Alcohol-Related Deaths Spiked During the Pandemic, a Study Shows
By Roni Caryn Rabin, March 22, 2022, NY Times

Almost a million people in the United States have died of
Covid-19 in the past two years, but the full impact of the
pandemic’s collateral damage is still being tallied. Now a
new study reports that the number of Americans who died of
alcohol-related causes increased precipitously during the
first year of the pandemic, as routines were disrupted,
support networks frayed and treatment was delayed.

The startling report comes amid a growing realization that
Covid’s toll extends beyond the number of lives claimed
directly by the disease to the excess deaths caused by
illnesses left untreated and a surge in drug overdoses, as
well as to social costs like educational setbacks and the
loss of parents and caregivers.

Numerous reports have suggested that Americans drank more
to cope with the stress of the pandemic. Binge drinking
increased, as did emergency room visits for alcohol withdrawal.
But the new report found that the number of alcohol-related
deaths, including from liver disease and accidents, soared,
rising to 99,017 in 2020, up from 78,927 the previous year —
an increase of 25 percent in the number of deaths in one year.

That compares with an average annual increase of 3.6% in
alcohol-related deaths between 1999-2019. Deaths started
inching up in recent years, but increased only 5% in 2018-19.

The study, done by researchers with the National Institute
on Alcohol Abuse and Alcoholism, a division of the National
Institutes of Health, was published in The Journal of the
American Medical Association on Friday. Using information
from death certificates, the researchers included all deaths
in which alcohol was listed as an underlying or contributing
cause. (Only a very small number also involved Covid-19.)

“The assumption is that there were lots of people who were
in recovery and had reduced access to support that spring and
relapsed,” said Aaron White, the report’s first author and a
senior scientific adviser at the alcohol abuse institute.

“Stress is the primary factor in relapse, and there is no
question there was a big increase in self-reported stress,
and big increases in anxiety and depression, and planet-wide
uncertainty about what was coming next,” he said. “That’s a
lot of pressure on people who are trying to maintain recovery.”

Among adults younger than 65, alcohol-related deaths actually
outnumbered deaths from Covid-19 in 2020; some 74,408 Americans
ages 16 to 64 died of alcohol-related causes, while 74,075
individuals under 65 died of Covid. And the rate of increase
for alcohol-related deaths in 2020 — 25% — outpaced the
rate of increase of deaths from all causes, which was 16.6%.

The alcohol-related deaths went up for everybody — men, women,
as well as every ethnic and racial group. Deaths among men and
women increased at about the same rate, but the absolute number
of deaths among men was much higher.

Drug overdose deaths also reached record levels during the
first year of the pandemic, with more than 100,000 Americans
dying of overdoses during the 12-month period that ended in
April 2021, a nearly 30 percent increase over the previous
year, according to reports issued in November. The number of
deaths from opioids in which alcohol played a role also increased.

Young adults ages 25 to 44 experienced the greatest increases
in alcohol-related deaths in 2020, rising nearly 40%
over the previous year, according to the new report.

Available data for 2021 indicates that alcohol-related deaths
remained elevated, Dr. White said, but he added that it was
hard to say whether that indicated a continuation of the
trend because alcohol consumption and deaths generally drop
in February after the holidays and then trend back up.

“Maybe they’ll go back down,” he said, “but this could be the new norm.”

The crisis has actually been brewing for years, as drinking
among adults has been increasing even as drinking among
adolescents has fallen off, said Katherine Keyes, a professor
of epidemiology at Columbia University, who was not involved
in the study. Mental health struggles were also becoming more
prevalent before the pandemic, making people more susceptible
to substance abuse.

“As with many pandemic-related outcomes, this is an exacerbation
of issues that were beginning before the pandemic for many people,”
Dr. Keyes said. “Drinking has been going up for 10 or 15 years
among adults, and the trend accelerated in 2020, as some of the
motivations to drink changed: Stress-related drinking increased,
and drinking due to boredom increased.”

Adults in their mid-20s to mid-40s with children at home were
under increased stress as they juggled remote working and learning,
she said; those without children, who generally drink more anyway,
may have been contending with more isolation and loneliness.

And when people drink at home, she noted, there’s no bartender
monitoring the size of the drink — “you have less ability to
regulate how much is going into the glass,” she said — and
drinking is much less expensive.

But it was the inability or reluctance to access treatment
during lockdowns and periods when the health care system was
overwhelmed that may have deterred those who needed treatment
from getting care, said John Kelly, a professor of psychiatry
at Harvard Medical School and the director of the Recovery
Research Institute at Massachusetts General Hospital.

That may have contributed to deaths from alcohol-related liver
disease, which accounts for about one-third of alcohol-related
deaths, Dr. Kelly said. Other major causes are drug poisoning,
which occurs when alcohol is involved in a drug overdose death,
and alcohol-related mental and behavioral disorders.

Total alcohol sales in the United States by volume increased
by 2.9% in 2020 over the previous year, the greatest annual
increase in sales since 1968, Dr. White said.

He called for new approaches to addiction that teach people to
cope with stress in a more productive manner.

“We are entering an era in public health where we are talking
more about promoting wellness and building resilient people,”
he said. “What we are doing now is not sufficient. We need to
help people live meaningful purpose-filled lives.”

https://www.nytimes.com/2022/03/22/health/alcohol-deaths-covid.html

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