For both males and females, rates rose with increasing age and peaked for those aged 55–64 before declining for all age groups 65 and over. Alcohol use is a known risk factor for mortality, and the rates of alcohol-induced deaths have risen over the past several years (1). Alcohol use in the United States increased during the first year of the Coronavirus Disease 2019 (COVID-19) pandemic, which may have affected mortality rates, especially for alcohol-induced deaths (2). Understanding trends in alcohol-induced mortality, with a particular focus on differences from 2019 to 2020, may help identify groups particularly affected during the COVID-19 pandemic.

U.S. alcohol-involved deaths climbed by 26.6%, and drug overdose deaths by 30.6%

New provisional data from CDC’s National Vital Statistics System predict a nearly 24% decline in drug overdose deaths in the United States for the 12 months ending in September 2024, compared to the previous year. This is the most recent national data available and shows a continued steep decline in overdose deaths. Provisional data shows about 87,000 drug overdose deaths from October 2023 to September 2024, down from around 114,000 the previous year. Trends in age-adjusted death rates were evaluated using the Joinpoint Regression Program (Version 5.0.2) (8).

Alcohol-Attributable Chronic Deaths (2016-

• The testimonies of these people highlight the role of declines in communities and families triggered by changes in economic opportunities.
• They found a large escalation in pain prevalence among adults over this period, with overall reports of pain in at least one anatomic site increasing by 10 percent (from 49% in 2002 to 54% in 2018), representing an increase of 10.5 million adults experiencing pain.
• Treatment rates are slightly higher among those who do receive a diagnosis–for instance, 10% of Medicaid enrollees diagnosed with an alcohol use disorder received medication, 34% received counseling services, and 74% received some type of interaction with a treatment, such as therapy, medication, assessment, or supportive service.
• Our results suggest that changes in women’s drinking behavior have led to disproportionate increases in mortality rates.

Purdue (and subsequently other pharmaceutical companies) exploited the now infamous five-sentence Porter and Jick letter, which was published in the New England Journal of Medicine in 1980, to convince the FDA, physicians, and the public that opioids were safe and not addictive. That letter actually stated that, among the nearly 12,000 hospitalized patients who had received at least one opioid administration in the hospital, only 4 had developed an addiction. Among the most well-known culprits in the opioid overprescribing crisis amphetamine addiction treatment is the pharmaceutical company Purdue Pharma. In 2020, Purdue reached an $8.3 billion settlement with the U.S. government and agreed to plead guilty to criminal charges that it enabled the supply of opioids “without legitimate medical purpose,” conspired to defraud the United States, and violated antikickback laws in its distribution of opioids. Kickbacks included payment to health care companies and physicians to encourage opioid prescribing (Sherman, 2020).

Deaths from Excessive Alcohol Use — United States, 2016–2021

Her interviewees cited feelings of hopelessness and social isolation related to the lack of economic activity in their communities as a motivation for their drug use (McLean, 2016). Drawing on fieldwork and in-depth interviews, Jennifer Silva explored how economic decline was experienced by working-class Whites, Blacks, and Hispanics living in rural Pennsylvania. In a presentation to the committee in October 2019, she described how—in a context in which family ties are fragile, opportunities for mobility seem scarce, and social safety nets have diminished—her respondents often had turned to drugs, alcohol, and even food to cope with life’s disappointments, the lack of economic opportunity, and hopelessness about the future. Scholars have offered a number of possible demand-related explanations for the surge in drug addiction and overdose seen over the past three decades and its particular impact on certain subpopulations and geographic areas. Some of these explanations focus on factors proximate alcohol overdose to individuals—physical pain, mental illness, adverse childhood experiences (ACEs), and psychological distress or despair—and others on factors more structural and distal—macro-level economic and social changes. This section first provides an overview of conceptual models of addictive behaviors and then summarizes the evidence for these explanations.

This finding suggests that mortality due to drug poisoning is not responsible for the growing gap in all-cause mortality between large central metros and nonmetros among working-age White adults. However, Monnat (2020a) notes substantial variation in drug poisoning mortality across different rural areas in the United States, and while some rural areas have among the lowest drug mortality rates in the country, others have the highest. Combining all rural areas into one composite rate averages out these wide divergences and masks the reality that drug poisonings accounted for a large share of the widening rural mortality penalty in certain regions (e.g., Appalachia, New England) and economic contexts (e.g., mining counties) (Monnat, 2020b).

Over the past three decades, several factors have directly impacted the chronicity and severity of alcohol consumption in the USA. Increased life expectancy and reduced fertility rates have led to an aging population, with the percentage of adults over 65 growing from 12% in 1990 to 16% in 2020 (United States Census Bureau, 2020). Alcohol’s effects on the body and central nervous system change with age, which may be due to metabolic efficiency changes and a decline in metabolic rate in older adults (Eckardt et al., 1998; Squeglia et al., 2014; Meier & Seitz, 2008; Pontzer et al., 2021).

FIGURE 7-8

• When it was crushed and snorted or dissolved and injected, users could obtain a very intense immediate high, making OxyContin much more addictive than other prescription opioid products already on the market.
• As a result, rates of drug overdose deaths presented in this report are not adjusted for race and Hispanic-origin misclassification on death certificates.
• These scholars chronicle the increases in the availability of inexpensive highly addictive and lethal drugs.
• However, these actions take place against a backdrop of industry activities that promote the use of the drug to providers and patients (NASEM, 2017, pp. 364–365).

In a study representing nearly 215,000 adults in 23 U.S. states, Merrick and colleagues (2018) found that nearly two-thirds had experienced at least one ACE, and a quarter reported three or more such experiences. Other studies using both clinic-based and national samples have found similar prevalence levels, ranging from half to 69.1 percent of the U.S. adult population (Anda et al., 2006; Brown et al., 2009; Campbell, Walker, and Egede, 2016; Choi et al., 2017; Monnat and Chandler, 2015). Susceptibility to substance abuse is influenced by individual/proximal factors (e.g., SES, psychological factors); community meso-level structures (e.g., family, peers, social environment); and macro-level structures (e.g., economic inequality, policies, corporate practices) (see Figure 6-1 in Chapter 6). Increases in substance-related mortality, while affecting all demographic groups and places, have been larger in some groups and places than others.

A Look at the Latest Alcohol Death Data and Change Over the Last Decade

Although mutual help and peer support groups are useful resources for people with substance use disorders, almost half of responding countries reported that they do not offer such support groups for substance use disorders. Since 2006 the rate of death among alcohol related incidents has increased among all levels of urbanization. Small/medium sized metropolitan areas also saw a significant rise in alcohol-related deaths from 2006 to 2019. Large metropolitan areas saw the fewest deaths and the smallest increase in the death rate between the 14 years.

Death due to Alcohol Poisoning

The committee’s recommendations differ from those prior recommendations in that they do not focus on specific policy and practice strategies. Rather, the committee believes broad efforts are needed to address all components of the U.S. addiction and overdose crisis, on both the supply and demand sides. As policy makers, state health officials, and physicians began to recognize the dangers of opioids and prescribing subsequently declined, prescription opioids became less available and more expensive. As a result, people who had become addicted to or dependent on them (and people with existing heroin addictions) turned increasingly to heroin. This transition introduced a new clientele and created a “thick market” for heroin, lowering its prices, and ushering in the second wave of the U.S. addiction and overdose crisis. The third wave began in the early 2010s with the infiltration of fentanyl into the U.S. drug supply.

• A variety of factors may have contributed to increases in drinking including a growing social acceptability of alcohol and loosening of alcohol policies at a state level.
• These measures included instituting prescribing limits, monitoring prescribing to identify excessive levels, and implementing “pill mill” laws requiring providers to submit clinical documentation from medical records to support their prescribing of opioids (Kiang et al., 2019).
• It is known that variation in state regulations regarding physicians’ ability to prescribe opioids influenced the magnitude of the opioid addiction problem across states.
• Our free phone numbers and chats allow you to connect with various institutions where you can receive professional help.
• From 2018 to 2020, alcohol-induced overall mortality rates sharply increased, corroborating other studies using multiple causes of death data that demonstrated a significant rise in alcohol-related deaths during this period (White et al., 2022; Yeo et al., 2022).
• The decline and transformation of industries that once provided good jobs for adults with only a high school education have resulted in the erosion of the character and nature of communities that depended on those industries.

Young adults (18-25) show the highest rates of alcohol consumption, with more than half reporting use. There’s a clear progression of increased alcohol use as students advance through grades, with rates nearly tripling from 8th to 12th grade. The data reveals concerning patterns of alcohol use, particularly among young adults, and shows the substantial health, safety, and economic consequences of excessive drinking in the state. This cross-sectional study estimates the mean annual number of deaths attributable to excessive alcohol use among US adults aged 20 to 64 years overall; by sex, age group, and US state; and as a proportion of total deaths.