Deadly mix
Many factors contribute to the rise in alcohol-related deaths
As the Chief of Behavioral Medicine for Beaumont Health, Darren Jones follows research reports pertaining to the pandemic’s impact on public health. The full effect is still being tallied but one disturbing fact has emerged.
The number of alcohol-related deaths rose to 99,017 in 2020, up from 78,927 in 2019, according to a startling new study conducted by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAA).
“That’s an increase of 25%,” Jones said. “Alcohol-related deaths actually outnumbered COVID-19 deaths in 2020 in the United States. That’s specific to adults under the age of 65 but still very startling.”
The new study comes amid a growing realization that once the pandemic is over data will show that it not only claimed the lives of millions but contributed to the excess deaths caused by illnesses left untreated.
The numbers
In 2020, 1,605 Michiganders died of alcohol-related causes during the first year of the COVID-19 pandemic, according to numbers released by the Michigan Department of Health and Human Services (MDHHS). The majority of those deaths, 1,153, were among males, specifically White males, 968.
That’s the highest number since at least 1980, the oldest MDHHS data available, and a nearly 36% increase over the 2019 number of 1,190 alcohol-induced deaths. In addition, 1,658 Michiganders died from chronic liver disease and cirrhosis, which is also a record number and a 15.5% increase over 2019.
In Michigan, the alcohol-induced death rate increased to 16 per 100,000 population.
In Clare, Gratiot, Isabella, Macomb, Oakland, and Wayne counties the rate increased to 25, 17, 27, 15, 11, and 12 percent respectively, all representing increases over the prior year except Clare where the rate was the same.
In terms of the total number of alcohol-induced deaths, each of those counties saw their highest total since at least 1980 including:
• Macomb: 133 (up from 115 deaths in 2019)
• Oakland: 148 (up from 108 deaths in 2019)
• Wayne: 211 (up from 188 deaths in 2019)
Dr. Aaron White, chief of epidemiology and biometry for the NIAA, who led the study published in the Journal of the American Medical Association said one of the primary factors that led to the significant increase in alcohol-related deaths includes drinking to cope with the stress, anxiety, depression and worries about the future, as the pandemic began to take its toll.
“We know that roughly equal percentages, around 30%, of Americans increased and decreased their alcohol consumption during the pandemic,” said White. “Drinking to cope with stress increases the chances of developing an alcohol use disorder.”
Jones concurred.
“I think the increased threat that people were under when the pandemic hit, the social isolation, parents having to watch their kids and work from home, and the fear of getting COVID or giving it, is one factor that contributed to usage,” Jones said. “Individuals who were in rehab also probably relapsed because they didn’t have access to treatment.”
Or did not seek the help they needed.
The Macomb County Community Mental Health (MCCMH) data from the past four years showed that in 2018, 1,726 people sought help for alcohol use disorder, as a primary problem. In 2019 that number rose to 1,817 but declined during the pandemic, from 1,519 in 2020 to 1,348 in 2021.
Providing help
During the pandemic many health care providers were able to find ways to reach their patients despite the shutdowns.
“Outpatient services moved to virtual care pretty quickly, once COVID hit,” said Helen Klingert, director of substance abuse services at MCCMH.
Zoom was not the only buzzword during the pandemic. Telehealth or telemedicine, which allows doctors to provide care for their patient without an inperson office visit, was also a word people became familiar with and despite inperson services returning has remained an option for many.
Thanks to telehealth, CARE of Southeastern Michigan’s Recovery United Community Center was able to continue its programming throughout the pandemic.
“The way we were able to shift virtually and put all of our programming on the Zoom platform was amazing,” said Lindsey Parton, program supervisor for the center. “We also started using social media to tell people out of recovery where they could go for meetings for alcohol use disorders and narcotics. We dealt with all substance abuse disorders.”
The same was not true for the residential treatment centers for alcohol and drug use disorders, which faced hurdles that left them operating at less than half capacity, such as restrictions
brought on by the pandemic, staff shortages, or isolation situations caused by COVID outbreaks, causing some who might have been seeking help to relapse.
“There is a small window of opportunity when a person wants help to stop drinking and is willing to take action to get it. If access to treatment is unavailable at that time the moment passes quickly until the next time,” Parton said.
Data from the National Survey on Drug Use and Health also shows there was already a problem with people seeking help for alcohol use disorder.
According to the survey between 2002-2019, only 8% to 13% of all Americans with alcohol use disorder sought out treatment services at a specialty facility or through a self-help group. The top self-reported reasons for not seeking out alcohol use treatment includes:
• Not ready to stop using
(45.7%)
• No health care coverage (29.3%)
• Might might have a negative effect on job (12.6%)
• Did not know where to go for treatment (12.3%)
Other factors
According to White, Michigan saw the 6th-biggest increase in the number of alcohol-related deaths in 2020 going from 2,200 in 2019 to 2,990 in 2020.
According to White, Michigan saw the 6th-biggest increase in the number of alcohol-related deaths in 2020 going from 2,200 in 2019 to 2,990 in 2020.
Data from the U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System shows 55.6% of Michigan adults had consumed at least one alcoholic drink within the past 30 days during 2020.
In 2020, around 18% of Michiganders reported
binge drinking, which is consuming five or more alcoholic drinks on one occasion. The number was much higher among males, 22%, than among females, 13%.
Based on data from the NIAA, it appears that some of the increase in deaths during the pandemic was due to an increase in acute consumption, such as overdoses and injuries from falls, while other deaths resulted from an exacerbation of long-term heavy drinking, such as liver disease.
Although the 2020 alcohol-related death numbers were staggering, White said he’s concerned the numbers from 2021 could be even higher because of rising alcohol sales.
According to the Organization for Economic Co-operation and Development, alcohol sales increased by 3% to 5% in the United States in 2020 compared to 2019. Sales of off-premise alcohol sales, such as e-commerce and retail stores, grew significantly. In the U.S., online sales increased by up to 234%.
Data from the Michigan Liquor Control Commission shows year-overyear increases in the gross amount of retail liquor sales between 2011 and 2020. In fiscal year 2020, $1.76 billion worth of alcohol was sold compared to $1.5 billion during fiscal year 2019 putting Michigan seventh nationally in total distilled spirits sales.
During fiscal year 2020, over 12,00 liquor products were made available to Michiganders, among the largest selections of liquor anywhere in the U.S., according to the MLCC 2020
annual report. That’s almost double what was offered in 2011.
All of the factors created a perfect storm in behavioral health circumstances, said Jones but what’s really important at this stage is to continue to really promote a message of hope and recovery.
And while the demand for services has been more than the number of services available for people, that is changing.
Getting help
Beaumont Behavioral Health Hospital in Dearborn is an example of Michigan moving forward to overcome the gap between people seeking help for mental health issues and the number of treatment centers available.
The state-of-the-art facility also features dual diagnostic units, which are rare now but likely to become the norm in the future.
“Substance use disorders — the repeated misuse of alcohol and/or drugs — often occur simultaneously in individuals with mental illness, usually to cope with overwhelming symptoms,” according to the National Alliance on Mental Health. “The combination of these two illnesses has its own term: dual diagnosis, or cooccurring disorders. Either disorder (substance use or mental illness) can develop first.”
“It just opened a few months ago,” Jones said.
CARE of Southeastern Michigan also has a variety of programs to help people with alcohol use disorder, as well as others.
“I’ll meet with them and, depending on their definition
of recovery, come up with a plan that works for them,” said Parton. “We support multiple pathways to recovery.”
CARE also offers shuttle services for people taking their programs, who might also be staying in one of the local residential treatment centers, most of which are now operating near or full capacity.
“We have seen participation in our programs increase big time,” Parton said, which is at least one indication that things are turning for the better.