Deaths involving alcohol have doubled in the US since the beginning of the millennium, particularly among women and those middle-aged and older, new research suggests.

Nearly three-quarters of Americans aged 18 and above reported consuming alcohol in 2017, averaging around 3.6 gallons of pure alcohol per drinker – that’s more than two standard drinks each day. In the last 20 years, the consumption of alcohol has increased by around 8 percent, both regular and binge drinking along with it. To determine how those increases translate into mortality, researchers at the National Institutes of Health analyzed death certificates between 1999 and 2017 recorded by the National Center for Health Statistics to estimate the annual number of alcohol-related deaths by age, sex, and ethnicity.

"Alcohol is far from a benign drug. I know of no other product a person can buy at a grocery store or gas station that can cause memory blackouts, car crash fatalities, deaths from falls, cirrhosis of the liver, brain damage and breast cancer," study author Aaron White of the National Institute on Alcohol Abuse and Alcoholism told IFLScience. 

"Simply providing people with information about the risks associated with alcohol is unlikely to change behavior on a large scale, but it is important for people to be aware of the scientific evidence so that they can make informed choices," White added.

Alcohol-related deaths per year have more than doubled in the last two decades, rising from just under 36,000 to more than 72,500. In 2017, more than 2 percent of 2.8 million deaths in the US involved alcohol. Overall, death rates were highest among males, people between 45 and 74 years of age, and among non-Hispanics, American Indians, and Alaska Natives.

However, the increase in alcohol-related deaths over time was largest for women and consistent with reports of increasing alcohol consumption, binge drinking, emergency department visits, and hospitalizations for women. Nearly half of all deaths resulted from liver disease (30 percent) or overdoses (18 percent) on alcohol either by itself or with other drugs. Nearly 9 in 10 alcohol-related deaths among people between 16 and 20 involved “acute alcohol consumption,” or binge drinking.

"Alcohol also plays a prominent role in deaths of despair," explained White. In 2015, Princeton University economists reported an increase in mortality, particularly among non-Hispanic whites aged 45-54, driven largely by drug and alcohol overdoses, suicides, and liver disease. White added that further research suggests that alcohol contributes to around 1 in 5 drug overdoses, suicides and half of the deaths from liver disease.

Even so, the study speculates that the actual rate of alcohol-related deaths is likely higher. While physicians, medical examiners, and coroners completing death certificates are encouraged to list alcohol if they have reason to believe it contributed, White notes that evidence suggests alcohol is commonly omitted. In many cases, the contribution of alcohol might not be apparent at the time a death certificate is completed. 

“Given previous reports that death certificates often fail to indicate the contribution of alcohol, the scope of alcohol-related mortality in the United States is likely higher than suggested from death certificates alone,” write the authors in the journal Alcoholism: Clinical and Experimental Research. 

Fewer than 1 in 10 people who struggle with an alcohol use disorder receive any treatment in a given year, a statistic that White says shows how crucial it is to develop effective strategies to connect those who need treatment with treatment options.