Alcohol-Related Deaths in the US Are Increasing, Says New Report

A new report published in the journal Alcoholism Clinical and Experimental Research shows a dramatic increase in the number of alcohol-related deaths in the United States since 1999. Based on death certificate data analyzed by  the National Institute on Alcohol Abuse and Alcoholism, the report cites an over 100 percent increase in deaths related to alcohol consumption — from about 36,000 in 1999 to 73,000 in 2017. Although men die more often from complications of alcohol use, the largest increase was seen in women, particularly middle-aged women aged 55 to 64. An increase in alcohol-related deaths in men over the age of 50 was also noted during that time. 

The spike in deaths in women was associated with an overall increase in alcohol consumption among women in the United States, particularly those over the age of 50. This is especially concerning because women generally are more susceptible to alcohol-related complications, including cardiovascular disease, some cancers, cirrhosis of the liver and acute liver failure due to alcohol abuse, the study authors say. Blood alcohol levels rise more quickly in women than in men after consuming similar amounts of alcohol, even in people of comparable size. This means that women’s bodies are exposed to more of the toxic metabolite acetaldehyde, which is responsible for many of alcohol’s damaging effects.  

Numbers May be Larger

The study authors also surmise that the actual number of alcohol-related deaths may be far greater than their research indicates. Citing several studies dating back as far as 40 years, they postulate that coroners and medical examiners routinely fail to include alcohol as a contributing cause of death in motor vehicle and pedestrian accidents in which alcohol was clearly involved. This, they believe leads to “gross underreporting” of the number of alcohol-related deaths. In one recent study, for example, researchers compared death certificate data to data in the Fatal Analysis Reporting System maintained by the National Traffic Safety Administration. They found that alcohol was listed as a contributing cause of death in only 16 to 18 percent of deaths in which the person killed was legally intoxicated (blood alcohol level greater than or equal to 0.08) at the time they died. 

“The large discrepancy between the number of death certificates noting alcohol involvement in fatal crashes and the number noted in the FARS database is a strong indication of the need to improve our surveillance of alcohol-related mortality,”  the study authors wrote.

Middle-aged and elderly women are increasingly experiencing alcohol-related complications and alcohol-related deaths

Seniors at Risk of Alcohol-Related Death

While the increase in alcohol-related deaths in older persons may be related to a higher incidence of chronic illness overall, there is evidence that seniors are engaging in more drinking and more binge drinking in recent years. According to a study published in the Journal of the American Geriatrics Society last year, about 10 percent of Americans over the age of 65 who consume alcohol can be characterized as “binge drinkers.” (The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a “pattern of drinking that results in a blood alcohol level of 0.08 or above.” This usually occurs when men consume five alcoholic beverages in 2 hours or less and women consume four in the same amount of time.) Binge drinking is associated with a number of harms, including falls, which can be far more serious in the elderly than in younger adults. The CDC estimates that over 30 percent of fatal falls in the United States involved alcohol use.

Additionally, various studies have shown a significant increase in alcohol consumption in U.S. seniors in recent years along with a corresponding increase in ER visits related to alcohol use. According to the aforementioned study, between 2001 and 2013 there was a 22 percent increase in alcohol use among seniors over the age of 65 and a 65 percent increase in high-risk drinking (e.g. binge drinking.) Alcohol use disorder in seniors  increased by 107 percent over that same period of time. 

More rigorous screening for high-risk alcohol consumption in seniors is needed, the study authors note, since older adults “may not be aware of their heightened risk of worsening of chronic disease and injury” as a result of excess alcohol use.