Alcohol has always been a part of American life. From colonial taverns to modern tailgate parties, it has been poured, toasted, and passed around during celebrations. In the 1700s, many Americans drank rum or cider with every meal — even children were given sweetened toddies (a drink made with liquor and honey). By the 1830s, Americans over age 15 were drinking more than 7 gallons of alcohol a year.1,2
Today, alcohol is still everywhere — at weddings, football games, and backyard barbecues. It’s legal, familiar, and touted to be “harmless” when consumed in moderate amounts.
But over the past two decades, something has shifted: Alcohol-related deaths have steadily surged across the country. Not just in cities or among heavy drinkers, but even in small towns and rural counties once considered low-risk.3
What a 25-Year National Study Uncovered About Alcohol Deaths
A major study published in the PLOS Global Public Health journal examined how alcohol-related deaths have changed in the U.S. over the past 25 years. Using data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) system, the researchers sought to identify which populations have been most affected by highlighting demographic disparities, geographic hotspots, and trends that worsened during the COVID-19 pandemic.4
• The study tracked alcohol-related deaths from 1999 to 2024 using statistical modeling — Researchers examined death rates by age, gender, race, and location. They focused on causes such as alcoholic liver disease, alcohol poisoning and mental or behavioral disorders linked to alcohol, using official medical codes from the International Classification of Diseases, 10th Revision (ICD-10).5
• Deaths rose by 89%, with the biggest spike during the peak of the pandemic — In 1999, the death rate was 7.0 per 100,000 people. By 2024, it had jumped to 13.2. The highest number of deaths occurred in 2021, with more than 54,000 lives lost. The sharpest increase began in early 2020, when the pandemic disrupted daily life and access to care. As noted by the study authors in PLOS Global Public Health:6,7
“Sharp increases occurred at the onset of COVID-19, peaking in 2021. For most demographics across the nation, crude rates remained abnormally high throughout 2023.”
• Native American and Alaska Native communities were hit hardest — In 2020, American Indian and Alaska Native men had a death rate of 80.8 per 100,000 — more than three times higher than white men. Women in these communities also had higher mortality rates than white women.8
“In Ogala Lakota County (South Dakota), McKinley County (New Mexico), and Apache County (Arizona), crude rates have exceeded an astonishing 80 fatalities per 100,000 annually since 2020,” the study authors reported.
• Experts say targeted action is urgently needed — The authors recommend better access to treatment, stronger alcohol policies such as higher taxes, and limits on advertising and programs designed for specific communities. They also call for more support in rural and underserved areas, saying:9
“These findings emphasize the urgent need for targeted policies to reduce excessive alcohol consumption and improve access to treatment.”
Alcohol Is Harming the Most Vulnerable in More Ways Than Before
Alcohol’s impact is shifting in unexpected ways. Young adults are dying at faster rates, women are facing rising mortality, and communities are feeling the emotional toll. These patterns reflect deeper cultural and psychological forces that are reshaping how, why, and who alcohol harms the most in today’s society.
• Native American and Alaska Native communities face the highest alcohol-related death rates and the deepest barriers to care — These communities don’t just experience the worst outcomes, they also face some of the most complex challenges. Many tribal and remote areas lack consistent access to addiction treatment, mental health services, and culturally sensitive care.
Jurisdictional issues between tribal, state, and federal systems often slow down or block public health efforts. Historical trauma, poverty, and underfunded healthcare systems also make long-term recovery harder to achieve.
• Young adults are dying at faster rates, with alcohol-related deaths nearly quadrupling in some age groups — Between 2012 and 2022, alcohol-related deaths among people aged 25 to 34 nearly quadrupled. This spike is linked to increased binge drinking, mental health struggles, and the normalization of heavy alcohol use in social settings. Young adults are also less likely to seek help, often due to stigma or lack of awareness.10
• Women’s mortality rates are rising sharply, driven by cultural shifts and targeted alcohol marketing — Alcohol-related deaths among women rose by 70% between 2012 and 2022. Researchers attribute this to changing gender roles, increased stress, and aggressive marketing of alcohol products toward women. Physiologically, women are more vulnerable to alcohol’s effects, making them more susceptible to liver disease and other complications.11
The alcohol crisis is reshaping families and entire communities across the country. Behind every statistic is a story of grief, disruption, and resilience. Families are losing loved ones in their prime, often without warning.
How the Pandemic Deepened America’s Hidden Alcohol Emergency
When COVID-19 swept across the country and lockdowns were imposed, alcohol became a lifeline for many; behind closed doors, drinking habits changed in ways that proved deadly. So even though the pandemic didn’t start the alcohol crisis, it accelerated it in ways we’re only beginning to understand.
• Lockdowns drove people to drink more and relapse faster — As routines collapsed and isolation set in, alcohol became a quick fix for stress, boredom, and fear. For those already struggling with addiction, the sudden loss of structure and support triggered widespread relapses. Drinking wasn’t just more frequent, it became more dangerous, with people consuming larger quantities alone and without oversight.12
• Support groups went virtual, but many couldn’t access them — Hospitals prioritized COVID patients, sidelining addiction care. The result? A breakdown in recovery infrastructure when it was needed most. People who had fought hard for sobriety found themselves without the tools to stay afloat.13
• Alcohol-related deaths surged in real time, and stayed high long after lockdowns ended — The numbers tell a chilling story. Monthly death rates spiked sharply in early 2020 and have yet to return to pre-pandemic levels.14
• The pandemic exposed how fragile America’s addiction and mental health systems really are — COVID-19 didn’t just overwhelm hospitals, it revealed how underprepared the country was to handle a surge in alcohol-related crises.15 Mental health services were stretched thin, and addiction care was often treated as secondary. The cracks in the system became chasms, especially in rural and underserved areas.
• Alcohol became a silent coping mechanism — For many, alcohol was a way to numb the grief, uncertainty, and isolation of the pandemic. But what started as a coping tool quickly became a health hazard.16 Liver disease, alcohol poisoning, and mental health disorders surged. Families lost loved ones not only to COVID, but also to the quiet crisis unfolding alongside it.
The Rise of Risky Drinking Among Women
Women are facing a distinct and growing alcohol crisis. Fueled by targeted marketing, shifting cultural norms, and biological vulnerability, their risk profile is changing fast. Just like the featured PLOS Global study, research published in the American Journal of Medicine also revealed how these forces are converging and driving up death rates, exposing the urgent need for gender-specific public health responses.17,18,19
• Alcohol-related deaths among women rose 2.5 times between 1999 and 2020, especially in younger age groups — This sharp increase signals a troubling shift in how alcohol affects women’s health. While men have historically had higher rates of alcohol-related mortality, the gap is narrowing. Younger women are experiencing faster rises in death rates, suggesting that cultural and behavioral changes are reshaping risk patterns.
• Marketing campaigns increasingly target women with lifestyle-driven alcohol messaging — Alcohol brands have shifted their strategies to appeal to women through themes of empowerment, relaxation, and social sophistication. From “mommy wine culture” to pink-branded spirits, these campaigns normalize frequent drinking as part of modern womanhood, often downplaying the risks.
• Cultural acceptance of drinking among women has grown, masking the health risks — Drinking is now more socially accepted among women than in previous generations. This shift has made it harder to recognize problematic patterns, especially when alcohol use is framed as self-care or stress relief. The normalization of drinking in everyday life can obscure the long-term consequences.
• Women metabolize alcohol differently, increasing vulnerability to liver disease and other complications — Biologically, women are more susceptible to alcohol’s harmful effects. They tend to absorb more alcohol into their bloodstream and take longer to metabolize it, which can accelerate damage to the liver, heart, and brain even at lower levels of consumption compared to men.
As alcohol-related deaths among women continue to rise, experts are calling for tailored interventions. These include awareness campaigns that address gender-specific risks, better access to treatment for women, and policies that regulate marketing practices targeting female consumers.
Alcohol Is Causing More Harm Than We’re Willing to Admit
Alcohol’s long-term effects on the body are anything but benign. Yet despite mounting evidence linking alcohol to serious health risks, its impact remains underacknowledged in public health conversations.
• Alcohol causes progressive damage to vital organs — The liver is the primary organ responsible for metabolizing alcohol, but chronic consumption overwhelms its capacity. This leads to a progression of liver conditions — from fatty liver to alcoholic hepatitis, and eventually cirrhosis. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA):20
“Alcohol-related liver disease (ARLD) is a major cause of liver-related morbidity and mortality. While early stages like fatty liver may be reversible with abstinence, advanced stages such as cirrhosis can result in permanent damage and liver failure.”
Recovery after quitting alcohol depends on the severity of the damage. In mild cases, liver function may begin to improve within weeks, but in more advanced stages, healing can take months or may not be fully possible. To fully understand how the liver begins to heal after alcohol cessation, I recommend reading “Here’s How Quickly Your Liver Heals When You Stop Drinking.”21
• It increases your risk of several types of cancer — Alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC),22 and has been linked to at least seven types of cancer, including breast, liver, colorectal, esophageal, and oral cancers.23
A 2024 study published in CA: A Cancer Journal for Clinicians identified alcohol as one of the top modifiable risk factors for cancer, alongside cigarette smoking and obesity.24
“Alcohol consumption was the fourth largest contributor to all cancer cases in men (4.7%; 42,400 cases) and the third largest contributor in women (6.2%; 54,330). Approximately one half of oral cavity (49.9%; 10,350) and pharyngeal (44.6%; 6460) cancers in men and one-fourth of oral cavity (25.1%; 2600), esophageal (24.2%; 1000), and pharyngeal (22.5%, 760) cancers in women were attributable to alcohol consumption,” the authors reported.
“However, female breast cancer had the largest number of attributable cases (44,180 cases), followed by colorectal cancer in both men (13,850) and women (4630). The proportions of cases attributable to alcohol consumption by cancer type were higher in men than in women, except for esophageal cancer.”
The World Health Organization reinforces this, stating: “The risk to the drinker’s health starts from the first drop of any alcoholic beverage,” emphasizing that even low levels of alcohol consumption can increase cancer risk. This risk is cumulative and applies regardless of the type or quality of alcohol consumed.25
• Long-term consumption increases risk of dementia — Alcohol is a central nervous system depressant that affects cognition, memory, and emotional regulation. Long-term use can shrink brain volume, damage white matter, and accelerate cognitive decline.26 According to the NIAAA:27
“Chronic alcohol misuse is associated with neurodegeneration and cognitive impairment, particularly in older adults. Alcohol-related brain damage can mimic or exacerbate symptoms of dementia.”
This risk is especially pronounced in individuals who begin drinking heavily at a younger age or who maintain high levels of consumption over time.
• Alcohol weakens the immune system and disrupts overall physical health — Chronic alcohol use disrupts gut microbiota, leading to inflammation and increased cancer risk. A review in the Indian Journal of Medical Research explains:28
“Dysbiosis may directly or indirectly contribute to carcinogenesis … through inflammation-mediated mechanisms, genotoxins, and deregulated cell signaling.”
Alcohol also increases gut permeability (“leaky gut”), allowing toxins to enter the bloodstream and reach the liver, compounding damage. When alcohol damages the gut lining, toxins can enter the bloodstream and reach the liver, triggering immune responses that further fuel inflammation. This chronic inflammatory state is a well-known contributor to cancer and other diseases.
Reclaim Your Health by Eliminating Alcohol
Despite its growing toll, alcohol-related mortality continues to fly under the radar compared to other public health crises. Media coverage and policy discussions tend to spotlight opioid and tobacco-related deaths, leaving alcohol’s impact largely overlooked.
But because of these featured studies about the surge in alcohol-linked deaths, many researchers are now calling for a national shift in how alcohol-related harm is addressed, emphasizing the need for culturally relevant messaging, stronger policies, and coordinated efforts across federal, state, and tribal agencies.29
I used to believe that having a few occasional drinks was harmless, or perhaps even healthy. But once I dug into the science, I couldn’t ignore the truth: Alcohol is a potent neurotoxin. It damages your brain, destroys your liver, and disrupts your body’s ability to heal, which is why I believe completely eliminating it from your life is one of the most important decisions you can make for your health. Here’s how you can start:
• Cut alcohol to zero — or as close as you can get — Every drink chips away at your brain’s resilience. If quitting cold turkey feels daunting, start by eliminating weekday drinking or saving it for rare occasions. But don’t fall for the “moderation is healthy” narrative. It’s been thoroughly debunked.
• If you do drink, protect yourself with N-acetylcysteine (NAC) —Taking 200 mg of N-acetylcysteine (NAC) 30 minutes beforehand, along with vitamins B1 and B6 will help your liver neutralize acetaldehyde, the toxic byproduct of alcohol metabolism. It’s not a free pass, but it can reduce the damage.30
• Swap alcohol for drinks that actually nourish you — If alcohol is your go-to for stress relief or winding down, it’s time to upgrade your routine. Try theanine-rich tea, fresh juices with pulp, or sparkling water with natural flavors. These options hydrate, energize, and support your cells without the toxic load.
• Rebuild your mitochondria with clean carbs — Alcohol wrecks mitochondrial function, which is essential for energy and brain clarity. To restore it, fuel your body with 200 to 250 grams of carbs per day from sources like white rice, whole fruits, and fruit juices with pulp. This helps your cells produce adenosine triphosphate (ATP), the energy currency your brain depends on.
• Heal your gut to lower brain inflammation — Alcohol damages your gut lining, allowing endotoxins to leak into your bloodstream and trigger inflammation, especially in your brain. To repair this, add fermented foods like sauerkraut, kimchi, or kefir to your diet. A healthy gut means a healthier brain.31
• Support your liver with choline — Once you stop drinking, your body begins to heal, especially your liver. But healing isn’t automatic. You need to support it with the right nutrients. One of the most powerful is choline, found in eggs, liver, and cruciferous vegetables. Choline helps repair liver damage, reduce inflammation, and restore cognitive function.32
If you want a deeper understanding of how choline supports your liver health, plus other strategies to keep this organ in top shape, read “How to Keep Your Liver Healthy in Your 50s and Beyond.”
Ready for More Support? Follow This 7-Step Plan
Dr. Brooke Scheller, founder of Functional Sobriety and author of “How to Eat to Change How You Drink,” also offers a practical, nutrition-based approach to quitting alcohol. Her philosophy is rooted in empowerment — not shame — and she emphasizes that you don’t need to hit rock bottom to make a change. Here are seven steps she recommends helping you take control of your relationship with alcohol:
1. Get curious — Read books, listen to podcasts, and explore the science behind alcohol’s effects.
2. Find your people — Join communities like the Functional Sobriety Network or other sober support groups.
3. Clean up your feed — Unfollow accounts that glamorize drinking and follow sober influencers who inspire change.
4. Look deeper — Identify the reasons you drink — stress, habit, social pressure — and find healthier coping strategies.
5. Support your body — Supplements like L-theanine, L-glutamine, NAC, B-complex vitamins, and milk thistle can reduce cravings and aid detoxification.
6. Balance your blood sugar — Eat protein-rich meals regularly to stabilize energy and reduce alcohol cravings.
7. Own your choice — If someone asks why you’re not drinking, simply say, “I’m doing it for my health.”
Alcohol has long been a social shortcut — a way to bond, relax, and feel connected. But this shortcut is now costing lives, quietly, steadily, and at alarming rates. It’s now one of the biggest public health crises we’re facing.
You don’t need a diagnosis or a dramatic wake-up call to decide alcohol no longer serves you. You just need to be willing to explore something better. As Scheller reminds us, quitting isn’t about punishment — it’s about possibility. It’s about reclaiming your clarity, protecting your future, and choosing life over slow decline.
Frequently Asked Questions (FAQs) About Alcohol-Related Deaths
Q: Has America always had a drinking problem?
A: Yes. Since the 1700s, alcohol has shaped American life. By the 1830s, Americans consumed about seven gallons yearly — normalizing a culture of heavy drinking that continues fueling health damage today.
Q: Who is most affected by alcohol-related deaths?
A: Native Americans, women, and young adults face the steepest increases. Targeted marketing, cultural pressures, and poor access to treatment put these groups at greater risk for serious disease and premature death.
Q: How many people are dying from alcohol?
A: Alcohol-related deaths nearly doubled over 25 years. In 2021 alone, more than 54,000 Americans died, according to UCLA and RAND researchers analyzing Centers for Disease Control and Prevention data.
Q: What role did the pandemic play?
A: COVID-19 magnified the crisis. Stress, isolation, and disrupted recovery services fueled relapses and dangerous drinking patterns. Deaths spiked sharply in 2020 and have remained alarmingly higher than pre-pandemic levels.
Q: How can I cut alcohol from my life?
A: The most effective step is removing alcohol completely. Building supportive habits, finding community, and choosing healthier routines empower lasting change and give your body the chance to heal and thrive.