Background Alcohol consumption is a leading cause of death for people aged 15–49 years globally, resulting in 2.8 million total deaths in 2016. The Global Burden of Disease (GBD) Study is a global enterprise, informing and developing policies through comprehensive systematic analysis of comparable data using standardised methodology. GBD estimations have become more robust for recent iterations, with new methodological improvements. Ireland is ranked 9th highest alcohol per-capita consumption amongst the OECD countries (10.8 litres/capita) and 8th highest rate of monthly binge drinking. Alcohol is a societal issue, with a complex association with health. Ireland has introduced the Public Health (Alcohol) Act (PHAA) in 2018. Therefore, a comprehensive baseline information on the attributable burden of alcohol harms is important to evaluate the full implementation of this Act later in Ireland.

Methods We estimated the burden of alcohol related fatal and non-fatal health outcomes in Ireland for 2019, using the most recently available GBD Compare data. Disability-Adjusted-Life -Years (DALYs) and total deaths attributable to alcohol were estimated using the GBD comparative risk assessment framework. Improvements to GBD methodology related to alcohol estimation process, including access to more recent data sources, and minimising compositional bias, and accounting for abstention, tourism-related and unrecorded information in statistical modelling. 95% Uncertainty Intervals (UI) are provided.

Results In 2019, there were 1543 (1237 – 1860 95% UI) deaths attributable to alcohol- 5% of all deaths in Ireland – proportionately more deaths in males: 1104 (896 – 1327 95% UI) compared to females: 439 (295 – 599 95% UI), giving a standardised mortality rate of 45 and 18 per 100,000 population, respectively. DALYs lost were 62237 (52062 – 73939 95% UI) in 2019. Chronic liver disease was the biggest alcohol related condition, with a risk factor attribution of 73.3% (57.4% – 86.0 %95% UI). 27% of deaths due to self-harm/interpersonal violence are alcohol attributable- estimating approximately 123 deaths in 2019. The largest number of alcohol attributable deaths were neoplasms (~635 deaths). Alcohol deaths ranked 8th in Ireland in 2019– up from being rank 13 in 1990.

Conclusion On average, four deaths per day are alcohol-related in Ireland, with a disproportionate distribution of alcohol attributable burden. Important provisions in the PHAA are yet to be implemented, including labelling, and regulation of advertising broadcast and content. The findings signal the need for full implementation of the PHAA, and accurate timely estimates of alcohol burden are crucially important to inform policymaking.