Deaths caused by alcohol use in the United States spiked during the Covid-19 pandemic, killing more than 49,000 people in 2020, according to data published Friday by the US Centers for Disease Control and Prevention.
The alcohol-induced death rate has been steadily increasing in recent decades, but it jumped 26% between 2019 and 2020 – making nearly the same climb in one year as over the decade before. In 2020, alcohol caused 13 deaths for every 100,000 people, up from 10.4 deaths for every 100,000 people in 2019.
“What’s a word bigger than crisis?” said Marvin Ventrell, chief executive officer of the National Association of Addiction Treatment Providers. “What was already a crisis, has exploded.”
Alcoholic liver disease was the underlying cause for more than half of the alcohol-induced deaths in 2020, followed by mental and behavioral disorders due to use of alcohol. This analysis does not include deaths where alcohol use may have directly contributed but was not the only factor.
Including other deaths attributable to excessive alcohol use but not directly caused by it – such as cancer, heart disease and unintentional injuries like car accidents – nearly triples the number of alcohol-related deaths, according to the CDC. This would bring the number of alcohol-related deaths well past the number of drug overdose deaths, which reached record levels during the Covid-19 pandemic.
Americans drank more during the Covid-19 pandemic, which experts say created an environment ripe for alcohol abuse.
“We know that in large-scale traumatic events to the population – like 9/11 or Hurricane Katrina – people historically start drinking more. The pandemic has been, as we all know, a major stressor to our lives,” George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism.
“What we’ve been picking up with numerous small studies is that about 25% of the population increased their drinking and these individuals were people who were drinking to cope with stress. And many people who drink to cope with stress inevitably go on to have an alcohol use disorder.”
Broad social acceptance and easy accessibility make alcohol an easy option to cope with stress – and easy to miss problematic use, experts say.
“If a substance is harmful, the greater the access there is to that substance, the more harm it will create. What is the most accessible substance? Alcohol. And what is the substance with the least social stigma relative to using it? Alcohol,” Ventrell said.
“You might say ‘Joe drinks a little too much, but that’s just Joe.’ But no one says, ‘Joe uses a little too much meth, but he’s a good dad.’”
And while experts say the effects of alcohol abuse may be less immediate than other drugs, they’re no less devastating.
“Alcohol really has an insidious course, meaning that it produces wear and tear on your body over a long time,” said Dr. James Latronica, a family medicine doctor with addiction medicine services at the University of Pittsburgh Medical Center Western Psychiatric Hospital.
According to the CDC data, middle-aged men were most likely to die from excessive alcohol use in 2020. The death rate was highest for men ages 55 to 64 – there were nearly 60 deaths for every 100,000 people in this age group, more than four times higher than the overall rate. Death rates for women were also highest for that age group, but three times lower than for men.
But in the first year of the pandemic, death rates increased the most for younger men under 45 and the largest increases for women were among those between 25 and 44 – furthering evidence that alcohol is causing health issues for younger groups than before. Another study published earlier this week found that in the five years prior to the Covid-19 pandemic, 1 in 5 deaths of US adults 20 to 49 was from excessive drinking.
At every age, men were at least twice as likely as women to die from alcohol-induced causes, but the overall gap narrowed in 2020.
Experts attribute some of this shift to the pandemic, too.
“There’s an interaction with mental health that has been more exposed during the pandemic,” Koob said. Women are twice as likely as men to experience anxiety and depression, and the stresses of the pandemic likely hit extra hard.
“And women are also more vulnerable to the pathological effects of alcohol, everything from liver disease to some of the mental health interactions,” he said.
Because of the compounding effects of excessive alcohol abuse, experts say it’s likely that the effects of the pandemic will continue to cause elevated alcohol-induced deaths for years to come.
But better access to treatment can ease the loss; screening rates have improved, experts say, but fewer than one in 10 people with an alcohol use disorder are getting the treatment they need.
“With these studies, some people might worry if their relationship with alcohol is unhealthy,” Latronica said. Alcohol can cause a lot of problems, he said, but it’s much easier to address them when you talk about them – and that can start at a primary care visit.