Sober Synthesis

9/8/2025

Jeff K – Update: Alcohol Liver Disease

This post reviews recent data concerning alcohol related mortality, alcohol cirrhosis, and hepatitis deaths occurring in the US between 1999-2022. These were published in the journal JAMA network open Aug. 2025.

The article is of particular interest as it includes the years of the COVID pandemic onset.

Alcohol liver disease is discussed in an earlier post here.

Data for the study was obtained from the Centers for Disease Control database using death certificates from all 50 states. Age adjusted death rates were collated. Data was further segregated by sex, age, and racial/ethnic demographics.

The graph represents total alcohol mortality rate per 100,000 population. The death rate doubled during the study period from 6.71 to 12.73 per 100,000. A steeper rise occurred from 2018 – 2022 with 8.74% increase in those years.

This represents deaths due to alcohol hepatitis. Hepatitis is a more acute onset disease and may occur at any stage of liver disease.

The rate increased during the study period from 0.47 to 0.76. The pattern again shows a sharp increase beginning around 2018.

Deaths attributed to alcohol related cirrhosis separated by age group. The 45 – 64 year age group accounts for the highest incidence of cirrhosis as it has in the past. The surprising finding was a sharp increase in cases in the younger adult population age 25 – 44. This group had the largest alcohol related mortality rate increase 17.4% over baseline. All groups had a sharp rate of increase beginning around 2018.

Death rate due to alcohol related cirrhosis. Male and female mortality rates both significantly increased during the study period. Females had a larger rate of increase of 8.32% per year versus 6.92% per year for males. Pattern is similar to overall alcohol related mortality with a steady rate of increase since 1999 and a sharper climb beginning around 2018.

Alcohol sales at the start of the pandemic 2020-2022 represented as percent change from the same months average 2017-2019. Alcohol sales consistently range between zero to 15% greater than previous years. This correlates to anecdotal reports of increased consumption during the peak pandemic, unemployment, and lockdown period. Longer term changes in mortality secondary to COVID effects will need to be addressed in follow up studies.

Mortality directly related to alcohol use has dramatically increased over the past 25 years. Younger age groups, women, and Native American populations have undergone the largest rates of increased mortality. These findings are highly concerning and should prompt action from public health and medical communities.

In particular rates have sharply increased since about 2018. Some if this may be secondary to increased alcohol consumption during the COVID pandemic. Causal factors contributing to the increasing mortality rate are not fully understood and may addressed in further studies.

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For information and educational purposes only. Images and data obtained from sources freely available on the World Wide Web. This post should not be considered medical or professional advice. Comments and suggestions are welcome jeffk072261@hotmail.com

References

Alcohol-Associated Liver Disease Mortality

Chun-Wei Pan, MD1; Yazan Abboud, MD2; Amit Chitnis, MD, MPH et al

JAMA Netw Open. 2025; 8(6):e2514857. 10.1001/jamanetworkopen.2025.14857

https://jamanetwork.com/searchresults?author=Chun-Wei+Pan&q=Chun-Wei+Pan

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COVID timeline CDC

https://www.cdc.gov/museum/timeline/covid19.html

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Graphs alcohol use trends

https://www.niaaa.nih.gov/publications/surveillance-reports/surveillance120

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