The deadliest drug: STAT investigates America's hidden alcohol epidemic

The drug kills nearly 500 Americans every day, and in a typical year, it causes more deaths than all infectious diseases combined. Manufactured internationally and domestically and distributed by powerful multinational organizations with vast distributor networks. Its promoters sometimes seem indifferent to its addictive and destructive properties.

For decades, centuries in fact, it has destroyed lives, torn families apart, stagnated economies, and killed millions. But alcohol, by far the most popular and most harmful mind-altering substance in the United States, is not considered a public health emergency.

Alcohol has become central to American life because it provides social and cultural benefits for many people who drink safely. But despite mountains of research linking heavy drinking to cancer, heart disease, stroke, cognitive decline, developmental disorders, gun violence, injuries, and countless other effects, alcohol remains ubiquitous. Alcohol-related injuries, illnesses, and deaths have skyrocketed in recent years, starting in 2020. Older people, women, and young people are especially affected, including a sharp increase in liver-related deaths. In the United States, the number of alcohol-related emergency department visits nearly doubled between 2003 and 2022.

Jenny Wilson, an emergency physician in downtown Reno, Nevada, said alcohol is “absolute poison” for addicts. Acute and chronic problems caused by excessive alcohol consumption appear in her work “every day, many times, without question.”

However, mass deaths and illnesses among Americans due to alcohol consumption are inevitable. STAT’s investigation shows that this epidemic is a multi-generational failure of medical systems, public health systems, industry and government, and that the Trump administration is wasting a unique opportunity to attack the problem.

Political leaders, including participants in Health Secretary Robert F. Kennedy Jr.’s health-minded Make America Healthy Again movement, have largely ignored the harm caused by alcohol. Even the economic costs of excessive alcohol use, which exceed $240 billion annually, have been ignored. Liquor tax revenues, meanwhile, have been declining for decades as alcohol costs fall and inflation rises.

Successive presidential administrations have done little to reduce the harms of alcohol. From the Reagan administration’s “Just Say No” campaign to the Obama administration’s “21st Century Drug Policy,” White House efforts on drug use have targeted illicit drugs such as crack cocaine, heroin, and marijuana. Alcohol was thrust into the spotlight in January 2025, just before President Trump was re-elected, when Biden-era Surgeon General Vivek Murthy released a report highlighting the link between alcohol and cancer. President Trump’s second term marks a return to business as usual, including giving special favors to the powerful alcohol industry.

If ever there was a leader who suffered the scourge of alcohol, it was President Kennedy and President Trump. Trump’s older brother, Fred Jr., died at age 42 of a heart attack caused by alcoholism, and the president has said that loss led him to become a teetotaler. Kennedy became the first secretary of health to make a clear recovery from alcoholism. They vowed to reduce rates of chronic disease, especially addiction.

“Right now, I’m the person in charge of trying to solve this problem,” Trump told The Washington Post in 2019. “…I don’t know if I would have done anything like that if I hadn’t had that experience with Mr. Fred.”

But neither has followed through on important policies regarding the country’s popular drug. Instead, the administration has relaxed drinking guidelines and cut efforts to understand alcoholism, prevent further addiction, and help people find a way out.

most deadly drug

Other works from “The Deadliest Drug”

“These claims are baseless,” said HHS spokeswoman Emily Hilliard. “Under Secretary Kennedy’s leadership, HHS continues to prioritize practical, evidence-based approaches to help people with substance use disorders receive care and achieve long-term recovery.”

Hilliard pointed to the billions of dollars in treatment and recovery funding that HHS has provided to states and local governments as evidence that Kennedy is taking the issue seriously. Requests for interviews with Kennedy or other health department leaders working on alcohol issues were not granted. The White House could not be reached for comment.

Meanwhile, industry groups are blocking proposals for higher taxes and tighter regulation by pressuring lawmakers and colluding with powerful figures in the philanthropic, medical, and scientific worlds.

Public health agencies are putting aside drug treatments and harm reduction strategies to prevent addiction, disease, and injury. In some cases, health authorities and major medical associations are using controversial science to promote the health benefits of alcohol. Efforts to address the harms of alcohol are almost nonexistent, but they are overshadowed by the opioid crisis, a parallel drug epidemic that attracts more funding, prompts more policy changes, and garners more media attention, despite being significantly less lethal.

STAT’s explanation is based on interviews with more than 100 researchers, public health experts, physicians, patients, industry officials, and legislators, a review of the latest scientific literature, addiction treatment protocols, legislation, and public health guidance, and lobbying disclosures from alcohol companies and the trade associations that represent them.

The hidden cost of drinks

Of the 178,000 alcohol-related deaths each year, about one-third are due to causes such as car accidents and alcohol poisoning. The remainder is due to cancer, heart disease, liver failure, and other chronic illnesses caused by continued heavy drinking. As far as drugs go, the harms of alcohol only exceed the long-term harms of tobacco.

But even though the United States has dramatically reduced tobacco use, it has never made any serious efforts to curb alcohol-related harm, except during the infamous Prohibition era. By 2024, more than twice as many Americans will have consumed alcohol as used tobacco products, according to federal estimates.

Alcohol, like obesity and tobacco, is a major cause of preventable cancer. Researchers estimate that if Americans who drink drank just one alcoholic drink per day, 17,450 cases of cancer could be avoided annually. According to the World Health Organization, addressing drinking problems is one of the best ways to save more lives at less cost.

The United States went in the opposite direction. Alcohol-related deaths have increased in recent years, increasing by 16% during the pandemic. Alcohol consumption has since declined, but alcohol-related deaths are still far above 2019 levels.

STAT+ exclusive story