Spiking death rate a harsh reminder of alcohol’s risks, especially for women

boozengals-300x180Tipple much, much less in 2020. That might be a life-saving bit of advice for too many Americans to follow, especially because of new data on a worrisome spike in alcohol-related deaths.

As NBC News reported, based on published research by federal researchers:

“The yearly total of alcohol-related deaths for people ages 16 and over more than doubled, from 35,914 in 1999 to 72,558 in 2017. There were almost 1 million such deaths overall in that time. While middle-age men accounted for the majority of those deaths, women — especially white women — are catching up, the study found. That’s concerning in part because women’s bodies tend to be more susceptible to the effects of alcohol.”

As the researchers noted in their study, the major rise of alcohol use and abuse by women is worrisome:

“Increases in alcohol use and related harms among women are concerning given growing evidence that women are at greater risk than men at comparable levels of alcohol exposure for alcohol‐related cardiovascular diseases, certain cancers, alcohol‐related liver disease, and acute liver failure due to excessive drinking (Guy and Peters, 2013; Nolen‐Hoeksema, 2004; Szabo, 2018). Because women reach higher blood alcohol levels than men of comparable weights after consuming the same amount of alcohol, their body tissues are exposed to more alcohol and acetaldehyde, a toxic metabolite of alcohol, after each drink (Gochfeld, 2017).”

Keith Humphreys, a Ph. D., a professor of psychiatry and behavioral sciences studying alcohol consumption at Stanford University, and an expert not involved in the study, blamed Big Alcohol for fostering new problems with women and booze, telling Yahoo news:

“Historically, the most protective factor for women was that it was less normative for women to drink a lot. That was changed largely by alcohol companies. Enormous amounts of women were targeted in advertising and it worked — and now women drink much more and now they’re dying much more.”

The researchers also expressed worry about the prevalence and persistence of problem drinking among middle-aged and older Americans, an issue soaring for them in comparison with younger booze users:

“The consistently high rates of alcohol‐related deaths among middle‐aged and older drinkers are concerning given the increasing size of the aging population. The number of people aged 65 and older in the United States is expected to nearly double from 51 million in 2017 to 95 million by 2060. By 2034, there will be more people in the United States over the age of 65 than under 65 for the first time (U.S. Census Bureau, 2018). Even if rates of alcohol consumption and alcohol‐related harms stay the same, the number of alcohol‐related healthcare visits and fatalities could increase substantially, thereby increasing the overall burden of alcohol on public health.”

The experts noted that death certificates, the basis of their study, can be imperfect and may understate alcohol mortality. But they said that updated data was needed, particularly as the nation grapples with an opioid and overdose crisis, evidence of which also was clear in their work:

“In 2017, death certificates captured 10,596 deaths due to overdoses on a combination of alcohol and other drugs and another 2,358 deaths from overdoses on alcohol alone. Alcohol causes respiratory depression on its own, and the risk of acute respiratory failure increases when alcohol is combined with other drugs that suppress respiration, such as opioids and benzodiazepines (Kircher et al., 1985; Krumpe et al., 1984; Ren et al., 2012). Alcohol plays a prominent role in overdoses on other drugs, contributing to roughly 21% of deaths involving heroin, 17% of deaths involving hydrocodone, and 22% of deaths involving diazepam (Warner et al., 2016 … The fact that a moderately intoxicating dose of alcohol significantly increased the respiratory depression produced by a medicinal dose of oxycodone suggests that any alcohol consumption could contribute to fatal overdoses involving opioids.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous drugs and other often abused substances like alcohol. Doctors, hospitals, insurers, regulators, politicians, and Big Pharma all bear their share of responsibility for creating the opioid and overdose crisis that has become a leading killer of Americans. This nightmare has provided us all a harsh reminder that substance abuse affects friends, neighbors, work colleagues, and family and loved ones as easily and readily as “others” we might imagine — criminals or wrong-doers.

This is a hard learning that is inescapable, too, with alcoholism and alcohol abuse. The federal Centers for Disease Control and Prevention estimates that in 2010 alone, “excessive alcohol use cost the U.S. economy $249 billion.” The agency says that excessive drinking contributes to high blood pressure, stroke, heart and liver disease, as well as cancers and injuries and deaths due to falls and, of course, car wrecks and other unintended harms. The National Highway Traffic Safety Administration reports that “Every day, almost 30 people in the United States die in drunk-driving crashes — that’s one person every 50 minutes.”

Experts’ recommendations may seem low for how many drinks per day might be acceptable for healthy adults, suggesting, for example, that women take in not more than one drink per day and men just two. It doesn’t take a bluenose, however, to see how fast cocktail hour or drinks with a ballgame can turn to excess — with the accompanying and rising risks. An estimated 14 million Americans already struggle with the disorder that prevents them from controlling their drinking.

Booze isn’t all fun and it isn’t harmless. We’ve got to keep that in mind and to ensure that it is consumed in moderation and responsibly, not lethally.

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