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Alcohol-Related Deaths Are Up in U.S.

Highest mortality rates from drinking seen in older adults

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Mark Hanna/Getty Images

En español | The United States has seen an increase in alcohol-related deaths over the past 20 years, with rates nearly doubling between 1999 and 2017, according to researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The researchers, who looked at U.S. death certificates filed between 1999 and 2017, found that in 2017 alcohol was mentioned as causing or contributing to 72,558 deaths (or 2.6 percent of all deaths in the U.S.) — more than twice as many as in 1999, when alcohol was included for 35,914 deaths (or 1.5 percent of all deaths).

Nearly half of alcohol-related deaths in 2017 resulted from liver disease (31 percent, or 22,245 deaths) or overdoses on alcohol alone or with other drugs (18 percent, or 12,954 deaths).

"The current findings suggest that alcohol-related deaths involving injuries, overdoses and chronic diseases are increasing across a wide swath of the population,” said George F. Koob, director of NIAAA, which is part of the National Institutes of Health. “The report is a wake-up call to the growing threat alcohol poses to public health."

Adults ages 45 to 74 had the highest rates of deaths related to alcohol, but people 25 to 34 saw the biggest increases over the 20-year span. Still, the researchers note that overall rates of alcohol-related deaths are more than four times as high among people ages 45 to 74 as among those ages 25 to 34 and that the nation is only growing older. The U.S. Census Bureau estimates that by 2034 there will be more Americans over 65 than under 18.

"The consistently high rates of alcohol-related deaths among middle-aged and older drinkers are concerning given the increasing size of the aging population,” the researchers said in a study published online in the journal Alcoholism: Clinical and Experimental Research. “Even if rates of alcohol consumption and alcohol-related harms stay the same, the number of alcohol-related health care visits and fatalities could increase substantially, thereby increasing the overall burden of alcohol on public health."

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The researchers suggest that health care providers talk with their patients about alcohol, “given that roughly 4 of 5 drinkers aged 65 and older are prescribed medications that could interact negatively with alcohol."

The increase in alcohol-related deaths is consistent with earlier studies that have reported increases in alcohol consumption, alcohol-involved emergency department visits and hospitalizations. The researchers, however, suggest that their findings likely undercount the actual death toll related to alcohol. For example, they point out a large discrepancy between the number of death certificates noting alcohol involvement in fatal crashes and those tallied by the National Highway Traffic Safety Administration.

Similarly, the Centers for Disease Control and Prevention estimates that 32 percent of fatalities from falls in the U.S. probably involve alcohol, but alcohol was listed as a contributing factor on only 1.8 percent of death certificates for fatalities from falls among people 65 and older.

"We know that the contribution of alcohol often fails to make it onto death certificates. Better surveillance of alcohol involvement in mortality is essential in order to better understand and address the impact of alcohol on public health,” Koob said.

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