The number of deaths caused by alcohol-related diseases more than doubled among Americans between 1999 and 2020, according to new research.

Alcohol was involved in nearly 50,000 deaths among adults ages 25 to 85 in 2020, up from just under 20,000 in 1999.

The increases were in all age groups. The biggest spike was observed among 25- to 34-year-olds, whose fatality rate increased nearly fourfold between 1999 and 2020.

Women are still far less likely than men to die of an illness caused by alcohol, but they also experienced a steep surge, with rates rising 2 1/2-fold over 20 years.

The new study, published in The American Journal of Medicine, drew on data from the federal Centers for Disease Control and Prevention.

Deaths related to alcohol included those caused by certain forms of heart disease, liver disease, nerve damage, muscle damage, pancreatitis and alcohol poisoning, as well as related mental and behavioral disorders.

The study, however, did not include other deaths influenced by alcohol, such as accidents.

“The totality of the evidence indicates that people who consume moderate to large amounts of alcohol have a markedly increased incidence of premature deaths and disability,” said Dr. Charles Hennekens, a professor of medicine at Florida Atlantic University and one of the study’s authors.

The study is one of several recently that have drawn attention to the toll of rising alcohol consumption, particularly since the COVID-19 pandemic, as Americans faced heightened anxiety, economic uncertainty and social isolation.

Deaths increased among all racial and ethnic groups and in all geographic regions, the study found. But the steepest increases occurred among Asian Americans and Pacific Islanders, whose death rate rose 2.4-fold.

Men still die of alcohol-related disease at the highest rates and numbers, but two groups especially vulnerable to the health effects of drinking — women and older Americans — are consuming more alcohol than in the past.

Hennekens and his colleagues hypothesized that rising rates of overweight and obesity may also be playing a role in alcohol-related deaths.

Obesity and heavy drinking are associated with risk factors for cardiovascular disease and liver disease.

The authors urged health care providers to be aware that high blood pressure linked to obesity can be worsened by drinking and to screen patients for alcohol consumption.