The Hidden Dangers of Alcohol: A Closer Look at a Common Killer

We often hear "Just say no!" and "Drugs can kill!" as warnings against drug use, but what about alcohol? Many people don't realize that alcohol is actually a drug—and one that's more deadly than many substances we typically associate with the word "drug."

Alcohol ranks among the leading causes of preventable deaths worldwide, making it crucial to examine this issue closely and consider what we can do about it. While "out of sight, out of mind" might work for some things, ignoring alcohol's fatal consequences only allows it to claim more lives. Let's explore how alcohol can cause death and how we can fight back.

How Much Alcohol Can Kill You?

Drinking is commonly associated with intoxication—what we call being drunk. Typical symptoms include slurred speech, impaired coordination, nausea, and reduced awareness. However, excessive drinking can lead to more severe symptoms and even prove fatal.

Studies indicate that alcohol becomes potentially lethal when blood alcohol concentration (BAC) reaches 0.40% or higher. To put this in perspective, that's roughly equivalent to 25 standard drinks. While that might sound like a lot, it's important to note that typical bar drinks often contain more than one standard drink. For example:

• A standard drink is 12 ounces of beer, but a pint is 16 ounces
• One shot of spirits equals one standard drink, but most cocktails contain 1-3 shots

The amount of alcohol that can be fatal varies from person to person. Factors like sex, weight, age, health status, and tolerance all play a role. Beyond knowing your tolerance, it's crucial to recognize signs of alcohol overdose:

• Vomiting
• Slow heart rate
• Low body temperature
• Seizures
• Pale, blue, or ashen skin
• Slow or irregular breathing
• Unconsciousness
• Confusion or altered mental state

Alcohol overdose requires immediate medical attention. In the U.S., call 911 for medical emergencies.

Types of Alcohol-Related Deaths

Overdose is just one way alcohol can cause death. To understand its full impact on public health and safety, let's examine the different types of alcohol-related fatalities.

Alcohol Poisoning

Alcohol poisoning occurs when blood alcohol levels become so high that the brain begins shutting down. Since the brain controls essential functions like breathing, heartbeat, and blood pressure, excessive drinking can lead to coma and death.

This type of poisoning typically results from binge drinking—defined by the CDC as drinking enough in a short period to reach a BAC of 0.08% or higher. According to the Alcohol-Related Disease Impact application, alcohol poisoning accounted for 12% of alcohol-related deaths from 2020-2021.

Alcohol-Related Health Conditions

The majority of alcohol-related deaths stem from health conditions caused by chronic alcohol misuse. In 2020, deaths from alcoholism represented 66% of all alcohol-related fatalities.

Alcohol significantly impacts health, directly increasing the risk of various diseases and cancers. These chronic conditions account for numerous deaths each year:

• Alcoholic liver disease
• Hypertension
• Liver cirrhosis
• Coronary heart disease
• Liver cancer

Chronic excessive drinking disrupts cellular and organ function. While most alcohol-related deaths result from long-term health conditions, sudden death from chronic alcoholism is also common. The staggering number of alcohol-related fatalities serves as a sobering reminder of alcohol's destructive effects.

Mental Health Impacts

Alcohol's negative effect on mental health can be equally destructive and sometimes fatal. The Alcohol-Related Disease Impact reports 9,801 alcohol-related suicides occurred in 2020. Combined with homicides, mental health-related deaths account for nearly 10% of annual alcohol-related fatalities.

Mental health is just as important as physical health. The 988 Lifeline is available 24/7 for suicide and crisis support.

Alcohol-Related Accidents

Because alcohol impairs judgment and coordination, it can turn ordinary activities into dangerous situations. Alcohol-related accidents—including drowning, falls, and aspiration—make up 17% of all alcohol-related deaths, with drunk driving accidents accounting for at least half of that number.

While statistics help us understand the scale, each incident represents a personal tragedy for affected families. And this is only part of the bigger picture.

How Many People Die From Alcohol Each Year?

According to the CDC, approximately 178,000 alcohol-related deaths occur in the U.S. annually—averaging 488 deaths per day. Recent analyses reveal several key patterns:

• New Mexico has the highest death rate per 100,000 people
• 80% of alcohol-related deaths involve adults aged 35 or older
• Long-term health consequences are the leading cause of alcohol-related deaths
• The 55-64 age group had the highest number of deaths in 2020
• Alcoholic liver disease is the most frequent underlying cause

Analyzing Trends in Alcohol-Related Deaths

A recent CDC study showed alcohol-related deaths increased by a shocking 29% from 2016 to 2021, with a particularly sharp rise from 2019-2021 that may be attributed to COVID-19. Even without the pandemic, alcohol-related deaths continue trending upward.

Impacts of COVID-19

Several factors likely contributed to increased alcohol-related deaths during the pandemic:

• Changed alcohol regulations: Social distancing led to looser alcohol rules, including home delivery and expanded purchasing options
• Lower federal taxes: Despite inflation, alcohol taxes decreased in recent years
• Health impacts: COVID-19's toll on health combined with alcohol-related conditions
• Mental health strain: Pandemic-related losses and stress increased substance misuse

The War on Drugs

While policies have targeted drugs like cocaine, fentanyl, and methamphetamine, alcohol often escapes similar scrutiny. Social acceptance and lack of regulation contribute to rising alcohol-related deaths.

Female Death Rates

Alcohol-related deaths have risen disproportionately among women. Research suggests female-focused alcohol advertising—including "wine mom" culture and marketing emphasizing slimness, motherhood, and femininity—may be responsible for this significant increase.

Why Rising Alcohol Death Rates Matter

Alcohol remains a leading cause of preventable death in the U.S. and worldwide. As the Alcoholics Anonymous saying goes, "Nothing changes if nothing changes." Without implementing measures to reduce alcohol consumption, death rates will continue climbing.

While drinking is widely accepted, alcohol misuse and alcohol use disorder (AUD) remain stigmatized. According to NIAAA's Core Resource on overcoming barriers to care, stigma significantly contributes to AUD undertreatment. Seeking support for alcohol misuse is crucial for preventing health conditions and fatalities.

How to Help a Loved One With Alcohol Dependence

Recognizing an unhealthy relationship with alcohol can be challenging. Approaching a loved one with compassion can help them gain clarity and support. Consider these approaches:

• Educate yourself: Understanding alcohol dependence helps you approach with empathy
• Listen compassionately: Avoid confrontation, which may prevent openness
• Offer support: Be an accountability partner, suggest alcohol-free activities, or provide a safe space
• Explore treatment options: Help research accessible treatment that meets their needs

While supporting loved ones, we might also examine our own relationship with alcohol.

Developing a Healthy Relationship With Alcohol

If you're ready to develop a healthier relationship with alcohol, consider these five steps:

• Track your drinking: Use journaling or mindful drinking apps like Quitemate to monitor consumption
• Set goals: Establish achievable targets for cutting back based on your tracking
• Limit triggers: Identify and prepare for situations that prompt drinking
• Find alternatives: Explore mocktails, new hobbies, and fulfilling activities beyond alcohol
• Seek support: Build a support system through friends, family, treatment options, and online resources

The Bottom Line

Behind its social facade, alcohol can rob us of our vitality. As F. Scott Fitzgerald wrote in The Great Gatsby, "First you take a drink, then the drink takes a drink, then the drink takes you." Data reveals alcohol's multifaceted path to death—from motor accidents and long-term health conditions to alcohol poisoning. While structural changes are essential for reducing alcohol-related fatalities, individual changes matter too. Practicing mindful drinking and developing healthier alcohol relationships can prevent negative consequences.