Rising Alcohol-Related Deaths in the US: Trends, Demographics, and Challenges

Alcohol use disorder (AUD) remains a significant public health concern in the United States, affecting over half of US adults who report a family history of the condition. While opioid overdose deaths have garnered substantial attention, alcohol-related deaths are also increasing and represent a substantial burden on the healthcare system. Recent shifts in federal guidelines and challenges in accessing treatment further complicate the issue.

Shifting Guidelines and Public Awareness

In early January 2026, the Department of Health and Human Services (HHS) updated the 2025-2030 Dietary Guidelines for Americans (DGA). A notable change from previous recommendations is the move away from specific daily intake limits for alcohol. Instead, the DGA now advises individuals to “drink less for better overall health.” This shift, while intended to promote moderation, may create challenges for both individuals and clinicians in identifying when clinical screening or treatment is necessary. Compounding this issue is a lack of public awareness regarding the health risks associated with alcohol consumption. fewer than 40% of US adults recognize alcohol as a carcinogen, compared to over 90% who understand the link between tobacco and cancer.

Trends in Alcohol-Related Deaths (2014-2024)

Analysis of data from the Centers for Disease Control and Prevention (CDC) WONDER database reveals concerning trends in alcohol-related deaths between 2014 and 2024. These figures represent “alcohol-induced deaths,” defined as conditions directly attributable to alcohol consumption, such as alcohol-associated liver diseases. Broader definitions, including cases where alcohol was a contributing factor, yield even higher mortality numbers.

• Overall Trends: Alcohol-related deaths increased gradually before the COVID-19 pandemic, surged in 2020 and 2021, and have since declined somewhat. However, even with these recent declines, deaths remain approximately 20% higher than in 2019.
• Demographic Variation: In 2024, the highest alcohol death rates were observed among adults aged 45 to 64, American Indian and Alaska Native (AIAN) individuals, and males. Rates remained elevated above 2019 levels for adults aged 26 to 44, those 65 and older, White individuals, and females.
• State Variation: Alcohol death rates varied significantly by state in 2024, ranging from 6.1 per 100,000 in Fresh Jersey to 35.9 per 100,000 in New Mexico. Most states experienced higher rates than in 2019, with increases ranging from declines in New Jersey (-9%) and West Virginia (-6%) to an 80% increase in Mississippi.

Demographic Disparities in Alcohol Deaths

In 2024, individuals aged 45 to 64 experienced the highest alcohol death rates (28.9 per 100,000), followed by those aged 65 and older (21.5 per 100,000). AIAN individuals had the highest death rate across all demographic groups (57.9 per 100,000), more than four times the rate among White individuals. While the total number of deaths was higher among White individuals due to their larger population size, the rate among AIAN individuals was disproportionately high. Alcohol death rates among males (17.3 per 100,000) were more than double those among females.

The Broader Impact of Alcohol-Related Deaths

When considering a broader definition of alcohol-related deaths – including cases where alcohol was a contributing factor – the total number of deaths nearly doubles to 93,118 in 2024. Under this broader definition, alcohol-related deaths exceeded opioid overdose deaths (55,535 when including underlying and contributing causes).

Challenges in Treatment Access

Despite the significant health risks associated with alcohol use, treatment rates remain low. In 2022, only 7.6% of individuals aged 12 and older with a past-year AUD received any treatment, and only 2.1% received evidence-based medication. Barriers to treatment include a lack of provider confidence and knowledge, limited patient awareness, and practical constraints such as coverage limits and cost. Approximately 95% of adults meeting the criteria for a substance use disorder (SUD) did not seek treatment and did not believe they needed it.

Resources for Help

If you or someone you know is struggling with alcohol use disorder, resources are available. The SAMHSA National Helpline can provide treatment referral and information about mental health and substance use disorders. Additional information about opioids and substance abuse can be found at the National Institute on Drug Abuse (NIDA) and the National Center for Drug Abuse Statistics.