Alcohol Deaths Have More Than Doubled in Two Decades, Study Finds

The number of deaths caused by alcohol-related diseases more than doubled among Americans between 1999 and 2020, according to new research. Alcohol was involved in nearly 50,000 deaths among adults ages 25 to 85 in 2020, up from just under 20,000 in 1999.

The increases were in all age groups. The biggest spike was observed among adults ages 25 to 34, whose fatality rate increased nearly fourfold between 1999 and 2020.

Women are still far less likely than men to die of an illness caused by alcohol, but they also experienced a steep surge, with rates rising 2.5-fold over 20 years.

The new study, published in The American Journal of Medicine, drew on data from the Centers for Disease Control and Prevention.

Deaths related to alcohol included those caused by certain forms of heart disease, liver disease, nerve damage, muscle damage, pancreatitis and alcohol poisoning, as well as related mental and behavioral disorders. The study did not include other deaths influenced by alcohol, such as accidents.

“The totality of the evidence indicates that people who consume moderate to large amounts of alcohol have a markedly increased incidence of premature deaths and disability,” said Dr. Charles Hennekens, a professor of medicine at Charles E. Schmidt College of Medicine at Florida Atlantic University and one of the study’s authors.

The study is one of several recently that have drawn attention to the toll of rising alcohol consumption, particularly since the Covid pandemic, as Americans faced heightened anxiety, economic uncertainty and social isolation.

Some local jurisdictions also eased restrictions on the sale of alcohol during the pandemic.

The increase at the onset of the pandemic appears to have persisted. Adults reported more heavy drinking and binge drinking in 2022, another recent study found.

Some 48,870 alcohol-related deaths were reported in 2020, up from 19,356 in 1999, the new study found. The mortality rate rose to 21.6 deaths per 100,000 in 2020, an increase from 10.7 deaths per 100,000 in 1999.

Alcohol-related deaths increased in all age groups, with the highest number among those aged 55 to 64. (The increase in deaths among those 85 and over was not significant.)

Deaths increased among all racial and ethnic groups and in all geographic regions, the new study found. But the steepest rises occurred among Asian Americans and Pacific Islanders, whose death rate increased 2.4-fold.

In the Midwest, the death rate increased 2.5-fold over the two-decade period.

The new study is not the first to confirm disturbing trends in U.S. alcohol consumption. Men still die of alcohol-related disease at the highest rates and numbers, but two groups especially vulnerable to the health effects of drinking — women and older Americans — are consuming more alcohol than in the past.

Moderate drinking is defined as one drink or less per day for women and two drinks or less for men.

Heavy drinking for women is four standard servings or more a day and eight or more a week; for men, heavy drinking is defined as five servings or more in a day, and 15 per week.

Binge drinking means having four to five drinks in a roughly two-hour period.

Dr. Hennekens and his colleagues hypothesized that rising rates of overweight and obesity may also be playing a role in alcohol-related deaths.

Nearly three-quarters of American adults are overweight or obese, according to a recent study. They are becoming overweight or obese at younger ages than in the past.

Both obesity and heavy drinking are associated with risk factors for cardiovascular disease and with liver disease. The combination of drinking and overweight may accelerate the progression of those illnesses, Dr. Hennekens said.

The authors urged health care providers to be aware that high blood pressure linked to obesity can be worsened by drinking, and to screen patients for alcohol consumption.

“We have a strong message for health care providers and their patients to try to do something about both these issues, alcohol consumption and overweight and obesity,” Dr. Hennekens said.