May 16, 2022

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Deaths from alcohol use disorder surged during pandemic

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Credit: Pixabay/CC0 Public Domain

Deaths involving alcohol use disorder increased dramatically during the pandemic, according to a new study by Cedars-Sinai investigators. The study also found that young adults 25 to 44 years old experienced the steepest upward trend in alcohol use disorder mortality.

In the study, published this month in JAMA Network Open, investigators used predictive modeling to compare expected—also called projected— rates to actual rates. They found that alcohol use disorder-related mortality rates increased among all ages and sexes during the pandemic.

"During the first few months of the pandemic, my colleagues and I saw increased numbers of patients being treated for acute alcohol use-related conditions in the and through out the medical center," said Yee Hui Yeo, MD, MSc, lead author of the study. "We also became aware of reports from single centers of elevated alcohol use-related complications. That prompted us to think, maybe this is a significant public health crisis."

Investigators obtained de-identified mortality data for seven years—2012-2019—from a Centers for Disease Control and Prevention database that registers more than 99% of all deaths in the U.S. They then used predictive modeling to determine 2020 and 2021 projected mortality rates based on previous years' trends, and compared those with the rates that were actually observed.

"What we found in our analysis reflects what we had been seeing anecdotally in our patients and in academic papers tracking complications like alcohol-related liver disease," Yeo said.

Results include:

"We also know that alcohol use disorder is often under-reported, so actual related to alcohol use may be even higher than reported," Yeo said.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the reference that use to categorize mental health disorders, defines alcohol use disorder as "a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period."

The manual then lists 11 criteria, such as a craving or strong urge to use alcohol; recurring use of alcohol that results in a failure to fulfill obligations at school, work or home; and continued alcohol use despite having persistent social or interpersonal problems that are created or exacerbated by alcohol use.

"In publishing this article, we want everyone, especially policymakers and physicians on the front lines, to know that during the pandemic, there is really a significant surge in alcohol use disorder-related deaths," Yeo said. "We also want to recognize that patients who die from alcohol use disorder-related causes tend to have social determinants of health, like lower socioeconomic status, that can make it harder for them to access healthcare and help. Finally, we want to make sure that patients who do seek treatment for or substance use have access to follow-up care to prevent secondary complications."

More information: Yee Hui Yeo et al, Evaluation of Trends in Alcohol Use Disorder–Related Mortality in the US Before and During the COVID-19 Pandemic, JAMA Network Open (2022). DOI: 10.1001/jamanetworkopen.2022.10259

Journal information: JAMA Network Open

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