Alcohol has long been one of the few legal mind-altering substances in the United States. While legal, messaging around its use – and misuse – has often been mixed. Moderate levels of drinking, such as a glass of wine or beer with dinner, were once recommended as a way to promote better heart health and to help control blood sugar and cholesterol levels.^1,2  

Lately, however, the public health sphere has become awakened to the fact that even a small amount of alcohol can lead to negative health consequences, increasing risks for a number of chronic diseases and different types of cancer.³ These risks are even more pronounced for women who, biologically, process alcohol differently than men, and face higher odds of developing chronic health conditions, disease, and even increased risk of death from alcohol-induced causes.^4,5

Using vital statistics data from the CDC’s WONDER system, a new brief from SHADAC researchers examines the concerning rise in alcohol-attributable deaths among women, which underscore larger patterns of growth seen across the U.S. We also examine differences in alcohol-attributable deaths between demographic groups, including by age, race and ethnicity, and geographic location during the COVID-19 pandemic period (2019-2022).

Key findings from our analysis of alcohol-attributable deaths during this time include:

• While men have traditionally seen high rates of alcohol-attributable deaths, women saw a 33% increase in alcohol-attributable deaths from 2019 to 2022 – an acceleration over the 28% growth in the rates of their male counterparts.

• Alcohol-attributable death rates for American Indian and Alaska native people, already at historic highs, surged by over 20 percentage points (from 54.0 deaths per 100,000 people in 2019 to 78.4 per 100,000 people in 2022) – well over the rate for the overall U.S. population (13.5 deaths per 100,000 people).

• Rates also increased for people living in non-metro (i.e., rural) areas during the pandemic, rising by 36% from 14.5 per 100,000 people in 2019 to 19.6 per 100,000 people in 2022.

Each of these individual trends make up an alarming larger pattern of accelerating alcohol-attributable death rates reaching all the way back to 2006, the year that the data for alcohol-attributable deaths first revealed any increase. While rates for years prior to 2006 remained generally stable, rates began steadily rising from 2006 onward, growing by nearly 30% from 7.4 alcohol-attributable deaths per 100,000 people to 10.4 per 100,000 people just prior to the COVID-19 pandemic in 2019. During the pandemic, this rate grew again by 30% from 10.4 deaths per 100,000 people to 13.5 death per 100,000 in 2022 in just three years – a worrying acceleration.

To learn more about alcohol-related deaths and our analysis of these trends, read the full brief, "Sobering Statistics: Acceleration of Alcohol-Attributable Deaths Across the United States During the COVID-19 Pandemic".

SHADAC has also built an interactive map that shows rates of alcohol-attributable deaths for the U.S. and the states from 2006 to 2022 for you to explore the data yourself. Start exploring below.

SHADAC Senior Research Fellow Colin Planalp presented at the APHA Annual Meeting in October 2024. In this presentation, Mr. Planalp reviews trends and patterns in fatal drug overdoses since the COVID-19 pandemic, including the increase in fentanyl related overdose deaths, which significantly increased from 11.4 deaths per 100,000 in 2019 to 22.7 deaths per 100,000 in 2022.

Click the image below to view the slides from this presentation in a PDF format. If you would like to view the presentation in a different format, please contact us.

Are you interested in learning more about the opioid epidemic? You can view all of our latest opioid crisis resources on our Opioid Epidemic in the United States page.

Soaring rates of fatal fentanyl, methamphetamine, and cocaine overdoses have worsened and spread to previously insulated groups, including teenagers and the elderly

It has been more than a decade since the U.S. Centers for Disease Control and Prevention (CDC) declared a national opioid “epidemic,” also known as the opioid crisis. In that time, hundreds of thousands of people have died, with the impact rippling out amongst friends, family, and communities: One in three U.S. adults know someone who has died of an overdose.¹ 

Despite knowledge of this crisis and efforts to reduce fatal overdoses and impacts of substance use disorder, we have seen the opioid epidemic continually worsen and evolve. Evidence suggests that increased regulations on prescription opioids pushed many to illicit alternatives.² The COVID-19 pandemic coincided with a huge increase in overdose deaths. Fentanyl, a once lesser-known contributor to the epidemic, has skyrocketed in its impact. Once insulated groups, like adolescents and the elderly, have seen overdose rates rise.

In this new brief from SHADAC, we examine changes in drug overdose death rates, and the types of drugs that cause these fatal overdoses, during the pandemic period (2019-2022). We also look at the history of the opioid epidemic: its beginnings, factors that influenced its evolution, and what it looks like now.

With this brief focusing on the four most common causes of drug overdoses — fentanyl, prescription opioids, methamphetamine, and cocaine — just some of the findings from this pandemic period include:

• Fatal overdoses from fentanyl increased 99%
• Fatal overdoses from methamphetamine increased 108%, and 
• Fatal overdoses from cocaine increased 69%

While overdose death rates generally increased across all the measured racial and ethnic groups, “we […] found evidence of dramatic and growing disparities across racial and ethnic groups in rates of fatal overdoses, with the crisis increasingly harming American Indian and Alaska Native people and Black people during the pandemic era,” lead author and Senior Researcher Colin Planalp says. 

In this brief, we explore these findings and more, including looking deeper at the impacts of the opioid crisis on different communities, demographics, and states. Click here to read the brief in full. The appendix for this piece is available here.

[1] Kennedy-Hendricks, A., Ettman, C. K., Gollust, S. E., Bandara, S. N., Abdalla, S. M., Castrucci, B. C., & Galea, S. (2024). Experience of Personal Loss Due to Drug Overdose Among US Adults. JAMA health forum, 5(5), e241262. https://pubmed.ncbi.nlm.nih.gov/38819798/

[2] Pitt, A.L., Humphreys, K., & Brandeau, M.L. (2018). Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic. American Journal of Public Health, 108(10), 1394-1400. https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2018.304590

This brief uses data from the National Survey on Drug Use and Health (NSDUH) to understand issues related to public health implications of Minnesota cannabis use prior to its 2023 legalization. Along with providing key background information and context on cannabis policy in the United States, this brief specifically examines three oft cited concerns with cannabis legalization:

1. The prevalence of cannabis use
2. Cannabis abuse and dependence (i.e., addiction)
3. Driving under the influence of cannabis

Researchers from the University of Minnesota School of Public Health’s State Health Access Data Assistance Center (SHADAC) and Cannabis Research Center (CRC) present data related to these commonly cited concerns from Minnesota, from other states, and from the United States as a whole. Where available and appropriate, estimates for alcohol are also presented for comparison as it is a legal and commonly used psychoactive substance that, like cannabis, entails a range of risks to public health.

The data in this brief are intended to serve as starting points for discussions on the public health impacts of Minnesota cannabis policy. Ultimately, there will be a great need for research into the rapidly evolving cannabis policy landscape and potentially refinements in policy to maximize benefits and minimize harms.

“The implications of cannabis legalization on public health also depend on the risks and benefits asso­ciated with cannabis use, which remain areas of uncertainty that warrant further study,” says SHADAC and CRC Researcher Colin Planalp. “It will be crucial for researchers and policymakers to monitor these and other issues into the future.”

• SHADAC blog accompanying this brief - “SHADAC and CRC brief provides pre-legalization data on Minnesota’s cannabis landscape”  
• Brief on the United States Opioid Crisis – “Opioid Crisis in the Pandemic Era”
• Explore data on the topic of substance use, alcohol-involved deaths, and more on State Health Compare