From 2007 to 2017, the number of deaths attributable to alcohol increased 35 percent. The death rate rose 24 percent. Deaths among women rose 67 percent.
Ron Byrd remembers losing his daughter Erika to complications of alcohol abuse, despite he and his wife June’s best efforts. USA TODAY
OAKTON, Va. – The last time lawyer Erika Byrd talked her way out of an alcohol rehab center, her father took her to lunch.
“Dad, I know what alcohol has done to me,” she told him that day in January 2011. “I know what it has made me do to you and mom. But that wasn’t me.”
By the time she died three months later, Byrd had blocked her parents’ calls because they kept having her involuntarily committed. They once had a magistrate judge hold a hearing at her hospital bed. He ordered herto undergo a month of in-patient treatment.
Byrd, who died in April 2011 at the age of 42, is among the rising number of people in the United States who have been killed by alcohol in the last decade.
It’s an increase that has been obscured by the opioid epidemic. But alcohol kills more people each year than overdoses – through cancer, liver cirrhosis, pancreatitis and suicide, among other ways.
From 2007 to 2017, the number of deaths attributable to alcohol increased 35 percent, according to a new analysis by the Institute for Health Metrics and Evaluation at the University of Washington. The death rate rose 24 percent.
One alarming statistic: Deaths among women rose 67 percent. Women once drank far less than men, and their more moderate drinking helped prevent heart disease, offsetting some of the harm.
Deaths among men rose 29 percent.
While teen deaths from drinking were down about 16 percent during the same period, deaths among people aged 45 to 64 rose by about a quarter.
People’s risk of dying, of course, increases as they age. What’s new is that alcohol is increasingly the cause.
“The story is that no one has noticed this,” says Max Griswold, who helped develop the alcohol estimates for the institute. “It hasn’t really been researched before.”
The District of Columbia, less than 10 miles away from the Venable law office where Byrd was a partner, had the highest rate of death from alcohol in the country, according to the institute’s analysis. Georgia and Alabama came in second and third.
Alabama, in fact, ranked third among states with the strongest alcohol control policies, as rated by medical researchers in a 2014 report published in the American Journal of Preventive Medicine.
States can influence drinking – especially dangerous binge drinking – with policies such as taxes on alcohol and restrictions on where and when it can be sold.
Psychologist Benjamin Miller, chief strategy officer at the nonprofit Well Being Trust, says the larger health challenges in the South are to blame for high alcohol death rates. Southern states typically rank near the bottom in national rankings in cancer, cardiovascular disease and overall health.
Oklahoma, Utah, Kansas and Tennessee rounded out the five states with the strongest alcohol control policies, the researchers reported. States with more stringent alcohol control policies had lower rates of binge drinking, they found.
Nevada, South Dakota, Iowa, Wyoming and Wisconsin had the weakest alcohol control policies.
David Jernigan, a professor at Boston University’s school of public health who has specialized in alcohol research for 30 years, notes that the beer industry holds considerable sway in Wisconsin.
Binge drinking is sending far more people to the emergency room, a separate team of researchers reported in the February 2018 issue of the journal Alcoholism: Clinical and Experimental Research.
The researchers, who looked at ER visits from 2006 to 2014,found the largest increases were among the middle aged – especially women. The number of teenage binge drinkers landing in the ER during that time actually declined.
Older, often lifelong drinkers don’t need only to have their stomachs pumped. They frequently have multiple complications from their drinking.
Their often bulbous bellies need to be drained of fluid, which builds up from liver cirrhosis, and their lungs cleared of aspirated vomit, says Dr. Anthony Marchetti, an emergency room doctor at Upson Regional Medical Center in Thomaston, Georgia.
They might also have brain hemorrhages or internal bleeding, because booze prevents their blood from clotting properly.
By middle age, Marchetti says, long-term drinking can also lead to heart failure, infections due to immune suppression, a type of dementia from alcohol-induced brain damage, stomach ulcers and a much higher risk of cancer.
As opioid overdoses, which kill about 72,000 people a year, grabbed America’s attention, the slower moving epidemic of alcohol accelerated, especially in Southern states and the nation’s capital. About 88,000 people die each year from alcohol.
Making matters worse, alcoholism is trickier to treat – and criticize – than opioid addiction.
“Culturally, we’ve made it acceptable to drink but not to go out and shoot up heroin,” Miller says. “A lot of people will read this and say ‘What’s the problem?’ “
It might be a more socially acceptable addiction, but alcoholism is at least three times costlier to treat than opioid addiction, according to the Centers for Disease Control and Prevention. And it’s a far more complicated midlife crisis to address.
The proven approaches – taxes on alcohol and limits on where and when alcohol is sold – are often rejected because the liquor industry has considerable clout with policymakers.
Ron Byrd says his daughter Erika was “beautiful inside and out.”
To him, there’s no question about what caused her death.
That’s despite the fact there was no alcohol in her system when she was found dead at home. She was so sick, Byrd says, she hadn’t been able to eat or drink for days.
“The death certificate never says alcoholism,” he says. “It said heart arrhythmia and heart valve disease. But nobody in our family had heart problems.”
Attorney Lisa Smith has been in recovery from alcohol and cocaine addiction for a decade. The New York City woman wrote the memoir “Girl Walks Out of a Bar” and co-hosts the podcast Recovery Rocks.
Smithspeaks at legal conferences and law firms such as Byrd’s about the hazards of lawyers’ high-stress days and booze-fueled dinners with clients. But she’s fighting forces far larger than her profession.
“It is poison, and we’re treating it like it’s something other than that because there‘s big corporate money behind it,” she says. “A lot of people are getting really rich on something that is toxic to us.”
Deaths of despair
In its Pain in the Nation report this year, the Well Being Trust called losses from drugs, alcohol and suicide “despair deaths.”
The three are closely related. Suicide is the third leading cause of death from alcohol, after cancers anddigestive diseases. One in five individuals who die from opioid overdoses have alcohol in their system at the time of their death.
Drinking can lead to cancers all along the digestive tract, from the mouth to the colon. About 15 percent of U.S. breast cancer cases are considered to be caused by alcohol. A third of those cases affected women who drank 1.5 drinks or less a week, according to a 2013 report in the American Journal of Public Health.
The “direct toxicity” of alcohol damages the nervous system from the brain down to the spinal cord and to peripheral nerves, says Marchetti, the Georgia emergency physician. It’s common for people in the late stages of alcoholism to have numbness in their feet and legs, which makes walking difficult even when they aren’t impaired.
Emergency rooms are the most expensive place to treat problems. Between 2008 and 2014, the rate of ER visits involving acute alcohol consumption rose nearly 40 percent, according to the study in the journal Alcoholism: Clinical and Experimental Research. For chronic alcohol use, the rate rose nearly 60 percent.
The increases for acute and chronic alcohol use were larger for women.
People who drink throughout their lifetime develop a tolerance for alcohol. But as they age, they lose muscle and gain fat and become less tolerant.
That leads to increased injuries and illnesses, says Rick Grucza, an associate professor of psychiatry at Washington University in St. Louis and lead author of the Alcoholism study.
But why are so many people drowning so many sorrows?
Brenda Padgett believes it was postpartum depression that led her daughter to take up the heavy drinking that ultimately killed her last year.
Ashley Hartshorn, who lived in Hendersonville, North Carolina, had already suffered the trauma of hearing her stepfather kill his girlfriend while she was on the phone.
Then Hartshorn testified against him in court, which helped send him to prison for life.
The depression came after the birth of her third child in February 2012.
“She wanted so badly to quit drinking, but the shame and the fear kept her from being able to allow herself to reach out for help,” Padgett says. “Like many, we were ignorant to the effects that alcohol has on the body. I thought she had time, time to hit rock bottom and time to seek help.
“I never knew that only five years of alcohol abuse could take the life of someone so young.”
Neither did Nancy Juracka. Her son Lance died in 2006 after just three years of heavy drinking. He was 36.