Alcohol disease deaths doubled in past 20 years

It’s a shocking trend.

From 1999 to 2020, the number of Americans who died from alcohol-related disease doubled from 19,356 per year to 48,870 per year, according to a November 10, 2024, article in The American Journal of Medicine. These deaths don’t include other fatalities associated with alcohol, such as car crashes, fights and accidents. The researchers used data from the U.S. Centers for Disease Control and Prevention (CDC) to identify trends.

They found alcohol-related disease deaths increased:

• 3.8 times in the age 25 to 30 group, the biggest increase of any 10-year age group.
• 2.5 times in the Midwest, the largest regional increase.
• 2.4 times among Asians and Pacific Islanders, the largest for ethnic groups studied.
• 2.5 times among women.

The last year of the study period coincided with the early part of the COVID-19 pandemic, which began in March of 2020.

Men Drink More

An increase in people being overweight or obese probably contributed to the rise in alcohol-related disease deaths, reported a March 2025 paper, also in JAMA.

According to CDC data, alcohol-related deaths in Massachusetts rose from approximately 2,760 per year from 2011-2015 to 3,098 deaths per year in 2021-2022. Of the latter total, 2,023 deaths were men and 1,025 were women.

While drinking increased among women, 69 percent of alcohol-related deaths from all causes are men, with 37 percent of those deaths related to vehicular accidents. Men are at higher risk for alcohol abuse disorder and liver disease.

“The healthy amount of alcohol to drink is probably none,” said Evan L. Guthrie, MD, FACP, who practices family medicine at Fontaine Primary Care, at Cape Cod Healthcare’s Fontaine Outpatient Center in Harwich. He recommended men not exceed two drinks per day and women one drink per day. Women’s blood alcohol levels rise more than men’s after drinking the same amount of alcohol.

Risk Factors for Alcohol Abuse

According to the CDC, the following may predispose someone to alcohol abuse:

• Mental health disorders, including anxiety, depression, ADHD (attention deficit hyperactivity disorder), PTSD (post-traumatic stress disorder) and schizophrenia.
• Low economic status
• Growing up in a dysfunctional family
• Parents who drink
• Previously smoked tobacco or marijuana
• Being a twin

People with mental health disorders and those under stress are more susceptible to use alcohol for relief. The March 2025 JAMA paper cited multiple pressures on middle-aged adults – the age group with the highest levels of drinking-related illness deaths. The authors suggested mental health screening and treatment as a way to reduce use of alcohol as a coping mechanism.

Dr. Guthrie said anyone interested in finding help can go online to SAMHSA (Substance Abuse and Mental Health Services Administration) for various help phone lines and locators for treatment and support.

“If you’re having trouble regulating something (alcohol or drugs), that’s probably a sign you’re better off without it,” he said. “Most humans are at risk of substance abuse at some point in their lives. Some are more at risk than others.”

Alcohol, Excess Weight and Disease

Liver disease accounts for 31 percent of alcohol-related disease deaths. The researchers in the November 2024 JAMA article wrote that alcohol’s adverse effects on health are complicated and worsened by being overweight or obese, which also can cause liver disease. The combination of too much body fat and alcohol overconsumption can lead to earlier death, they wrote.

According to the CDC, regularly drinking substantial amounts of alcohol contributes to developing cancer, heart disease, high blood pressure, stroke, digestive ills, and a weakened immune system. In addition, it can worsen depression, anxiety and other mental illness, interfere with learning and memory, and lead to dementia.

The March 2025 JAMA analysis said the prevalence of excess body weight and obesity probably expanded the number of alcohol-related disease deaths, as these conditions raise the risk of cardiovascular disease, alcoholic cardiac myopathy, cardiac metabolic syndrome, hypertension (high blood pressure), type 2 diabetes, as well as cirrhosis (scarring of the liver) and liver cancer.

A September 2024 post from the CDC said 40.3 percent of American adults were obese, with 9.4 percent being severely obese, an increase from 7.7 percent in 2013-2014 to 9.7 percent in 2021-2023.

Counseling is Available

Dr. Guthrie said he screens all patients for alcohol use with questionnaires. He also discusses the risks of alcohol in light of a patient’s age and condition.

“For young adults, avoiding alcohol is good for brain development,” he said, adding that the brain keeps maturing through the early 20s. “I already tell younger adults to avoid anything habit-forming.”

Older patients may find they’re more affected by alcohol than when they were young, Dr. Guthrie said. They may also suffer combined effects from drinking while also taking prescription drugs. For example, consider the blood thinner warfarin, sold as Coumadin and Jantoven. Alcohol can reduce its effectiveness and increase the chances of a major bleeding episode, according to the American Heart Association.

Patients ages 25 to 34, or even 50 or so “feel young, they feel strong,” he said. These are the patients most resistant to limiting or stopping their drinking, he said.

Tide Turning?

Americans may be cutting back on alcohol. According to an August 13, 2025, article by Gallup, 54 percent of adults polled in July said they drink alcohol, a new low – by one percentage point – in the years since 1939. The percentage of Americans who told Gallup they drink has dropped in recent years but has generally bounced between the mid-50s and 70 percentage points since 1939.