Fewer Americans say they drink alcohol now than they have done for decades, but for those that do, the habit appears to have become dramatically deadlier over time, with the alcohol-related death rate in the U.S. almost doubling in the last twenty years.
Researchers at the University of California, Los Angeles examined data from the U.S. Centers for Disease Control and Prevention to find that the rate of alcohol-related death increased between 1999 and 2024, with an especially sharp uptick during the height of the Covid-19 pandemic. And while such deaths have declined since that peak, they remain markedly high.
“These findings emphasize the urgent need for targeted policies to reduce excessive alcohol consumption and improve access to treatment,” the authors write in a paper published Tuesday in PLOS Global Health.
A shocking rise
The new findings jibe with past studies that also suggested alcohol-related deaths in America have been climbing for decades. But it remained unclear as to the specific kinds of deaths caused by alcohol, or whether the increase in deadly drinking seen during the pandemic has been sustained.
To try and tease apart the answers to those questions, the researchers analyzed mortality data from the CDC across 14 causes of death induced by alcohol use. These included alcoholic liver disease, several forms of alcohol poisoning, as well as mental and behavioral conditions caused by alcohol.
Overall, the rate of alcohol-related deaths rose 89% between 1999 and 2024, the researchers found. The single deadliest year during this period was 2021, which saw 54,258 reported deaths that year. By 2024, deaths had begun to level off, but the average alcohol-induced death rate was still 25% higher than it was in 2019.
Trends in deadly drinking
The findings also offer more clarity on who is dying from alcohol misuse, and why, the researchers said.
The majority of alcohol-related deaths were caused by alcoholic liver disease, followed by mental and behavioral conditions caused by alcohol. Interestingly, the rate of alcohol poisoning deaths remained low throughout the study period, indicating that acute overdoses are relatively uncommon compared to chronic and heavy alcohol use.
Alcohol-related deaths have historically been more common among men, but the researchers’ findings suggest that may be changing: They found that the single largest increase in the death rate of any demographic during the study period was among women aged 25–34, followed by men in the same age group. American Indian and Alaskan Native populations were also found to be at particular risk.
“The rapid rise of alcohol-induced deaths among women is particularly concerning. Although men still die at higher rates, the gender gap appears to be closing,” said senior study author Maria R. D’Orsogna, an adjunct associate professor in the Department of Computational Medicine at UCLA, in a statement. “Notably, for the population aged 25–34, the male-to-female mortality ratio has decreased from three-to-one in 1999 to two-to-one in 2024.”
The researchers noted that they looked at deaths most directly tied to alcohol use, so their findings likely do not capture the full toll of alcohol on Americans’ health. Alcohol is known to raise the risk or worsen myriad chronic health conditions, including certain cancers. And other research has suggested that more than 178,000 deaths in the U.S. linked to excessive alcohol use occur every year.
More work needs to be done to figure out how best to prevent these deaths, the researchers said.
“The rise in alcohol-induced mortality and its heterogeneous trends across demographics highlight the need for a better understanding of the socioeconomic factors linked to excessive alcohol consumption and of targeted prevention and treatment efforts, particularly for males, youth, and the [American Indian/Alaska Native] population,” they wrote.
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