According to a recent study, more people in the United States are drinking more alcohol and experiencing the harmful effects. The number of hospitalizations is rising, as are death rates.
“Alcohol is not a benign substance, and there are many ways it can contribute to mortality,” says George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
These range from more apparent contributors, such as liver disease and overdoses, to less obvious ones, such as falls.
A growing concern among experts is that rising consumption levels are leading to an increasing number of related deaths.
In the past 2 decades, alcohol consumption has risen sharply in the U.S., according to the findings of a new analysis, now summarized in the journal Alcoholism: Clinical and Experimental Research.
According to data from 2017, the researchers report, 70.1% of the U.S. population aged 18 and older drank alcohol that year. Each person who drank consumed approximately 3.6 gallons of pure alcohol, or about 2.1 standard drinks daily.
As consumption has risen, so has the level of harm. Various studies have noted an increase in alcohol-related hospitalizations and emergency department visits since 2000.
Between 2000 and 2015, the number of hospital visits related to alcohol shot up by 76.3% for people aged 12 and over.
The total number of emergency department visits linked with alcohol rose by over 47% between 2006 and 2014.
The researchers saw the biggest increases among the female population. They reported a 10.1% rise in the number of women who consumed alcohol between 2000 and 2016, and a 23.3% increase in binge drinking among women during the same period.
Similarly, the authors found that the increases in hospitalizations and emergency department visits were greater among women than men.
Studying death certificates
After considering the increases in alcohol consumption and associated medical intervention, the researchers — all of whom work for the NIAAA — set out to investigate whether alcohol-related deaths were similarly on the rise.
Death certificates provide the most comprehensive way of determining the causes of death among large populations. However, tracking alcohol-related mortality is difficult because a certificate may be issued before the doctor can tell that alcohol was involved.
A 2014 study found that only 1 in 6 certificates recording death as a result of drunk driving listed alcohol as a contributor.
Fully aware of the unreliability of the reporting, the NIAAA team analyzed all death certificates filed in the U.S. between 1999 and 2017, in an effort to determine the number of alcohol-related deaths among people aged 16 and over.
They looked for any certificates that listed alcohol as a contributing cause of death. They also included certificates that recorded an alcohol-induced cause of death.
The investigators analyzed the results as a whole before separating them by age, sex, ethnicity, and race.
Highest rises among women, younger adults
The team found that the number of deaths linked to alcohol had more than doubled within the period of their investigation. Almost 1 million people had died from alcohol-related causes between 1999 and 2017.
In 1999, there were only 35,914 such deaths. In 2017, this figure had increased to 72,558.
That year, almost one-third of these deaths had resulted from liver disease, and nearly one-fifth had resulted from overdoses — either from alcohol alone or in combination with other drugs.
Although people aged 45–74 had the highest rate of alcohol-related death, the most significant increase occurred among people aged 25–34. In fact, every age group, except people aged 16–20 and 75 or over, saw an increase.
Although rates among Hispanic men and non-Hispanic black people decreased at first, they later increased, in line with all other groups.
As with rises in consumption and subsequent hospital visits, the increases in alcohol-related deaths were higher among women than men. The female population demonstrated an 85.3% rise, compared with a 38.7% rise among men.
A wake-up call
The head of the NIAAA describes alcohol as “a growing women’s health issue.” He says: “The rapid increase in deaths involving alcohol among women is troubling and parallels the increases in alcohol consumption among women over the past few decades.”
Speaking about the report in its entirety, Koob states that it is “a wake-up call to the growing threat alcohol poses to public health.”
Koob also reminds us that the number of recorded alcohol-related deaths may be greatly underestimated, “We know that the contribution of alcohol often fails to make it onto death certificates.”
The middle-aged and elderly range is of particular concern. With that population set to almost double by 2060, the researchers point out, complications of their alcohol consumption could place a considerable burden on the healthcare system. The NIAAA director emphasizes:
“Better surveillance of alcohol involvement in mortality is essential in order to better understand and address the impact of alcohol on public health.”