Alcohol-involved injuries linked to increased risk of death in the next year: Study
IMAGE: AMBULANCE RESPONDING TO AN EMERGENCY view more
CREDIT: JOURNAL OF STUDIES ON ALCOHOL AND DRUGS
By Kimberly Flynn
PISCATAWAY, NJ — When people are injured severely enough to require treatment at the hospital and they are either intoxicated or have an alcohol use disorder, they have a fivefold increased risk of dying in the next year, according to a new study in the Journal of Studies on Alcohol and Drugs.
“Injuries are one of the most immediate hazards of problematic drinking behavior,” says lead researcher Sidra Goldman-Mellor, Ph.D., from the Department of Public Health at the University of California, Merced. “In addition to getting injured from things like car accidents and falls, some people may get injured in fights or even engage in self-harm after they’ve been drinking. However, we actually know very little about what happens to people with an alcohol use disorder after they’ve had a serious injury. So we wanted to investigate the most important outcome of all: how likely they were to die.”
To study this, Goldman-Mellor and colleagues examined data on all 10 million emergency department visits by California residents age 10 and older from 2009 to 2012. Of these patients, 262,222 had a nonfatal injury and either had a diagnosis of an alcohol use disorder or were intoxicated at the time of the injury.
Most (76.9%) of these injuries were coded as unintentional, with an additional 13.2% due to assault, 7.9% to self-harm and 2.1% due to undetermined intent.
Within 12 months of their hospital visit, 13,175 of these patients had died -- more than 5% -- with a total mortality rate of nearly 5,205 per 100,000. The researchers determined this is more than five times the rate for the rest of the California population, matched for age, gender, race and ethnicity, all strong determinants of mortality risk.
Goldman-Mellor says she and her colleagues were prompted to study this topic because of evidence that alcohol use -- including problematic alcohol use -- has increased over the last several years, especially during the pandemic. She says they were surprised by their findings.
“Injuries associated with alcohol use disorders are a public health problem in their own right, but now we know that they’re also associated with a substantially increased risk of death,” says Goldman-Mellor. “Most people who struggle with alcohol misuse don’t get the help they need.”
The research team was not able to examine what happened to the patients after discharge but suspects that many were already quite sick when they initially came to the hospital, with patients’ health declining after that.
Goldman-Mellor points to emergency departments themselves as one place in which people with alcohol problems might be able to get additional help. She notes that some emergency departments can connect patients to resources such as outpatient programs integrating substance use treatment with regular primary care for chronic conditions such as heart disease, diabetes and liver disease.
“Hopefully studies like ours can be used to increase resources for getting all such patients connected with comprehensive care, both for their substance use and general health,” she says.
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Goldman-Mellor, S., Kaplan M. S., & Qin P. (2022). Mortality risk following nonfatal injuries with alcohol use disorder involvement: A one-year follow-up of emergency department patients using linked administrative data. Journal of Studies on Alcohol and Drugs, 83, 879–887. doi:10.15288/jsad.21-00444
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To arrange an interview with Sidra Goldman-Mellor, Ph.D., please contact Juan Flores at jflores331@ucmerced.edu or (562) 201-7317.
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The Journal of Studies on Alcohol and Drugs (jsad.com) is published by the Center of Alcohol & Substance Use Studies (alcoholstudies.rutgers.edu) at Rutgers, The State University of New Jersey. It is the oldest substance-related journal published in the United States.
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The Journal of Studies on Alcohol and Drugs considers this press release to be in the public domain. Editors may publish this press release in print or electronic form without legal restriction. Please include a byline and citation.
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To view the public domain, stock-photo database of alcohol, tobacco and other drug-related images compiled by the Journal of Studies on Alcohol and Drugs, please visit www.jsad.com/photos.
JOURNAL
Journal of Studies on Alcohol and Drugs
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Mortality risk following nonfatal injuries with alcohol use disorder involvement: A one-year follow-up of emergency department patients using linked administrative data
ARTICLE PUBLICATION DATE
12-Dec-2022
Alcohol causes 1 in 20 deaths in Massachusetts
This toll likely Increased during the pandemic.
Reports and ProceedingsAlcohol’s health, safety and economic toll on the Bay State residents far outstrips revenues from state alcohol taxes, according to a new report from Boston University School of Public Health (BUSPH).
According to data from the Centers for Disease Control and Prevention (CDC), alcohol kills on average 2,760 people per year. The leading causes include 641 poisoning deaths, 350 deaths from alcoholic liver disease, 294 deaths from cancers attributable to alcohol use, and 211 liver cirrhosis deaths.
Alcohol’s toll in terms of death and disability rose by 13.8% from 2009 to 2019—faster than lung cancer, diabetes, hypertension, dietary risks or tobacco use. During the pandemic, nearly two in five (38%) of Massachusetts adults reported they increased their drinking, while nationwide, deaths involving alcohol increased by 25.5% from 2019 to 2020.
Meanwhile, the state’s alcohol taxes have lost 72% of their value in real dollars since they were last raised, and now amount to less than a nickel per drink. The CDC estimated that alcohol problems cost the state $5.6 billion in 2010, the last year for which an estimate is available. Of that, $2.26 billion (or $345 per person and $.77 per drink consumed) was paid directly by governments.
“Alcohol is clearly not paying its way in the Bay State,” said Rep. Kay Khan (D-11th Middlesex District), in response to the report. Rep. Khan has repeatedly introduced bills in the legislature to increase the state’s alcohol tax. “Our taxes on alcohol are far out of date, while alcohol problems have continued to increase.”
Massachusetts has a reputation for strict alcohol policies and high taxes, but according to the report, this is inaccurate. While Bay State drinkers consume and binge drink more than the national average, the state’s alcohol policies rank 17th in restrictiveness among the 50 states, and they have fallen behind other states in moving in more restrictive directions.
Massachusetts has five times as many licenses for bars and restaurants as are permitted in New Jersey and Pennsylvania. Of 16 states that set quotas on retail alcohol outlets, just three—Montana, South Dakota and Washington State—are more generous with these licenses than the Bay State.
And the state’s taxes on beer and wine are the lowest of the New England states, while its tax on distilled spirits is lower than all its neighbors except New Hampshire, which sells spirits at a discount in its state-run stores.
“In Massachusetts, alcohol policies are mostly discussed from a business point of view,” said David Jernigan, lead author of the report and a professor of health law, policy and management at BUSPH. “Health and safety data tell a different alcohol story, and need to be part of the policy debate.”
Binge drinking—consuming four or more drinks for females or five or more for males within two hours—is the most common and costly pattern of excessive alcohol use in the U.S., according to the CDC. In Massachusetts, binge drinking is common among both in the general population and among underage drinkers: 44% of current (past-30 day) drinkers age 12 and above, and 63% of current underage drinkers (ages 12-20) binged in the past month.
“The fact that Massachusetts has such a high rate of youth binge drinking is very concerning,” said Senator Jason Lewis, Senate Chair of the Joint Committee on Education and previously Senate Chair of the Joint Committee on Public Health. “This is no doubt linked to the easy and widespread availability of cheap alcohol, and is a public health issue that I hope we will tackle in the new legislative session.”
The report was coauthored by Xixi Zhou, a Master of Public Health candidate at BUSPH, and it was funded by a grant from BUSPH’s idea hub.
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About Boston University School of Public Health
Founded in 1976, Boston University School of Public Health is one of the top five ranked private schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.
METHOD OF RESEARCH
Literature review
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Alcohol, Health and Safety In Massachusetts
ARTICLE PUBLICATION DATE
13-Dec-2022
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