What heavy drinking costs a life
Excessive drinking kills about 178,000 Americans a year. The people who die from it lose, on average, 24 years of life.
Alcohol is woven into celebrations, friendships and ordinary evenings in most of the countries where One Life is set. It is also one of the leading preventable causes of death. The US Centers for Disease Control and Prevention estimates the toll from what it calls excessive alcohol use: binge drinking, heavy weekly drinking, and any drinking by people who are pregnant or under the legal age.
The numbers
In 2020 and 2021, excessive alcohol use caused about 178,000 deaths a year in the United States, up from about 138,000 a year in 2016 and 2017. That is roughly 488 deaths a day.
The people who died from it lost, on average, 24 years of life each, and together about 4 million years of potential life a year. That high figure reflects who dies: many alcohol deaths happen young, from injuries, crashes and poisoning, rather than at the end of a long life.
Two kinds of harm
The CDC’s total combines two quite different patterns.
- Short-term harm comes from single episodes of heavy drinking: road crashes, falls, drowning, violence and alcohol poisoning. These deaths fall disproportionately on young adults.
- Long-term harm builds over years of heavy drinking: liver disease, several cancers, heart disease and stroke. These deaths come later, often after long illness.
Most people who drink are not heavy drinkers, and most heavy drinkers do not have alcohol use disorder. But risk rises with the amount. Habits formed in the twenties, when heavy drinking is most common, tend to persist into middle age unless something changes them.
What changes drinking habits
People do change how they drink, and often for the same reasons: a new relationship, a child, a health scare, a job that needs a clear head, or simply getting older. Treatment and support help those who find cutting down hard, and many people who once drank heavily drink moderately or not at all later in life.
Drinking also interacts with the rest of a life. It disturbs sleep, adds stress to relationships, costs money and makes other health problems worse. Someone who drinks heavily and smokes carries a much higher risk of some cancers than either habit alone would suggest.
The parts the statistics miss
Deaths are the easiest harm to count. The others are just as real: the relationships worn down by drinking, the jobs lost, the money spent, the children affected by a parent’s drinking. And the benefits that make alcohol so widespread, such as relaxation, celebration and the company of others, are real too. That is what makes it a choice people make again and again, every week of their lives.
Questions people ask
What counts as excessive drinking? The CDC includes binge drinking (four or more drinks on one occasion for women, five or more for men), heavy drinking (eight or more drinks a week for women, fifteen or more for men), and any drinking by pregnant people or people under 21.
Is moderate drinking good for you? Older studies suggested that a drink a day might protect the heart. More recent research has cast doubt on that, and many health bodies now say that less alcohol is better for health and that nobody should start drinking for health reasons.
Do most heavy drinkers have alcohol use disorder? No. Most people who drink excessively are not dependent on alcohol, which means that cutting down is often a matter of habit and circumstance rather than treatment, though support helps.
In One Life
Drinking in One Life is part of the habits a life arrives in adulthood with, and it is tracked year by year like the rest of the body: exercise, sleep, smoking, stress. Nights out, celebrations, hard weeks and lonely evenings all offer it. Health Life Questions such as “Respond to warning signs?” are where the game asks you directly what you are going to do about it.
The odds are real ones, and they compound. A life that drinks heavily in its twenties and stops at thirty is a different life from one that never stops, and the game will show you the difference in the late chapters and in how long the life lasts.