American women drinking more, and dying much more often, as a result

A new study released by the National Institute on Alcohol Abuse and Alcoholism reports a horrifying 85% increase in deaths among women related to the use of alcohol. To put this in concrete terms, about 7,600 women died this way in 1999, but 18 years later, in 2017, the number was over 18,000. Not only is alcohol claiming the lives of more women, but women tend to be harmed more by this substance, in the form of higher rates of cancer and heart disease. The reserch is reported online in the journal Alcoholism: Clinical and Experimental Research.

Image Credit: Peerayot / Shutterstock
Image Credit: Peerayot / Shutterstock

Drinking on the rise

The National Institute on Alcohol Abuse and Alcoholism looked at the death certificates of people who died as a result of alcohol consumption, directly or indirectly, over 1999 to 2017. What they found worried a lot of people.

The individual consumption of alcohol has gone up by 8%, but the most heavily affected are women and middle-aged people. However, drinking among teenagers has shown a decrease over the last few years, a welcome trend which may indicate that alcohol is finally being seen as the devil it really is.

On the other hand, mixed-up girls are often drinking like men, seeking to prove their independence. However, says institute deputy director Patricia Powell, the feminist liberation message doesn’t show how women are at greater risk from alcohol due to their physiology.

When it comes to men, there isn’t much obvious change in the rate of binge drinking or the number of times they had a drink over a week or month. However, with women the case is different, with the frequency rising by a tenth, and binge drinking up by almost one quarter!

Several officials involved in public health think that drinking is increasing because of the way many novel formulations conceal the taste of the strong spirit. This means that people can’t always tell how much they are drinking, and even more, don’t get the necessary sensory input that they are consuming alcohol.

Deaths due to alcohol

Alcohol-related deaths made up about 2.6% of all deaths in 2017, and 75% of them occurred among men. There were well over 72,500 deaths from alcohol in 2017 in the US, of which one in three was due to liver disease. Compare this to the almost 36,000 in 1999. To put this in another perspective, over 18 years, drinking has claimed a million precious lives!

It appears that while the rate of drinking-associated deaths in the general population has gone up by over 50%, it rose by a terrifying 85% among women but by 39% for men. The reasons are not defined yet, but heart disease and cancer occur more frequently among women who drink, compared to men. The conditions associated with alcohol ingestion included cardiovascular disease, acute liver failure and other chronic illnesses. Injuries, such as those sustained during an accident caused by drunk driving or a drunken bout, are often far more frequent as a cause of death than alcohol-induced cirrhosis and other illnesses, according to Melissa Moore of the Marathon County Health Department.

Older people drinking – and dying – more

The increased mortality was seen to affect white middle-aged women (65-74 years) disproportionately. The American population is expected to have an increasing proportion of people aged 65 and over, from 51 million in 2017 to almost double that, at 95 million, in just another 40 years! This automatically means a lot more people are going to have health issues related to drinking. And if this group is showing a greater affinity for drinking, public health demands are bound to show a steep jump upwards.  

The increase brings with it a 76% higher number of emergency room visits, a greater number of days in hospital, and more deaths. The maximum mortality rate was in those between 45 and 74 years, a fourfold higher rate than in people aged 25 to 34 years. However, the slope is steeper, at almost 6%, in the younger group. These numbers are almost certainly an underestimation, because death certificates don’t always reveal the role of alcohol in the death.

Implications

The seriousness of the situation should be gauged from the fact that no organization or research body has ever been able to define any level of alcohol consumption as ‘safe’. Almost 2.5 billion people drink, worldwide, precipitating a host of health issues such as cancer, liver disease including alcoholic cirrhosis, fatty liver, and liver failure, as well as pancreatitis. However, the risks of alcohol consumption are far greater than any of the health benefits traditionally cited in favor of moderate drinking. This is primarily because alcohol is an addictive substance and induces tolerance, causing the risks to rise rapidly over a relatively short period of time as people tend to drink more and more.

An earlier study published in the Lancet shows that from a negligible increase in risk from 914/100,000 for alcohol-associated disease or injury in non-drinkers to 918/100,000 among those who had only one drink a day, the risk rose sharply to 977 with 2 drinks a day and to 1,252 among those who had 5 drinks a day.

In contrast to the selective benefit shown with the ingestion of very small amounts of alcohol, on fertility or on the heart, for example, the overall health risks are always greater, at any dosage, especially for women who seem to be prone to cancer, injury and infectious disease.

The take-home

The study findings come during “Dry January”, which is the name for this month when many try to go an entire month abstinent from alcohol. Koob notes that this is a good time for individuals to look at the place alcohol holds in their lives, to detect the slide into addiction, and the onset of alcohol-use disorder, which requires treatment.

Calling the current findings “a wakeup call to the growing threat alcohol poses to public health,”, institute director George Koob attributed the deaths to chronic illnesses, injuries and excessive consumption. He sums up: “Alcohol is a hidden addiction, one that everybody knows about but nobody wants to talk about. What we have to learn as Americans is to moderate our drinking.”

Source:
Journal reference:

White, A.M., Castle, I.‐J.P., Hingson, R.W. and Powell, P.A. (2020), Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcohol Clin Exp Res. doi:10.1111/acer.14239, https://onlinelibrary.wiley.com/doi/10.1111/acer.14239

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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