Global Burden of Disease (GBD) Overview on Alcohol-Related Disorders and Risks
01 Dezembro 2025
Global Burden of Disease (GBD) Overview on Alcohol-Related Disorders and Risks
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is a well-established reference for measuring health, mortality, and disability in a comparable way across more than 200 countries and over time. The GBD integrates multiple data sources and applies standardized methods to estimate the burden of hundreds of diseases and injuries, as well as the impact of various risk factors — extending far beyond alcohol (such as tobacco use, diet and hypertension, obesity, air pollution, among others).
The GBD uses a set of complementary metrics to quantify health burdens in a comparable manner. For mortality, it reports the number of deaths (in thousands). For morbidity (non-fatal losses), it uses YLDs (Years Lived with Disability), which estimate how long the population lives with diseases and limitations, weighted by the severity of symptoms. It also uses YLLs (Years of Life Lost), which measure how many years of life are lost when someone dies before the expected age for their cohort. The summary measure is the DALY (Disability-Adjusted Life Year). This framework allows for the assessment, for example, of alcohol’s impact on both fatal outcomes (such as cirrhosis or accidents) and non-fatal outcomes (such as alcohol use disorders, depression, and injuries), comparing periods and regions using the same measurement standard.
Although the GBD includes data going back to 1990, the structure of the most relevant findings focused on long-term percentage changes in alcohol-related mortality and morbidity used 2000–2023 and 2010–2023, respectively, as reference periods.¹,²
Morbidity and Global Trends in Alcohol Use Disorder and Excessive Alcohol Consumption (2010–2023)
In 2023, Alcohol Use Disorder (AUD) accounted for 11.6 million Years Lived with Disability (YLDs) (95% UI: 8.08–16.5), corresponding to 1.2% of the global disability burden (UI: 0.9–1.4), ranking 26th among causes of morbidity. Between 2010 and 2023, the non-fatal burden from AUD increased 12.6% in absolute numbers (UI: 9.6–15.3), while the age-standardized rate of YLDs per 100,000 population decreased by 4.9% (UI: −6.7 to −3.1), suggesting a slight reduction in average individual risk despite population growth and aging.
For fatal outcomes, between 2000 and 2023, Years of Life Lost (YLLs) due to AUD decreased 8.9% in total count, from 7,088.2 thousand (UI: 6,447.9–7,992.7) to 6,460.2 thousand (UI: 5,727.4–7,529.1), and the age-standardized YLL rate dropped 39.7% (UI: −49.8 to −27.1).
Considering the total burden in Disability-Adjusted Life Years (DALYs), excessive alcohol consumption as a risk factor rose from 14th place in 2010 to 11th in 2023 in the global ranking — reflecting the combined effect of deaths and disabilities attributable to alcohol use.
Mortality Burden from Alcohol Use Disorders (2000–2023)
Between 2000 and 2023, mortality fully attributable to alcohol use disorder remained virtually stable in absolute numbers, while declining significantly when adjusted for age: total deaths changed by only +0.8% (UI: −14.9 to +19.9), whereas the age-standardized death rate dropped 36.7% (UI: −46.6 to −24.5). In other words, although population growth and aging kept the number of deaths at similar levels, the average risk of dying from AUD — per 100,000 inhabitants and age-adjusted — decreased over the period.
Mortality from Diseases Fully Attributable to Alcohol (2000–2023)
Specific and severe consequences of alcohol use, such as cirrhosis and cardiomyopathy, were also tracked:
- Alcohol-attributable cirrhosis showed opposite trends across the two metrics: between 2000 and 2023, total deaths increased 22.6% (UI: +6.3 to +41.5), while the age-standardized death rate decreased 29.9% (UI: −39.5 to −19.3). In simple terms, there are more deaths in absolute numbers — an effect of population growth and aging — but the average risk per person, adjusted for age, has decreased.
- For alcoholic cardiomyopathy, improvement was observed in both dimensions: total deaths fell 18.6% (UI: −28.8 to −7.4), and the age-standardized rate dropped even more sharply by 52.3% (UI: −58.3 to −45.7), suggesting a consistent reduction in risk over time.
- In contrast, alcohol-attributable liver cancer presents a more concerning picture: total deaths rose 86.1% (UI: +58.3 to +116.7), and the age-standardized rate remained virtually unchanged (+1.3%; UI: −13.8 to +17.7). In other words, the absolute burden increased substantially, and there was no clear decline in average risk — underscoring the need for prevention and early diagnosis.
In Summary
Despite decreases in age-adjusted rates, the absolute burden linked to alcohol continues to rise due to population growth and aging. The path forward is clear: reduce harmful alcohol use, expand screening and treatment, and monitor outcomes using robust metrics such as those employed by the GBD.
References: