ALCOHOL-RELATED emergency department visits have more than doubled in the U.S. since 1993, with chronic alcohol misuse now driving a disproportionate share of cases, according to a new nationwide analysis.
A serial cross-sectional study analyzing nearly three decades of data from the National Hospital Ambulatory Medical Care Survey reveals a 139% increase in fully alcohol-attributable emergency department (ED) visit rates between 1993–1994 and 2019–2021. Rates rose from 4.4 to 10.5 visits per 1,000 individuals aged 15 and older, significantly outpacing the 28% increase in overall ED visit rates during the same period.
Using the CDC’s Alcohol-Related Disease Impact methodology, the study distinguishes between 100% alcohol-attributable (AAF1) and partially attributable conditions, also categorizing cases as either chronic or acute. The most substantial relative increases in AAF1 visits occurred among adults aged 50 and over (242%), men (146%), and White patients (190%).
Chronic alcohol-related visits increased by 158%, suggesting a growing burden of long-term alcohol misuse on emergency services. In contrast, acute alcohol-related visits declined slightly by 12%. This shift highlights a pressing need for long-term management and prevention strategies focused on chronic alcohol-related health conditions.
The data suggest that alcohol misuse is not only a persistent driver of ED utilization but is increasingly associated with older age groups and chronic health burdens. These findings support calls for tailored interventions, such as age- and population-specific public health campaigns, early screening, and referral pathways for high-risk groups.
As healthcare systems face growing demands, addressing the rising tide of alcohol-related ED visits, particularly those stemming from chronic misuse, may be critical to reducing preventable emergency care and improving long-term health outcomes.
Reference:
Rocha LR. Longitudinal Analysis of Alcohol-Related Emergency Department Visits from 1993 to 2021. Am J Epidemiol. 2025:kwaf139.
