'Startling' Increase in Alcohol-Induced Deaths Requires 'Urgent Action'

Megan Brooks

February 26, 2020

Rates of alcohol-induced deaths in the United States have increased substantially over the past 17 years among men and women across all racial/ethnic groups, with more rapid increases in recent years, a new analysis shows.

These deaths are "an urgent public health crisis calling for concerted public health action," study investigator Susan Spillane, PhD, of the National Cancer Institute's Division of Cancer Epidemiology and Genetics, Rockville, Maryland, told Medscape Medical News.

The increases are particularly concerning, especially inasmuch as they affect many segments of the population, including young people, she added. It is also "striking" that the observed increases were largest in more recent years.

The study was published online February 21 in JAMA Network Open.

National Data

Using national vital statistics data, the researchers examined how rates of alcohol-induced deaths changed in the United States from 2000 to 2016.

Alcohol-induced deaths were defined as deaths due to alcohol consumption that could be avoided if alcohol weren't involved. They include, but are not limited to, alcoholic liver disease, alcohol-induced acute or chronic pancreatitis, alcohol-related mental and behavioral disorders, alcoholic cardiomyopathy, and alcohol poisoning.

From 2000 to 2016, 425,045 alcohol-induced deaths occurred. In 2000, there were 19,627 deaths (76% men). By 2016, the number was 34,857 (73% men).

On average, rates of alcohol-induced deaths per year rose 1.4% in men and 3.1% in women and accelerated in recent years: 4.2% per year in men from 2012 to 2016, and 7.1% per year in women from 2013 to 2016.

The largest increases by race/ethnicity were observed among American Indian and Alaska Native (AIAN) men and women and white women, but increases throughout the study period were also noted for Asian and Pacific Islander (API) men and women and Latina women.

Despite an initial decline among black women from 2000 to 2007, black men from 2000 to 2012, and Latino men from 2000 to 2013, these "promising" trends reversed course, and rates of alcohol-induced deaths increased from 2013 to 2016 in all examined racial/ethnic groups, the authors report.

In keeping with previous trends, the researchers found large absolute increases in alcohol-induced deaths among white individuals during midlife, particularly among men.

"However, the steepest increases in the rates of alcohol-induced deaths among white individuals in our study population occurred among younger adults, particularly women," they note.

Among people aged 25 to 34 years, alcohol-induced deaths ranged from 4.6% to 6.9% per year among men and from 7.3% to 12.0% per year among women.

Call to Arms

As previously reported by Medscape Medical News, the US Preventive Services Task Force recently recommended screening for unhealthy alcohol use among adults in primary care settings as well as providing behavioral counseling interventions.

The findings in this analysis "justify the authors' call to arms to address alcohol-related morbidity and mortality of this long-recognized yet growing public health crisis among Native people and other segments of the US population," Spero Manson, PhD, with the Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus in Aurora, writes in a linked commentary in JAMA Network Open.

He notes it's also important to realize that alcohol-induced deaths are just the "tip of the iceberg."

"Alcohol-related deaths — notably suicide, motor vehicle collisions, drowning, and homicide — remain high among AIAN individuals and continue to rise. Combined, they underscore the urgency of the authors' call to action," Manson writes.

"Recent concerns about the opioid epidemic sweeping through AIAN populations are well founded and demand immediate attention. However, attendant shifts in funding and programming emphases threaten to overshadow the continued, growing crisis of alcohol use and dependence in this population. We forget this peril at great risk to the future of Native peoples," he concludes.

Funding for the study was provided by a grant from the Health Research Board of Ireland and by the Cancer Prevention Fellowship Program within the Intramural Research Program of the National Cancer Institute. Spillane and Manson have disclosed no relevant financial relationships.

JAMA Netw Open. Published online February 21, 2020. Full text, Commentary

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