are no symptoms. Therefore, many people who are well on their way to an advanced stage of the disease don’t even know it.

Top line from the CDC report

The CDC collected death rate data from excessive alcohol use among Americans in 2016-2017, then again in 2020-2021.

Researchers included two categories: (1) deaths entirely attributed to alcohol, such as from alcohol use disorder (AUD) and liver disease; and (2) deaths partially attributed to alcohol, such as from injuries, motor vehicle accidents, and certain cancers.

When the researchers combined the two categories, they found that 138,000+ people died from excessive alcohol use in the year 2016-2017. Just four years later, in 2020-2021, that number climbed to more than 178,000—a jump of 29 percent.

Although roughly twice as many males die from excessive alcohol use as females, the death rate went up faster during those years among women versus men: 35 percent for women versus 27 percent for men.

The COVID-19 effect

As with so many aspects of our physical and mental health, the COVID-19 epidemic likely played a part in the increased death rate from excessive alcohol use.

As the CDC researchers point out, alcohol was more available during the peak COVID-19 years of 2020-2021. Some states implemented policies to expand alcohol carryout as well as home delivery.

In many areas of the country, liquor stores were designated as essential businesses and, therefore, were allowed to stay open during lockdowns.

The researchers also believe many people likely avoided emergency room visits for alcohol-related issues and injuries, for fear of contracting COVID-19. This may have affected the death rate from excessive alcohol use. Coping with stress, loneliness, and social isolation likely also played a part in driving up alcohol use.

What can we do to lower the death risk?

The CDC researchers believe a big reason behind excessive alcohol use is that it’s so available and accessible these days. To reverse that trend, say the researchers, we likely need to consider public policies that decrease the number of places that sell it. Another option: Increase the alcohol sales tax so it’s more expensive to buy.

I have a few answers aimed more at individual drinking behavior. More than two-thirds of deaths from excessive alcohol use are partially attributed to alcohol, and those deaths often occur through injuries and motor vehicle accidents. When do these episodes happen? Oftentimes, it's when people are binge drinking.

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With that in mind, consider these commonsense strategies to help you stay safer if you’re going to drink more than usual:

• Don’t drink alone.
• Eat food while you’re drinking.
• Space your drinks out, waiting at least 15 minutes between them.
• Drink water while you’re taking in alcohol.
• Count drinks along the way.
• Know that in our “upsized” world of bar and restaurant portions, the alcohol content of beer, wine, or mixed drinks can be higher than the average.

Final thoughts on excessive alcohol consumption

I’m going to be the wet blanket here because, as an addiction psychiatrist discussing alcohol consumption, that’s my job. Bottom line: Alcohol is dangerous, highly addictive for many, and, yes, deadly.

Alcohol is by far the most commonly abused substance in this country, with many more addicted to it than opioids, weed, cocaine, or any other single drug. Alcohol ruins thousands of lives in the United States every year and does enormous damage to their families and communities.

Despite all that, or in some cases because of it, millions of dollars are spent on promoting alcohol to the public (including young people). Alcohol’s deadly dangers and drawbacks get completely drowned out by that marketing tidal wave. An hour of watching Super Bowl ads tells you all you need to know about the potent and relentless promotion of alcohol.

About that marketing: To me, it’s not the glamorizing of alcohol that has the most impact on public opinion. Most of us recognize that for what it is: pure hype. Rather, it’s the normalizing of alcohol that does the most damage.

Alcohol is so integrated into so many aspects of our daily lives that many of us are no longer able to recognize the danger it poses.

As the CDC data clearly show, that danger is here, and it’s increasing.