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expert reaction to ONS figures for quarterly alcohol-specific deaths in England and Wales

The Office for National Statistics (ONS) have released data on quarterly alcohol-specific deaths in England and Wales: 2001 to 2019 registrations and Quarter 1 (Jan to Mar) to Quarter 4 (Oct to Dec) 2020 provisional registrations.


Dr Tony Rao, Visiting Researcher at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said:

“For people aged 20 and over, the number of alcohol specific deaths has increased from 3846 to 7422 – an increase of 93 per cent – over the past 20 years. Over the past year alone, there has been an increase of 19 per cent.  

“The data shows a clear association with deprivation, particularly for males. There is also an association with age in that the highest percentage rise in the number of alcohol specific deaths is seen in people aged 50 and above – a population already known to show the fastest rise in alcohol related harm over the past 20 years.  

“Data from Public Health England has shown an increase in alcohol consumption at levels that suggest dependent drinking from 1.5 million before lockdown to 2 million during the third lockdown. The highest percentage increase (8%) was in the 55-64 age group. It also supports findings from other studies which have found that, across all age groups, people drinking at higher risk levels before lockdown were more likely to have increased their alcohol consumption further during lockdown.  

“Although considerable efforts have been made to provide access to alcohol services during lockdown, the absence of face to face contact and the psychological impact of lockdown is likely to have a played a major role in the increased harm evident from alcohol specific deaths over the past year. A recent study found an increase in the proportion of older people with harmful alcohol use presenting to mental health services during, compared with before the first lockdown.  

“This data calls for a more integrated approach public health, the NHS and Third sector in reducing alcohol related harm.” 


Dr Matt Parker, Senior Lecturer Neuroscience and Psychopharmacology, University of Portsmouth, said:

“The ONS data shows that there was a stark and robust increase in the number of alcohol-related deaths during the first year of the covid-19 pandemic. The increase rose steadily throughout the pandemic, suggesting that the reasons behind this increase was the impact of changes in both lifestyle and access to services during the pandemic.

“Although it’s too early to say what the precise causal factors underlying the increase in alcohol-related deaths were, there are several possible reasons. (1) Alcohol services were severely disrupted during the pandemic, with local authorities and front line services diverting their attention and time to covid. This means that other health issues may have been pushed to one side. Alcohol services are one such example of this, with patients that would usually be helped within the systems being diverted away. (2) the pandemic was stressful for many people, particularly for people from lower socioeconomic backgrounds. For example, many may have lost jobs, or livelihoods, and stress is known to be a major catalyst and risk factor for alcohol misuse. (3) people have been isolated, and particularly at-risk people (ie those who have been alcohol misusers in the past) have lost vital social support networks that may have led to an increase in their risky drinking. (4) changes in habit and routine, particularly in those at risk (ie those that have been alcohol misusers in the past) may lead to the development of maladaptive habits, such as alcohol misuse. This is commonly seen in those that have changes in their lifestyle, and could be at play here.”

“We raised severe concerns about the impact of lockdown on alcohol misuse (Clay and Parker, Lancet Public Health,, and our fears appear to have been realised. Governments must ensure that in future lockdown situations, two changes are made: (1) access to alcohol services is maintained as a critical front line service; (2) access to alcohol is not treated as an “essential” (off-licences were “essentially services” during the lockdown) as this not only gives the wrong message, but also, potentially, facilitates at-risk people causing themselves significant harm.”


Dr Sadie Boniface, Head of Research, Institute of Alcohol Studies and Visiting Researcher, King’s College London, said:

“ONS has today released provisional alcohol-specific deaths data for England and Wales for all of 2020. This is an update to data released in February this year, which covered Jan to Sept 2020. These are official figures that are published routinely by the Office for National Statistics.

“It is alarming to see a 19.6% increase in alcohol specific deaths in a single year, on the back of two decades of no progress on this measure of alcohol harm.

“ONS report the increase coincides with the beginning of the pandemic.

“Because of the way alcohol-specific deaths are defined, most of these deaths were as a result of chronic health conditions caused by longer term higher risk or dependent drinking. Around 4 in every 5 alcohol-specific deaths is from alcoholic liver disease.

“This means the increase is not explained by people who previously drank at lower risk levels increasing their consumption during the pandemic. There have been substantial changes to drinking patterns during the pandemic, but the health consequences of these for individuals and at a population level largely remain to be seen.

“Reasons behind the increase in 2020 urgently need to be better understood. They are likely to include further increases in consumption among people who were already drinking at higher risk or dependent levels for some time, but also around access to health care. For example, liver disease often presents as an emergency, but people may have been frightened to go to A&E because of the virus. Last year there was a reduction in emergency presentations and admissions across the board, and addiction treatment data also showed fewer new clients starting treatment last summer. 

“These deaths were not inevitable, but sadly one of many indirect consequences of the pandemic, which need to be considered carefully in recovery planning.

“Last week in parliament the Parliamentary Under-Secretary of State for Health and Social Care said ‘nothing is off the table’ regarding a strategy to address alcohol harm. Now more than ever, effective policies are needed across the whole of the UK to increase prices, reduce availability, and control marketing, such as those called for by the Alcohol Health Alliance and recommended by the World Health Organization.”



All our previous output on this subject can be seen at this weblink:



Declared interests

Dr Sadie Boniface: “I work at the Institute of Alcohol Studies which receives funding from the Alliance House Foundation.”

None others received.

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