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Alcohol deaths surged in the US in the wake of the covid pandemic, peaking in 2021 to almost 40% above the pre-pandemic level (see table). The alcohol death toll in 2024 was still 20% above that seen in 2019, according to the latest provisional CDC data for deaths directly attributable to alcohol. There is still no full-year figure for 2025, but extrapolating the provisional figure of 39,558 for the year to December 6th suggests alcohol deaths are likely to be at least 11% higher than in 2019. Provisional figures typically increase because the CDC data collection network adds to them over time. The provisional figure for 2024 increased by a thousand since Alcohol Review first reported it in April, adding three percentage points in the comparison to 2019. ■

The Trump administration this week advised Americans to “consume less alcohol for better overall health”, dropping specific low-risk amounts from its guidance after 35 years. Alcohol harm experts had recommended the low-risk amount should be halved for men.

Alcohol harm experts say the official dietary guidelines should tell consumers what a low risk amount of alcohol consumption is based on robust statistical research, rather than leave it up to them to decide for themselves.

“The guidelines abandon specific consumption benchmarks—such as the long-standing limits of two drinks per day for men and one for women—leaving consumers without clear, actionable guidance.,” wrote Mike Marshall, CEO of US Alcohol Policy Alliance in an email.

Earlier drafts of the guidelines reportedly kept specific low-risk guideline amounts. Officials from the US Department of Health and Human Services had drafted a proposal to halve the recommended low risk amount of alcohol for men to one standard drink (18ml) a day like for women, said a Reuters news agency report.

The new guidelines also have other flaws, Marshall said, omitting mention of underage drinking, alcohol’s links to cancer.The US lobbing disclosure register shows the alcohol industry spent millions on lobbying efforts over the last two years. Alcohol industry hailed the new guidelines as a victory.

Alcohol deaths in the US were 20% above the pre-pandemic level in 2024 and look to have been at least 10% above in 2025, according to an Alcohol Review estimate based on provisional CDC data. These numbers tend to increase over time as data is gathered from data centres across the country. ■

Looking to the bottom of alcohol-free drink bottles can only take us so far in any bid to curtail our alcohol consumption. Even alcohol’s bogus answers to life’s problems are not to be found there.

It is true alcohol-free drinks can be tastier and healthier alternatives to sickly soft drinks. This is good. And they can also provide a useful visual prop for places hostile to people not drinking alcohol. But they are not alcohol alternatives.

To genuinely replace alcohol they would need to help us relax, feel rewarded, gain confidence, have fun, feel carefree and be sociable. Alcohol-free drinks will not do this for us. We need to look to alternative activities, not alternative beverages.

The quest for sober satisfaction turns what might be seen as an act of self-denial into one of hedonistic exploration. There are an endless array of new experiences, new skills and new social situations to be had. It is a journey not an event. 

Eleven years ago I was a standard-issue British Gen X weekend binger and then I gave alcohol for a couple of years to inform my book on alcohol. I then stayed off it for another three years, before becoming a low-risk alcohol drinker.

The first month was hard, really hard. It was not nearly enough time to find new activities or to build and find environments which suited me. But it got easier over time, until it was the new normal. One never stops learning how to make it better.

One thing that is perhaps worth sharing is that while it is nice to feel okay as a non-drinker in alcohol drinking scenarios, it is a questionable end goal. Even after more than a decade alcohol drinking scenarios can be okay for a while, but typically it is not where I would want to do for the whole night.

Not drinking alcohol around alcohol drinkers is typically very challenging and is very likely to remain so. We are, after all, literally in a different state of mind. Why fight it? Why not invest all that energy into alternative activities instead?

It is typically far easier for non-drinkers to spend time in alcohol-free environments and make one at home. So why not do that? Dodge the alcohol aisle at the supermarket and filter whatever alcohol ad and media exposure you can.

We deserve the freedom to look for the feelings we might want, be it relaxation, excitement, humour, camaraderie, whatever it might be. There is an likely activity to get closer to all of them and none of them need involve a bottle. ■

The UK’s New Year’s Honours list today recognised six people working to reduce the impact of alcohol harm, a former frontbench Labour MP, a family judge and four public health directors. 

Jonathan Ashworth, a former shadow health secretary, receives a CBE in part for advocating on behalf of the children of people with alcohol problems for the Children of Alcoholics charity. He made a poignant speech in parliament about his own experiences in 2017.

Judge Patrick Perusko receives a CBE for services to the administration of justice for his work pioneering Family Drug and Alcohol Courts in Bedford and Bedfordshire. He talked about the courts, and his background, in Oct 2021.

The honours list also recognises the work of several directors of public health. Greg Fell, president of the Association of Directors of Public Health (ADPH) and director of public health at Sheffield council, received an OBE.

MBEs went to three more public health directors: Dr Tim Allison, recently retired from NHS Highland; Dr Catherine Mbema at Lewisham council; and Professor Alice Wiseman in Gateshead, who is also vice-president of ADPH. 

Professor Wiseman’s presentation on combatting alcohol industry influence at the local level at AR2025 in March is available on the event page under the heading “Full live plenary sessions”.  ■

The global effort to curb alcohol harm will see a wave of change from the rollout of artificial intelligence (AI), but how big will it be? Will it be a ripple, crashing breaker, tidal surge or shattering tsunami? Alcohol Review’s annual conference in March will try to find out, while showcasing many other key developments in the field. To read on, please, register for the event and newsletter, or the free event preview and log in.

Note: For more on joining these online sessions on AI and the wide-ranging participant presentations, please visit the conference homepage and check out the new preview. ■

AR2026: Alcohol harm and artificial intelligence

+ all the latest research, advocacy and innovation.
Thursday, March 26th 2026, everywhere. Registrations open

Alcohol deaths in England were 32% above pre-pandemic levels in 2024, despite a 7% fall from the post-pandemic peak the year before, according to new new figures. A total of 38,399 people in England died of causes directly linked to alcohol drinking in the five years to 2024, over 9,304 more than if alcohol-specific deaths had remained at 2019 levels.■