What’s driving the dramatic rise in alcohol-related deaths during the pandemic?

PBS
By William Brangham & Karina Cuevas
March 23, 2022

During the first year of the pandemic, alcohol-related deaths increased dramatically by 25 percent, according to a new study. In 2020, deaths jumped from about 79,000 a year to 99,000, with the spike seen across all drinking-age groups. Katherine Keyes, an epidemiologist at Columbia University’s Mailman School of Public Health, joins William Brangham to discuss.

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• Judy Woodruff:

We have regularly reported on the continuing rise in opioid and overdose deaths during the pandemic. But what’s gotten far less attention is a sharp increase in alcohol-related deaths as well.

William Brangham looks at a new study about that crisis and the reasons behind the surge.

• William Brangham:

That’s right, Judy.

Alcohol-related deaths were going up before the pandemic began, but they really accelerated once the virus emerged. A study this week in “The Journal of the American Medical Association” found that, during the first year of the pandemic, alcohol-related deaths increased dramatically by 25 percent.

In 2020, deaths jumped from about 79,000 a year to 99,000. And this spike was seen across all drinking age groups. So, what is driving this?

Katherine Keyes is an epidemiologist at Columbia University’s Mailman School of Public Health. She focuses on substance abuse, addiction and psychiatry.

Katherine, great to have you on the “NewsHour.”

So, as I mentioned, alcohol-related deaths had been rising before the pandemic, but then really took off. When you look at that, those results, does that make sense to you?

• Katherine Keyes, Columbia University:

Yes.

Certainly, what we know pre-pandemic is that alcohol consumption and alcohol-related deaths have been going up in the United States for about the last 10 years. And what we know is that, during the pandemic, there were a couple of factors that have really contributed to that acceleration.

One is the loss of connection with alcohol-related services and treatment programs for people who have a history of alcohol-related problems. And that’s then combined with the stress of the pandemic and financial stressors that are associated with it that created the conditions that led to relapse and other increases in heavy drinking, especially among people with a history of heavy drinking and related problems.

• William Brangham:

And the things that you cited, that people are stuck at home, it is stressful, perhaps it’s not as expensive, vs. if you’re drinking out, it costs a lot more than if you have bought that alcohol yourself, does that give any sense as to what we ought to be doing as far as trying to prevent these kinds of deaths from happening?

• Katherine Keyes:

Sure, of course.

Yes, there were many changes in alcohol policy that occurred across many states that made alcohol less restrictive and lower-cost, especially people who are drinking at home.

And what we know from decades of public health work is that population level interventions, such as increasing the price of alcohol, have a population level effect, so bring down alcohol consumption sort of at all points along the distribution of people who are consuming alcohol.

So, certainly, increasing price and providing more tighter regulations on access to alcohol would be an evidence-based and effective intervention to reduce alcohol-related death.

• William Brangham:

What are the other ways that people may not be as aware of that alcohol hurts the human body? I mean, how is it that alcohol is causing this many deaths?

• Katherine Keyes:

Yes, alcohol is a carcinogen and that affects many systems in the body.

We know that heavy levels of alcohol consumption can be associated with cardiovascular disease and even acute cardiomyopathy and other conditions that might affect otherwise healthy people, even at young ages. And at older ages, a cascade of deaths related to alcohol can involve both heart disease, liver damage and other are other sources of chronic morbidity, including cancer in many older folks.

• William Brangham:

We mentioned earlier that there were certainly a surge in opioid-related deaths during the pandemic that had really — again, those had also been going up, but really took off also during the pandemic.

Are those things connected? Is there often an overlap between alcohol use and other drug use?

• Katherine Keyes:

Yes, that’s right.

Alcohol and opioids can be a very fatal combination. And we know that many people who die of an opioid overdose, there are more than one substance involved. And, oftentimes, that does involve alcohol. So these polysubstance-related deaths are increasing across the United States.

And the contribution of alcohol to opioid overdose can’t be understated. Certainly, what we’re seeing in terms of this acceleration of alcohol-related deaths intersects very directly with the opioid overdose epidemic.

• William Brangham:

You touched on this before, but certainly anyone that has ever tried to get anyone into psychiatric care or substance abuse treatment knows that it’s a very, very difficult thing to do, with access and insurance and just availability.

And that seems like that’s going to be an ongoing issue, that, even if the virus recedes, that this is going to be a real problem that people are going to have a hard time getting care for.

• Katherine Keyes:

Yes, although I would say now we have a variety of relatively low-barrier outpatient interventions for people who want to reduce their drinking, even for people who don’t want to be completely abstinent from drinking, but just feel like they’re drinking too much.

And so I would certainly encourage anyone who is concerned about their drinking level or the drinking level of a loved one to talk to a health care provider about the different types of interventions that are available, because, oftentimes, this is a condition that can be treated in an outpatient environment.

• William Brangham:

All right, Katherine Keyes is an epidemiologist at Columbia University’s Mailman School.

Thank you so much for being here.

• Katherine Keyes:

Thanks so much for having me.

• Judy Woodruff:

Something to surely pay attention to.