From time to time we highlight senior living–adjacent topics that are serious in nature, including mental and behavioral health, to spark important conversations that can be difficult to start. The pandemic’s more than two years have strained people in many ways. Worries about staying physically healthy overlapped with financial and employment concerns, child care and schooling challenges, and the health of loved ones. For many, these pressures — along with isolation — created mental health challenges and, according to recent research, appear to have contributed to increased alcohol use across the U.S.
Experts at the National Institute on Alcohol Abuse and Alcoholism (a division of the National Institutes of Health) published findings on the rise in alcohol consumption and alcohol-related deaths during the first year of the pandemic, and the results are alarming.
Between 2019 and 2020, researchers documented a 25 percent increase in alcohol-associated deaths — cases in which alcohol was listed on the death certificate as an underlying or contributing cause. Even more troubling, the rise appeared across every age group, beginning with people as young as 16.
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A startling increase in alcohol-related deaths
Death certificates in the U.S. list one underlying cause and up to 20 contributing causes. The NIH researchers classified a death as “alcohol-related” when an alcohol-induced condition appeared as either an underlying or contributing cause — examples include alcohol-associated liver disease, alcohol-related mental and behavioral disorders, or deaths from drug overdoses where alcohol contributed.
Using data from the National Center for Health Statistics, the study found that alcohol-related deaths rose from 78,927 in 2019 to 99,017 in 2020 — a 25.5 percent increase.
For comparison, deaths from all causes increased at a lower rate: total deaths rose 18.8 percent (from 2,823,460 to 3,353,547), and the age-adjusted death rate increased 16.6 percent (from 938.3 to 1,094.3 per 100,000).
In 2019 alcohol-related deaths accounted for 2.8 percent of all U.S. deaths; in 2020 that share rose to 3.0 percent. The jump in alcohol-related deaths in 2020 far outpaced the increase in overall mortality.
It’s notable that 2,042 death certificates in 2020 listed both alcohol and COVID-19 as contributing causes: 1,475 listed COVID-19 as the underlying cause and 323 listed alcohol as the underlying cause. Researchers therefore concluded that only a small portion of the 25.5 percent rise in alcohol-related deaths directly involved COVID-19.
Rates of alcohol-related deaths had already been rising before the pandemic, but at a much slower pace — about a 2.2 percent mean annual change from 1999 to 2017.
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A growing problem for all age groups
The increase in alcohol-related deaths affected every age group. The largest relative rise occurred among people aged 35 to 44, where rates climbed from 22.9 to 32.0 per 100,000 — a 39.7 percent increase. Those aged 25 to 34 experienced a 37 percent increase, from 11.8 to 16.1 per 100,000.
Older adults were also affected. Deaths involving alcohol rose 21.7 percent for people aged 55 to 64, 20.8 percent for those aged 65 to 74, and 15.3 percent for people 75 and older.
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An unexpected toll of the pandemic
These NIH findings highlight an unexpected and often hidden toll of the COVID-19 pandemic. Multiple pandemic-related factors likely drove increased drinking and the resulting rise in alcohol-related deaths.
Many people turn to alcohol to cope during stressful periods, and the pandemic introduced many such stressors: health fears for oneself and loved ones, financial and job instability, parental strain from childcare and virtual schooling, and widespread isolation.
Additional contributors may have included temporary policy changes that expanded access to alcohol (for example, to-go cocktails), and disruptions to or reduced access to treatment and support services.
Isolation and grief, particularly among older adults, can also lead to heavier alcohol use. Seniors living alone experienced significant social disruptions, and losing loved ones to COVID-19 or other causes increased loneliness and distress, making increased drinking more likely.
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Good intentions, unhealthy drinking habits
Some pandemic-era changes intended to support residents’ wellbeing may have unintentionally encouraged more drinking. Early in the pandemic, outdoor happy hours became a way for senior living communities to offer safe social interaction. While these gatherings provided social connection, they may have also led some residents to drink more frequently or in larger amounts.
Other community-level efforts, like delivering meals to residents, sometimes included bottles of wine as a gesture of care. Though well intentioned, regular delivery of alcohol to a resident’s door may have made increased consumption more likely for some individuals.
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Signs of a drinking problem
Regular heavy drinking poses health risks at any age and can be especially dangerous for older adults: it can worsen balance and vision issues and interact harmfully with many medications.
The National Institute on Alcohol Abuse and Alcoholism lists screening questions used to identify alcohol use disorder. If you answer “yes” to two or more of these questions about the past year, you may have this condition:
- Have you ended up drinking more, or longer, than you intended?
- Have you wanted to cut down or stop drinking more than once, or tried to but couldn’t?
- Have you spent a lot of time drinking, or recovering from drinking?
- Have you experienced cravings — a strong need or urge to drink?
- Has drinking or being sick from drinking interfered with caring for your home or family, or caused work or school problems?
- Have you continued to drink even though it caused trouble with family or friends?
- Have you given up or reduced activities that were important or pleasurable in order to drink?
- Have you more than once put yourself in situations while or after drinking that increased your chance of getting hurt (for example driving, swimming, using machinery, or walking in a dangerous area)?
- Have you continued to drink even though it made you feel depressed or anxious or worsened another health problem, or after experiencing a memory blackout?
- Have you needed to drink much more than before to get the desired effect, or found that the usual number of drinks had less effect?
- Have you experienced withdrawal symptoms when the effects of alcohol wore off, such as trouble sleeping, shakiness, irritability, anxiety, depression, nausea, sweating, or hallucinations?
Help is available!
If you believe your relationship with alcohol has become unhealthy, help is available. Treatment approaches are no longer one-size-fits-all: options include behavioral counseling, medications, support groups, or combinations tailored to individual needs.
Experts recommend starting with a conversation with your primary care provider to discuss concerns and identify appropriate options. You can get support and recovery is possible.