By John Salak –
Alcohol consumption in the U.S. is exacting fearful consequences for virtually all Americans, with its deadly impact earning the grim reality of ‘drink to your death.’ It is a major cause of preventable death and disability, driving increases in liver disease, mental health disorders and accidents—and the threat is rising at alarming rates.
A clinical study published in The American Journal of Medicine notes that alcohol-related deaths have surged dramatically in the last two decades, with the mortality rate nearly doubling from 10.7 per 100,000 in 1999 to 21.6 per 100,000 in 2020.
The jump in the raw number of deaths is even greater as the total rose from 19,356 in 1999 to 48,870 in 2020. Every age group has suffered increases, with those between the ages of 25 to 34 recording the most alarming spike—a nearly fourfold increase.
Those 85 and older saw a nonsignificant increase. Additionally, individuals aged 55-64 had both the steepest rise in mortality and the highest absolute rates in both 1999 and 2020. Both men and women experienced significant increases in alcohol-related deaths, but men had the highest rates in both years and saw the steepest increase overall.
“Our study found significant gender differences in alcohol-related mortality. While men had higher overall death rates, women experienced a larger relative increase, which may reflect changing social norms and the alcohol industry’s increased targeting of women through marketing campaigns,” said the study’s senior author Panagiota Kitsantas, Ph.D., professor at Florida Atlantic University’s Schmidt College of Medicine.
“As alcohol consumption among women has grown, so have the associated risks. Women appear to be more vulnerable to alcohol’s harmful effects due, possibly, to differences in body composition and metabolism, leading to higher blood alcohol concentrations. Moreover, mental health issues like depression and anxiety, already more common in women, can be worsened by alcohol use,” Kitsantas added.
FAU’s findings underscore the significant and growing clinical and public health challenges that may benefit from targeted interventions. Risk factors such as obesity, diabetes and liver damage complicate these challenges, accelerating alcohol-related mortality, the study noted. Gender, demographic and regional differences should also guide health care strategies.
“Addressing these factors through tailored interventions could help combat the growing U.S. alcohol mortality epidemic,” said Kitsantas.
The research results, when combined with further basic studies, will enable more informed clinical decisions and public health policies. In the meantime, the FAU data suggest actionable solutions for health care providers and public health officials at all levels, the university’s team stressed.
“Healthcare providers should recognize that heavy alcohol use is a leading risk factor for total mortality and cardiovascular disease, especially heart attacks and stroke,” said co-author Dr. Charles H. Hennekens. “To mitigate these risks, screening for alcohol use in primary care settings is essential. Coexisting conditions like overweight and obesity can accelerate liver damage, which may in turn lead to earlier onset of cirrhosis and liver cancer. The U.S. has the highest rates of overweight and obesity in the world and low levels of daily physical activity. The deleterious interaction of these factors may contribute to the observed trends in alcohol-related mortality, particularly in younger adults.”
Alcohol consumption in the U.S. is relatively high. Approximately 225 million people ages 12 and older, about 80 percent of this age group, report having drunk alcohol at some point during their lifetime. This total includes more than 20 percent of Americans between 12 and 17 years old and about 85 percent of those 18 and over.
“Both globally and in the U.S., high levels of alcohol consumption are closely linked to premature deaths and disability,” Hennekens explained. “The difference between consuming small amounts of alcohol daily and larger amounts could be the difference between preventing and causing premature death. One immediate effect of alcohol is liver damage, and in the U.S., the rising rates of obesity and diabetes also contribute to early liver damage.”
