U.S. Deaths From Excessive Drinking, 2016–2021

Deaths from causes fully attributable to alcohol, such as alcoholic liver disease and alcohol use disorder, have risen in the United States over the past two decades, especially from 2019 to 2020 as the COVID-19 pandemic began; alcohol-related emergency visits and alcohol sales rose too. But earlier trend studies left out deaths partly caused by alcohol — injuries and certain cancers, for example. This CDC analysis counted both.

How deaths were counted

CDC's Alcohol-Related Disease Impact (ARDI) application estimates deaths from 58 alcohol-related conditions using death records from the National Vital Statistics System. For each condition, an "alcohol-attributable fraction" gives the share of deaths due to excessive drinking — 100% for the 15 conditions fully caused by alcohol (including alcohol poisonings and suicides by alcohol poisoning), and smaller shares for conditions with other causes too, estimated from research on risk and from drinking data adjusted for underreporting. Deaths "from excessive alcohol use" include all fully alcohol-caused deaths, injury and other acute deaths involving binge drinking, and chronic-disease deaths tied to medium or high average daily drinking.

Results

• Deaths rose 5.3% between the first two periods, then 22.8% — for a 29.3% rise overall. That's about 488 deaths a day in 2020–2021.
• About two-thirds of deaths in each period came from chronic conditions.
• Fully alcohol-caused deaths rose 46.2%, to 51,665 a year (29.0% of the total); partly alcohol-caused deaths rose 23.5%, to 126,642 (71.0%).

By sex:

Among men, death rates were highest from chronic conditions fully caused by alcohol; among women, from heart disease and stroke. Deaths rose in every age group for both sexes, and rates rose for most causes.

Average annual deaths from excessive alcohol use by age group and period, males (A) and females (B), 2016–2021. CDC figure.

What it means

• The faster rise among women matches another recent study.
• An earlier study found one in eight deaths among adults 20–64 in 2015–2019 was due to excessive drinking; with the increases in 2020–2021, the share could now be higher.
• Binge drinking among adults 35–50 was higher in 2022 than in any year of the previous decade, which could drive more deaths ahead.
• With fewer than a third of deaths from fully alcohol-caused conditions, counting partly alcohol-caused deaths is essential to see the full harm.

Limitations: estimates are likely conservative — they are based only on current drinkers, and conditions such as HIV/AIDS and tuberculosis, for which heavy drinking is a major risk, were left out for lack of U.S. risk estimates.

What can help

• Evidence-based alcohol policies that make alcohol less available and more expensive — such as limiting the number and concentration of places selling it and raising alcohol taxes.
• CDC's electronic screening and brief intervention, which lets adults check their drinking, get personalized feedback and plan to drink less, in clinics and elsewhere.
• Routine screening and brief intervention in health care, and mass media campaigns supporting drinking less.

These steps can also protect people harmed by others' drinking — relatives, friends and strangers.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States.

Sources

• Esser MB, Sherk A, Liu Y, Naimi TS. "Deaths from Excessive Alcohol Use — United States, 2016–2021." Morbidity and Mortality Weekly Report 73(8), Centers for Disease Control and Prevention.