Excessive drinking during the COVID-19 pandemic increased alcoholic liver disease deaths so much that the condition killed more Californians than car accidents or breast cancer, a KFF Health News analysis found.
Lockdowns made people feel isolated, depressed and anxious, leading some to increase their alcohol intake. Alcohol sales rose during the pandemic, with especially large jumps in the consumption of spirits.
While this led to a rise in all sorts of alcohol-related deaths, the number of Californians dying from alcoholic liver disease spiked dramatically, with 14,209 deaths between 2020 and 2022, according to provisional data from the Centers for Disease Control and Prevention.
Alcoholic liver disease is the most common cause of alcohol-induced deaths nationally. In California, the death rate from the disease during the last three years was 25% higher than in the three years before the pandemic. The rate peaked at 13.2 deaths per 100,000 residents in 2021, nearly double the rate from two decades ago.
The disease is usually caused by years of excessive drinking, though it can sometimes occur after a short period of heavy alcohol use. There are often no symptoms until late in the disease, when weakness, confusion and jaundice can occur.
Many who increased their drinking during the pandemic were already on the verge of developing severe alcoholic liver disease, said Jovan Julien, a postdoctoral researcher at Harvard Medical School. The extra alcohol sped up the process, killing them earlier than they would have otherwise died, said Julien, who co-wrote a modeling study during the pandemic that predicted many of the trends that occurred.
Even before the pandemic, lifestyle and dietary changes were contributing to more deaths from alcoholic liver disease despite little change in alcohol sales, said Brian Lee, a hepatologist and liver transplant specialist with Keck School of Medicine of the University of Southern California.
Lee and other researchers found a connection between alcoholic liver disease and metabolic syndrome, a condition often characterized by excess body fat around the waist. Metabolic syndrome — often caused by poor diet and an inactive lifestyle — has risen across the country.
“Having metabolic syndrome, which is associated with obesity, high blood pressure and diabetes, more than doubles your risk of having advanced liver disease at the same level of drinking,” Lee said.
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Excessive drinking during the COVID-19 pandemic increased alcoholic liver disease deaths so much that the condition killed more Californians than car accidents or breast cancer, a KFF Health News analysis found.
The Californians alcoholic liver disease most often kills are those between 55 and 74 years old. They make up about a quarter of the state’s adults but more than half the deaths from alcoholic liver disease.
However, death rates among Californians 25 to 44 roughly doubled during the last decade. About 2,650 Californians in that age group died of the disease during the past three years, compared with 1,270 deaths from 2010 through 2012.
“People are drinking at earlier levels,” Lee said. “People are developing obesity at younger ages.”
The highest death rates from alcoholic liver disease occur in rural eastern and Northern California. In Humboldt County, for instance, the death rate from alcoholic liver disease is more than double the statewide rate.
Jeremy Campbell, executive director of Waterfront Recovery Services in Eureka, said Humboldt County and other rural areas often don’t have the resources and facilities to address high rates of alcohol use disorder. His facility provides high-intensity residential services and uses medication to get people through detox.
“The two other inpatient treatment facilities in Eureka are also at capacity,” he said. “This is just a situation that there’s just not enough treatment.”
Campbell also pointed to the demographics of Humboldt County, which has a much higher proportion of white and Native American residents than the rest of the state. Alcoholic liver disease death rates in California are highest among Native American and white residents.
Death rates rose more among Native American, Latino, Asian and Black Californians during the last decade than among non-Latino white Californians, CDC data shows. Part of that is due to disparities in insurance coverage and access to care, Lee said. In addition, he said, rates of metabolic syndrome increased more quickly among nonwhites than among whites.
Racial health disparities also manifest in differing survival rates for Black and white patients after liver transplants, he added.
The trend is expected to continue.
Julien projects a temporary dip in deaths because many people who would have died of the disease in 2022 or 2023 instead died sooner after a boost in drinking during the pandemic but deaths will rise later, as bad habits developed during the pandemic begin to take a long-term toll.
“As people increased their consumption during COVID-19, we have more folks who have now initiated alcohol use disorder,” Julien said.
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17 unusual alcohol laws that could get you busted across the world
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It's been 90 years since Prohibition was repealed in the United States with the passing of the 21st Amendment in 1933. But even though the law that outlawed alcohol manufacture and sales was ultimately repealed, that doesn't mean the U.S. became a free-for-all when it came to liquor distribution and consumption.
In fact, after the national ban was lifted, each state had its own approach to legalizing the hard stuff—and as a result, there are still lots of laws to keep boozehounds in check throughout the nation.
CheapInsurance.com reviewed legislative statutes of U.S. state liquor laws and scoured news stories from around the world to find some of the weirdest laws related to alcohol that are still enforced today. Some hark back to a more puritanical time of temperance and morality, while others boil down to a public safety issue. Still, others are a bit more baffling and may leave you scratching your head wondering, "Why?"
Read on to learn about 17 of the most unusual reasons you could get nabbed for violating an alcohol law in the United States or around the globe.
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It's been 90 years since Prohibition was repealed in the United States with the passing of the 21st Amendment in 1933. But even though the law that outlawed alcohol manufacture and sales was ultimately repealed, that doesn't mean the U.S. became a free-for-all when it came to liquor distribution and consumption.
In fact, after the national ban was lifted, each state had its own approach to legalizing the hard stuff—and as a result, there are still lots of laws to keep boozehounds in check throughout the nation.
CheapInsurance.com reviewed legislative statutes of U.S. state liquor laws and scoured news stories from around the world to find some of the weirdest laws related to alcohol that are still enforced today. Some hark back to a more puritanical time of temperance and morality, while others boil down to a public safety issue. Still, others are a bit more baffling and may leave you scratching your head wondering, "Why?"
Read on to learn about 17 of the most unusual reasons you could get nabbed for violating an alcohol law in the United States or around the globe.
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17 unusual alcohol laws that could get you busted across the world
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Although New York City is known for its nightlife (and its 4 a.m. last call), there's one aspect of its entertainment offerings that restricts alcohol entirely: all-nude strip clubs. Gentlemen's clubs that feature exotic dancers who bare it all aren't eligible for liquor or beer and wine licenses—so selling a bottle of bubbly at one of these clubs could get a proprietor busted.
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Although New York City is known for its nightlife (and its 4 a.m. last call), there's one aspect of its entertainment offerings that restricts alcohol entirely: all-nude strip clubs. Gentlemen's clubs that feature exotic dancers who bare it all aren't eligible for liquor or beer and wine licenses—so selling a bottle of bubbly at one of these clubs could get a proprietor busted.
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17 unusual alcohol laws that could get you busted across the world
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In New York, the State Liquor Authority restricts the sale of whiskey, vodka, and other types of liquors within 200 feet of—or even on the same street as—any place of worship. It's called the "200 Foot Law," and it applies to both restaurants and "taverns" (or bars with pub food). Although these establishments can't qualify for a liquor license, they can legally sell beer and wine within close proximity to a church, synagogue, or even a school.
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In New York, the State Liquor Authority restricts the sale of whiskey, vodka, and other types of liquors within 200 feet of—or even on the same street as—any place of worship. It's called the "200 Foot Law," and it applies to both restaurants and "taverns" (or bars with pub food). Although these establishments can't qualify for a liquor license, they can legally sell beer and wine within close proximity to a church, synagogue, or even a school.
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17 unusual alcohol laws that could get you busted across the world
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Throughout California, even adults of legal drinking age can't enjoy an adult beverage while galloping down the street. That would be in violation of the state's open container law because horses are considered vehicles under the state vehicle code—which also means you could get busted for a DUI if you're found drunk while behind the reins. And that's not all—you could also get charged with animal cruelty if the horse gets hurt in a drunk-riding accident.
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Throughout California, even adults of legal drinking age can't enjoy an adult beverage while galloping down the street. That would be in violation of the state's open container law because horses are considered vehicles under the state vehicle code—which also means you could get busted for a DUI if you're found drunk while behind the reins. And that's not all—you could also get charged with animal cruelty if the horse gets hurt in a drunk-riding accident.
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17 unusual alcohol laws that could get you busted across the world
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17 unusual alcohol laws that could get you busted across the world
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The other dry state in the U.S. is Kansas, which never voted to ratify the 21st Amendment in 1933. That means the state never repealed Prohibition—aka the 18th Amendment, which prohibited making, selling, or transporting alcoholic drinks beginning in 1919 (although you could consume them legally). Like Tennessee, the default is "dry," which means serving and selling alcohol is officially outlawed—but individual counties that have approved a 1986 amendment to the state constitution are now allowed to sell and serve adult beverages.
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The other dry state in the U.S. is Kansas, which never voted to ratify the 21st Amendment in 1933. That means the state never repealed Prohibition—aka the 18th Amendment, which prohibited making, selling, or transporting alcoholic drinks beginning in 1919 (although you could consume them legally). Like Tennessee, the default is "dry," which means serving and selling alcohol is officially outlawed—but individual counties that have approved a 1986 amendment to the state constitution are now allowed to sell and serve adult beverages.
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17 unusual alcohol laws that could get you busted across the world
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While the state of Ohio does stick to the National Minimum Drinking Age Act of 1984, which makes it illegal to purchase or be in possession of alcoholic beverages on your own under the age of 21, there's an interesting exception to the rule. Under-agers can imbibe in public when accompanied by a parent or legal guardian who is "of age" and who provides the drink. They'll just get busted if they try to order for themselves.
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While the state of Ohio does stick to the National Minimum Drinking Age Act of 1984, which makes it illegal to purchase or be in possession of alcoholic beverages on your own under the age of 21, there's an interesting exception to the rule. Under-agers can imbibe in public when accompanied by a parent or legal guardian who is "of age" and who provides the drink. They'll just get busted if they try to order for themselves.
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17 unusual alcohol laws that could get you busted across the world
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In 2014, South Carolina became the last U.S. state to stop following a pre-Prohibition law that banned alcohol sales on Election Day. But that doesn't mean that every state in the country allows its citizens to booze it up before casting their ballot. In Alaska, a law is still on the books that prohibits the serving or sale of alcoholic beverages until the polls close, which is usually 8 p.m. It's only then that the bars can open—unless it's in a city that's adopted an ordinance that states otherwise.
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In 2014, South Carolina became the last U.S. state to stop following a pre-Prohibition law that banned alcohol sales on Election Day. But that doesn't mean that every state in the country allows its citizens to booze it up before casting their ballot. In Alaska, a law is still on the books that prohibits the serving or sale of alcoholic beverages until the polls close, which is usually 8 p.m. It's only then that the bars can open—unless it's in a city that's adopted an ordinance that states otherwise.
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17 unusual alcohol laws that could get you busted across the world
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In Allegany County, a southernmost county of New York adjacent to Pennsylvania, an odd law keeps its fine citizens sober for the coming of Santa Claus. Although grocery and convenience stores can normally sell alcohol until 1 a.m. on weekdays and weekends—and restaurants, bars, and taverns can all serve alcoholic drinks for on-site consumption until 2 a.m.—Christmas Eve is a different story, with an early closing time of 10 p.m. for both.
Any retailer or venue in violation of this deadline could get busted. Still, drinkers have another option: liquor and wine stores, which are exempt for some reason and can stay open at regular hours on the night before Christmas (which means until midnight on weekdays and until 9 p.m. on Sundays).
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In Allegany County, a southernmost county of New York adjacent to Pennsylvania, an odd law keeps its fine citizens sober for the coming of Santa Claus. Although grocery and convenience stores can normally sell alcohol until 1 a.m. on weekdays and weekends—and restaurants, bars, and taverns can all serve alcoholic drinks for on-site consumption until 2 a.m.—Christmas Eve is a different story, with an early closing time of 10 p.m. for both.
Any retailer or venue in violation of this deadline could get busted. Still, drinkers have another option: liquor and wine stores, which are exempt for some reason and can stay open at regular hours on the night before Christmas (which means until midnight on weekdays and until 9 p.m. on Sundays).
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17 unusual alcohol laws that could get you busted across the world
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The Alcoholic Beverages Control Commission of Massachusetts has a host of rules under what it calls its "Happy Hour Regulation"—which, as the name suggests, restricts the sale of discounted drinks during certain hours of the day (aka "time-limited drink specials"). In fact, the prices for alcoholic beverages must remain constant for the entirety of a calendar week. That same law, first enacted in 1984 as part of a campaign against DUIs, could get a bar or restaurant busted for selling an entire pitcher of beer or an entire bottle of wine to just one person, too—no matter what time of day or day of the week.
siemon // Shutterstock
The Alcoholic Beverages Control Commission of Massachusetts has a host of rules under what it calls its "Happy Hour Regulation"—which, as the name suggests, restricts the sale of discounted drinks during certain hours of the day (aka "time-limited drink specials"). In fact, the prices for alcoholic beverages must remain constant for the entirety of a calendar week. That same law, first enacted in 1984 as part of a campaign against DUIs, could get a bar or restaurant busted for selling an entire pitcher of beer or an entire bottle of wine to just one person, too—no matter what time of day or day of the week.
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17 unusual alcohol laws that could get you busted across the world
Juergen Faelchle // Shutterstock
Most U.S. states have laws on the books about not driving while under the influence of alcohol—and not drinking while driving. But in Louisiana, there's a workaround to the "open container" law that's allowed patrons to purchase daiquiris at the drive-thru since 1981: They have to be frozen, and they have to be covered by a lid that's not been pierced by a straw. You could get busted, however, if you try to drink your spirited slushy through that little hole in the top, as none of the contents can be removed from the cup while you're in the car.
Juergen Faelchle // Shutterstock
Most U.S. states have laws on the books about not driving while under the influence of alcohol—and not drinking while driving. But in Louisiana, there's a workaround to the "open container" law that's allowed patrons to purchase daiquiris at the drive-thru since 1981: They have to be frozen, and they have to be covered by a lid that's not been pierced by a straw. You could get busted, however, if you try to drink your spirited slushy through that little hole in the top, as none of the contents can be removed from the cup while you're in the car.
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17 unusual alcohol laws that could get you busted across the world
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It's a Class B misdemeanor in Indiana for convenience stores, grocery stores, and drug stores (all considered "beer dealers") to sell beer that's been chilled in any way—a relic from the post-Prohibition "blue laws" that attempted to instill a sense of moderation in those who partake in adult beverages. (Theoretically, selling the beer at room temperature would keep the customer from cracking it open right away and maybe even finishing it on the ride home.)
That makes Indiana the only U.S. state to restrict alcohol sales based on its temperature. Want a cold brewski without getting busted? Head to an Indiana liquor store (where cold carryout is legal) or a local brewery, which can sell its own beer at a drinkable temperature.
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It's a Class B misdemeanor in Indiana for convenience stores, grocery stores, and drug stores (all considered "beer dealers") to sell beer that's been chilled in any way—a relic from the post-Prohibition "blue laws" that attempted to instill a sense of moderation in those who partake in adult beverages. (Theoretically, selling the beer at room temperature would keep the customer from cracking it open right away and maybe even finishing it on the ride home.)
That makes Indiana the only U.S. state to restrict alcohol sales based on its temperature. Want a cold brewski without getting busted? Head to an Indiana liquor store (where cold carryout is legal) or a local brewery, which can sell its own beer at a drinkable temperature.
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17 unusual alcohol laws that could get you busted across the world
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Establishments in Oklahoma are banned from offering alcoholic beverages that are available in truly unlimited quantities—aka "bottomless"—for a single fixed price. Likewise, they can't give away drinks or host BOGO (buy-one-get-one) deals. However, the sky's the limit in terms of the number of drinks that a restaurant or bar can sell to a patron who's paying per serving—that is until they become intoxicated (at which point they can't be served and must leave the premises).
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Establishments in Oklahoma are banned from offering alcoholic beverages that are available in truly unlimited quantities—aka "bottomless"—for a single fixed price. Likewise, they can't give away drinks or host BOGO (buy-one-get-one) deals. However, the sky's the limit in terms of the number of drinks that a restaurant or bar can sell to a patron who's paying per serving—that is until they become intoxicated (at which point they can't be served and must leave the premises).
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17 unusual alcohol laws that could get you busted across the world
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According to the Utah Department of Public Safety, it's not just public drunkenness that's illegal—you could also get busted for being intoxicated in private, where you might "unreasonably" disturb somebody else. That means it's actually against the law to "get drunk" anywhere in the entire state of Utah—even at home, where you could be charged with a Class C misdemeanor if caught! The definition of "under the influence" is the strictest in the country, too: The blood alcohol content limit for a DUI is just .05%, compared to .08% in all other 49 states and the District of Columbia.
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According to the Utah Department of Public Safety, it's not just public drunkenness that's illegal—you could also get busted for being intoxicated in private, where you might "unreasonably" disturb somebody else. That means it's actually against the law to "get drunk" anywhere in the entire state of Utah—even at home, where you could be charged with a Class C misdemeanor if caught! The definition of "under the influence" is the strictest in the country, too: The blood alcohol content limit for a DUI is just .05%, compared to .08% in all other 49 states and the District of Columbia.
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17 unusual alcohol laws that could get you busted across the world
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17 unusual alcohol laws that could get you busted across the world
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17 unusual alcohol laws that could get you busted across the world
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The experts at Fodor's Travel advise that manufacturing, selling, consuming, or even just having alcohol in your possession is an offense punishable by flogging in Saudi Arabia. In fact, according to Amnesty International, flogging is a mandatory punishment for anyone the Saudi religious police force catches drinking alcohol—or even using cooking wine—as it's in violation of Shariah, or Islamic law, to which the kingdom strictly adheres.
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The experts at Fodor's Travel advise that manufacturing, selling, consuming, or even just having alcohol in your possession is an offense punishable by flogging in Saudi Arabia. In fact, according to Amnesty International, flogging is a mandatory punishment for anyone the Saudi religious police force catches drinking alcohol—or even using cooking wine—as it's in violation of Shariah, or Islamic law, to which the kingdom strictly adheres.
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17 unusual alcohol laws that could get you busted across the world
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A "beer purity law" has strictly regulated the ingredients that go into German beer for over 500 years (and counting). It's called "Reinheitsgebot," and it was issued in 1516 to ban using wheat to make beer so its supply could be reserved for bread-making. But the added benefit was that it also protected consumers by preventing brewers from contaminating their lagers with anything nefarious (like hallucinogens) beyond the basic ingredients of water, hops, malted grains, and, as of 1906, yeast.
Today, the German Brewers Association still uses it as a guideline for making heritage-style beers. But unlike in the 16th century, you won't get your beer confiscated if you don't follow the law to a T.
This story originally appeared on CheapInsurance.com and was produced and distributed in partnership with Stacker Studio.
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A "beer purity law" has strictly regulated the ingredients that go into German beer for over 500 years (and counting). It's called "Reinheitsgebot," and it was issued in 1516 to ban using wheat to make beer so its supply could be reserved for bread-making. But the added benefit was that it also protected consumers by preventing brewers from contaminating their lagers with anything nefarious (like hallucinogens) beyond the basic ingredients of water, hops, malted grains, and, as of 1906, yeast.
Today, the German Brewers Association still uses it as a guideline for making heritage-style beers. But unlike in the 16th century, you won't get your beer confiscated if you don't follow the law to a T.
This story originally appeared on CheapInsurance.com and was produced and distributed in partnership with Stacker Studio.
