Battling the Crisis of Alcohol-Related Liver Diseases

Chronic liver disease is a serious health issue in the United States, ranking as the 9th leading cause of death overall and the 6th leading cause among adults aged 25 to 64 years old. These liver diseases, which include fatty liver disease or cirrhosis, i.e., scarring of the liver, can be dangerous to health and quality of life the longer they go untreated. However, few people realize that chronic drinking leads to these issues or that it can happen at any age to people who drink heavily or mix drugs with their alcohol use.

Impact of Chronic Liver Disease

Specialists like transplant hepatologists focus on caring for individuals with chronic liver disease, affecting approximately 4.5 million Americans, or nearly 2% of the adult population. Some may progress to alcohol-related cirrhosis, a condition often leading to liver failure. Those most affected by chronic liver disease and cirrhosis are frequently medically and socially disadvantaged individuals, especially those residing in rural areas.

Chronic liver disease is a common complication for people living with alcohol use disorder. People who drink heavily for many years may scar their liver, making it harder and harder for it to do its job and clean toxins from our bodies. Binge drinkers often have medical incidents that contribute to liver damage even if they don't drink every day.

Alcohol Use Disorder Has Been Increasing

The COVID-19 pandemic has exacerbated the crisis of alcohol use disorder (AUD) and the associated harms, leading to increased rates of consumption and related consequences worldwide.

According to a study published by the National Institute of Alcohol Abuse and Alcoholism and Rand Corporation, alcohol consumption surged during the pandemic, increasing by 14% among adults in the United States. Heavy drinking episodes rose by 41% among women. These statistics highlight the alarming escalation of alcohol misuse during the pandemic, which has intensified the existing public health concerns surrounding AUD.

While diseases like cardiovascular conditions and certain cancers have seen declining mortality rates in recent decades, chronic liver disease and cirrhosis have experienced a concerning rise in mortality. Deaths related to alcohol use disorder are both tragic and avoidable, but the medical establishment still has not caught up.

What's Driving Alcohol-Related Liver Disease?

The surge in alcohol-associated liver disease is a significant factor driving the increase in chronic liver disease-related deaths. Over the past two decades, harmful alcohol use has escalated, marked by a 30% increase in high-risk drinking.

During the COVID-19 pandemic, alcohol consumption worsened, with nearly 1 in 4 adults reporting increased drinking to cope with pandemic stress.

Recognizing Alcohol Use Disorder

Many people live with alcohol use disorder and are in denial of the problem. They may characterize their drinking as different from an “alcoholic,” which is why language has been expanded to include any and all people who drink despite negative consequences. You don’t have to drink in the morning or every day to have an alcohol use disorder. You only need to exhibit signs and symptoms of the disorder.

Understanding the symptoms of AUD is crucial for early identification and intervention.

Here are some typical symptoms:

Cravings: Experiencing a strong desire or compulsion to consume alcohol.
Loss of Control: Difficulty in limiting the amount of alcohol consumed once drinking has begun, often leading to excessive intake.
Physical Dependence: The development of tolerance, requiring increased amounts of alcohol to achieve desired effects, and experiencing withdrawal symptoms when not drinking.
Neglecting Responsibilities: Prioritizing drinking over obligations such as work, school, or family responsibilities.
Continued Use Despite Consequences: Using alcohol to excess or alongside other substances despite experiencing negative consequences, such as legal issues, relationship problems, or health complications.
Social and Relationship Issues: Difficulties in maintaining relationships or engaging in social activities due to alcohol use.
Loss of Interest: Interest in once enjoyable activities and hobbies decreases, with alcohol consumption becoming the primary focus.
Denial: Minimizing or denying the severity of one's alcohol consumption or its impact on one's life.
Withdrawal Symptoms: Experiencing physical or psychological symptoms when attempting to cut down or stop drinking, such as tremors, anxiety, nausea, or sweating. These people will need detox to help them get sober.
Increased Tolerance: Needing to consume larger amounts of alcohol to achieve the desired effects previously experienced with smaller amounts.

These symptoms may vary in severity and can fluctuate over time. People who experience a loss of control when drinking need to be evaluated for alcohol use disorder.

The presence of multiple symptoms indicates a potential AUD diagnosis. Seeking professional help from healthcare providers or support groups is essential for managing AUD and promoting recovery.

Early Diagnosis of Alcohol-Related Liver Damage

There’s a big push to have medical professionals diagnose people with AUD earlier in the disease process so they can be treated. Late diagnosis often results in individuals being too ill for a liver transplant, leading to preventable deaths. Recognizing the signs of alcohol-associated liver disease early is crucial for timely intervention.

Many individuals with alcohol-associated liver disease are diagnosed late, as liver disease can progress silently for years. However, signs of liver failure, such as jaundice, swelling, and bleeding, may suddenly appear.

Addressing the Crisis of Alcohol-Related Liver Diseases (ARLD)

Chronic and heavy alcohol consumption can lead to inflammation, scarring, and irreversible damage to the liver, impairing its ability to function correctly.

Alcohol-related liver diseases (ARLD) encompass a spectrum of liver conditions caused by excessive alcohol consumption, ranging from fatty liver disease and alcoholic hepatitis to more severe outcomes such as cirrhosis and liver cancer.

ARLD represents a significant public health concern globally, with the potential for severe morbidity and mortality if left untreated.

Combatting the Stigma of AUD

For doctors, there is a new drive to eliminate stigmatizing language surrounding alcohol use disorder. Changing terminology from "alcoholic" to "alcohol-associated" or "alcohol-related" cirrhosis reduces stigma and encourages early intervention. Rather than call people the outdated term “alcoholic,” the medical profession prefers to use the term “person with alcohol use disorder” or “person with addiction.”

Public Awareness and Policy Changes

Increasing public awareness about cirrhosis, mainly its association with alcohol consumption, is vital. National public health campaigns led by organizations like the American Liver Foundation are crucial in educating the public about liver health.

Implementing stricter alcohol policies and legislation holds promise in reducing alcohol-related harms and liver disease mortality. Studies have shown that more restrictive alcohol regulations correlate with lower alcohol-associated liver disease mortality rates.

Increasing Taxes: Higher taxes on alcohol products can deter excessive drinking by raising prices.
Restricting Advertising and Marketing: Limiting alcohol advertising, especially to vulnerable populations, reduces the normalization of excessive drinking.
Creating Minimum Pricing Policies: Setting a minimum price prevents the sale of cheap, high-strength alcohol favored by heavy drinkers.
Reducing Availability Controlling the number of places that can sell alcohol in areas with high rates of alcohol-related problems can decrease accessibility.
More Vigorous Enforcement of Age Restrictions: Strengthening enforcement of legal drinking age laws helps prevent underage drinking.
Promoting Responsible Beverage Service: Mandatory training for alcohol servers helps identify and intervene in cases of intoxication. Holding bars responsible for drunk drivers is also a way to force accountability and keep bartenders from overserving.
Expanding Access to Treatment: Increasing funding for alcohol addiction treatment provides resources for those struggling with AUD.

ARLD Is Preventable

Alcohol-related liver disease is a preventable disease that can be life-altering for its sufferers. People with alcohol use disorder, including binge drinking disorders, are most likely to suffer from it.

Screening for alcoihol use disorder can help physicians also know who to screen for alcohol-related diseases like cirrosis.

The rising prevalence of alcohol-associated liver disease demands urgent action. By combatting stigma, raising public awareness, and having healthcare professionals implement effective policies, we can address this crisis and save lives.

Getting Help for Alcohol or Substance Use Disorder

Addiction to alcohol or other substance can impact individuals in profound ways, but there is hope for healing and recovery.

Present Moments Recovery offers comprehensive support to individuals grappling with addiction. Our holistic programs prioritize healing the mind, body, and spirit, incorporating therapeutic activities that promote overall well-being.

Within our supportive community, individuals find the understanding and guidance to navigate recovery challenges. Take the courageous step towards a healthier, more fulfilling life—contact us today to explore our personalized programs.