Lead: Trends in alcohol-related deaths in the United States over 55 years: 1968-2023Lead: Trends in alcohol-related deaths in the United States over 55 years: 1968-2023
This Week in Addiction Medicine from ASAM
A concise research briefing summarises trends in alcohol-related deaths and a range of studies on treatment models, medications, ethics, and youth drug risk. The episode is aimed at those interested in evidence-based perspectives on addiction and recovery.
6:53•21 Jul 2026
Alcohol Mortality, Ethical Treatment, and New Research in Addiction Medicine
Episode Overview
- Alcohol-related mortality in the US has risen over recent decades, with 1.3 million deaths between 1998 and 2023 and higher age-adjusted rates in males than females.
- Racial patterns in alcohol-related deaths have shifted, with a 50% decline for Black individuals and nearly doubled rates for white individuals.
- Prenatal alcohol exposure alters choline-related metabolic pathways in sex-specific ways, and choline supplementation may modulate these changes.
- Legally mandated substance use treatment raises ethical issues around choice, court involvement, provider conflicts of interest, and targeting individuals who may not need treatment.
- Shared medical appointments for substance use disorder appear feasible with good treatment retention, but more research is needed on long-term outcomes compared with individual care.
“Between 1998 and 2023, there were 1.3 million alcohol-related deaths.”
Curious about how others navigate their sobriety journey? This news-style episode from "This Week in Addiction Medicine" takes a more clinical angle, giving you a brisk tour of current research that shapes how professionals think about addiction, treatment, and policy. Host Zach Caruso opens with a striking headline on alcohol harm: a study of alcohol-related deaths in the United States from 1968–2023 based on CDC WONDER data.
As he notes, "Between 1998 and 2023, there were 1.3 million alcohol-related deaths," with age-adjusted mortality rates climbing from 13 to 19 per 100,000 and a clear peak during COVID. You’ll hear how trends differ by sex, race, age, and region, including a sharp rise among white individuals and heavy impact on adults aged 65 and over.
The episode then moves through several key studies, touching on prenatal alcohol exposure and choline supplementation, and how sex-specific changes in choline metabolism might relate to neurocognitive outcomes. There’s a careful look at ethically tricky territory too, as Zach summarises a review of legally mandated substance use treatment, highlighting tensions around choice, court involvement, and whether some people targeted actually need treatment.
For those interested in clinical models of care, there’s a review of shared medical appointments for substance use disorder and what current evidence says about retention and participation. Medication-focused segments cover buprenorphine–naloxone versus extended-release naltrexone after medically managed opioid withdrawal, plus a small trial of mirtazapine for methamphetamine use disorder and its potential effect on craving and relapse.
The briefing wraps up with tobacco and youth drug risk, including compensatory smoking with very low nicotine content cigarettes and how adolescents perceive the risk of fentanyl use. If you’re looking for concise, research-heavy updates that can inform treatment conversations and personal reflection on alcohol and other drugs, this episode might spark a few new questions about what effective and ethical care should look like today.
Do you want to link to this podcast?
Get the buttons here!
More From This Show
The latest episodes from the same podcast.