Recently researchers at NIAAA used the national death certificate database to assess changes in alcohol-related deaths during the first year of the pandemic. The results, published in JAMA, show that after increasing around 2.2% per year over the previous two decades, deaths involving alcohol jumped 25.5% between 2019 to 2020, totaling 99,107 deaths.1

The study showed that alcohol-associated liver disease deaths increased 22.4% (from 24,110 to 29,509) with the largest change occurring among people ages 25 to 44. The number of deaths involving a combination of alcohol and opioids increased by 40.8% (from 8,503 to 11,969), with deaths involving alcohol and synthetic opioids (e.g., fentanyl) increasing by 59.2% (from 6,302 to 10,032).1

Reasons for the unprecedented increase in alcohol-related deaths during the first year of the pandemic are still being explored. In 2020, the first year of the pandemic, sales of alcohol increased by 2.9%, the largest annual increase in over 50 years.2 For those who were drinking more during the pandemic, research suggests that stress, anxiety, and previous alcohol misuse are contributing factors.3,4,5,6

The increase in alcohol-related deaths appears to reflect a widespread increase in alcohol consumption and related harms. For example, research suggests that increased alcohol consumption during the pandemic has been associated with negative health outcomes such as increases in transplants for alcohol-associated liver disease,7 emergency department visits for alcohol withdrawal,8 and the percentage of emergency department visits that involved acute alcohol consumption.9 Additionally, the National Highway Traffic Safety Administration reported a 14% increase in alcohol-related traffic fatalities in 2020 after decades of general decline.10


1 White, A. M.; Castle, I. P.; Powell, P. A.; Hingson, R. W.; Koob, G. F. Alcohol-Related Deaths During the COVID-19 Pandemic. JAMA, 327(17), 1704–1706, 2022. PMID: 35302593

2 Slater, M.E.; Alpert, H.F. Surveillance Report #119: Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977-2020. Sterling, VA: NIAAA, Division of Epidemiology and Prevention Research, April 2022. . Accessed June 30, 2022.

3 Acuff, S. F.; Strickland, J. C.; Tucker, J. A.; Murphy, J. G. Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 36(1), 1–19, 2022. PMID: 34807630

4 Capasso, A.; Jones, A. M.; Ali, S. H.; et al. Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Preventive medicine, 145, 106422, 2021. PMID: 33422577

5 Grossman, E. R.; Benjamin-Neelon, S. E.; Sonnenschein, S. Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults. International journal of environmental research and public health, 17(24), 9189, 2020. PMID: 33316978

6 Rodriguez, L. M.; Litt, D. M.; Stewart, S. H. Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women. Addictive behaviors, 110, 106532, 2020. PMID: 32652385

7 Cholankeril, G.; Goli, K.; Rana, A.; et al. Impact of COVID-19 Pandemic on Liver Transplantation and Alcohol-Associated Liver Disease in the USA. Hepatology (Baltimore, Md.), 74(6), 3316–3329, 2021. PMID: 34310738

8 Sharma, R. A.; Subedi, K.; Gbadebo, B. M.; et al. Alcohol Withdrawal Rates in Hospitalized Patients During the COVID-19 Pandemic. JAMA network open, 4(3), e210422, 2021. PMID: 33656526

9 Esser, M. B.; Idaikkadar, N.; Kite-Powell, A.; et al. Trends in emergency department visits related to acute alcohol consumption before and during the COVID-19 pandemic in the United States, 2018-2020. Drug and alcohol dependence reports, 3, 100049, 2022. PMID: 35368619

10 National Center for Statistics and Analysis, National Highway Traffic Safety Administration. Overview of Motor Vehicle Crashes in 2020. Washington, D.C.: U.S. Department of Transportation, 2019. Accessed June 30 , 2022.