Drinking during pandemic increased Calif. death rates

Excessive alcohol consumption led to rise in alcoholic liver disease

Excessive drinking during the COVID-19 pandemic increased alcoholic liver disease deaths so much that the condition killed more Californians than car accidents or breast cancer, a KFF Health News analysis has found.

Lockdowns made people feel isolated, depressed, and anxious, leading some to increase their alcohol intake. Alcohol sales rose during the pandemic, with especially large jumps in the consumption of spirits.

While this led to a rise in all sorts of alcohol-related deaths, the number of Californians dying from alcoholic liver disease spiked dramatically, with 14,209 deaths between 2020 and 2022, according to provisional data from the Centers for Disease Control and Prevention.

Alcoholic liver disease is the most common cause of alcohol-induced deaths nationally. In California, the death rate from the disease during the last three years was 25% higher than in the three years before the pandemic. The rate peaked at 13.2 deaths per 100,000 residents in 2021, nearly double the rate from two decades ago.

The disease is usually caused by years of excessive drinking, though it can sometimes occur after a short period of heavy alcohol use.

There are often no symptoms until late in the disease, when weakness, confusion, and jaundice can occur.

Many who increased their drinking during the pandemic were already on the verge of developing severe alcoholic liver disease, said Jovan Julien, a postdoctoral researcher at Harvard Medical School.

The extra alcohol sped up the process, killing them earlier than they would have otherwise died, said Julien, who co-wrote a modeling study during the pandemic that predicted many of the trends that occurred.

Even before the pandemic, lifestyle and dietary changes were contributing to more deaths from alcoholic liver disease, despite little change in alcohol sales, said Brian Lee, a hepatologist and liver transplant specialist with Keck School of Medicine of the University of Southern California.

Lee and other researchers found a connection between alcoholic liver disease and metabolic syndrome, a condition often characterized by excess body fat around the waist. Metabolic syndrome — often caused by poor diet and an inactive lifestyle — has risen across the country.

“Having metabolic syndrome, which is associated with obesity, high blood pressure, and diabetes, more than doubles your risk of having advanced liver disease at the same level of drinking,” Lee said.

The Californians’ alcoholic liver disease most often kills are those between 55 and 74 years old. They make up about a quarter of the state’s adults but more than half the deaths from alcoholic liver disease.

However, death rates among Californians 25 to 44 roughly doubled during the last decade.

“People are drinking at earlier levels,” Lee said. “People are developing obesity at younger ages.”

Jeremy Campbell, executive director of Waterfront Recovery Services in Eureka, California, said Humboldt County and other rural areas often don’t have the resources and facilities to address high rates of alcohol use disorder. His facility provides high-intensity residential services and uses medication to get people through detox.

“The two other inpatient treatment facilities in Eureka are also at capacity,” he said. “This is just a situation that there’s just not enough treatment.”