Sharp rises in alcohol-induced deaths in the United States (1999-2022) across genders, ages, races

ImportanceAlcohol-induced deaths rose by 163% in the United States between 1999 and 2022, with sharp increases across most gender, age, and race groups in Spring 2020, concurrent with the onset of COVID-19. This study analyzes monthly mortality rates by demographics from 2018 to 2022. ObjectiveTo determine which demographic groups in the United States experienced the largest variations in alcohol-induced crude rates, yearly between 1999 and 2022, and monthly between 2018 and 2022. Design, setting, and participantsThis cross-sectional study used yearly (1999 to 2022) and monthly (January 2018 to December 2022) mortality data from the Centers for Disease Control and Preventions Wide-Ranging Online Data for Epidemiologic Research. Fourteen alcohol-related causes of death were identified according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Population data was used to determine crude rates for given demographic groups. Main outcomes and measuresThe month and magnitude of sharp rises in crude rates were determined using Bayesian regression implemented through Rbeast. Data were stratified by gender, age, race and/or three classes of cause-of-death (alcohol liver disease; mental and behavioral disorders due to alcohol use; alcohol poisoning). ResultsAlcohol-induced deaths for individuals aged 15 and older increased 163% from 19,458 in 1999 to 51,184 in 2022, with a peak in 2021. Most affected were those aged 25-34, with a +345% (males) and a +441% (females) increase from 1999 to 2022. Rbeast applied to monthly data shows that for most gender, age, race groups, mortality rose sharply in Spring 2020 due to alcohol-related liver disease and mental and behavioral disorders. The largest relative increases by race were among American Indian and Alaska Native males with a 42% jump (May-Jun 20) and Black females with a 33% jump (Apr-May 20). By age, those between 35-44 (both genders) experienced the largest increase with a 29% jump (Apr-May 20). Conclusions and relevanceAlcohol-induced deaths have been steadily increasing since 1999, with major increases emerging in Spring 2020 for most gender, age, race groups. Policies to reduce excessive alcohol consumption, address the social determinants of addiction, and improve access to treatment can be most effective when targeted to specific groups. Key PointsO_ST_ABSQuestionC_ST_ABSHow do trends in alcohol-induced deaths vary by gender, age, race, and specific causes of death between 1999 and 2022 in the United States? FindingsFrom 1999 to 2022, alcohol-induced deaths surged across most demographics, with female crude rates increasing faster than males. Mortality spiked in Spring 2020, concurrent with the start of the COVID-19 pandemic, with the largest relative increases observed among American Indian and Alaska Native males (+42%) and Black females (+33%). MeaningTargeted prevention and intervention efforts are crucial for addressing differential trends in alcohol-induced deaths, which were likely worsened by social isolation and treatment disruptions during the pandemic.