Alcoholic liver disease on the rise among young people, especially women

When Austin Johnson was 29, his liver had been so damaged from heavy drinking that his doctors feared he would die.

For years, he’d stored nearly a full bottle of alcohol every night to soothe his emotional anguish. Everything in her life revolved around drinking.

“It was normal for me to come home after work, get drunk, call friends drunk, play video games drunk,” said Johnson, now 33. “It was to the point where I fell asleep with the bottle in my hand. The pain literally disappeared when I drank enough.

Then he started feeling sick, and not just from a hangover. She was vomiting profusely and coughing up blood, early symptoms of liver damage. Her doctor did blood tests and the results were appalling.

“They said, ‘How are you still walking? You need to go to the emergency room right away,’” Johnson recalled.

Austin Johnson in August 2019, when his eyes and skin had turned yellow from liver disease brought on by years of alcoholism.Courtesy of Austin Johnson

Cirrhosis or severe liver disease was something that mostly affected middle-aged or older people. Increasingly, alcohol-related liver disease is killing young people in the United States

Johnson is part of a disturbing trend of men and women aged 25 to 34 who suffer serious, and sometimes fatal, liver damage linked to their alcohol use. A 2018 study reported that between 2009 and 2016, deaths attributed to alcohol-related cirrhosis — scarring of the organ that can lead to its failure over time — rose steadily, with the sharpest increase among those in that age range.

The pandemic has made things worse. Between 2017 and 2020, deaths from alcohol-associated liver disease continued to rise, accelerating during the first year of the coronavirus, according to a March 2022 report in Clinical Gastroenterology and Hepatology.

Again, there was a large increase among young adults, ages 25 to 34, especially among women.

Mortality rates have been rising every year for both sexes. While there were still more men dying than women, the annual death rate was rising faster in women (37%) than men (29%), according to the report, which pulled data from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

There are many potential causes, from economic uncertainty to isolation during the pandemic to underlying trauma, the researchers say. Another reason could be that drinks have gotten more potent and people are “drinking more per unit volume,” Dr. Elliot Tapper, a liver disease expert and gastroenterology specialist at the University of Michigan Medical, told NBC News. School in Ann Arbor.

A liver damaged by excessive alcohol consumption can be cured, but it will not save a patient’s life if the alcohol is still present. That’s why liver specialist Dr. Jessica Mellinger and doctors at the University of Michigan Medical School, where Mellinger is an assistant professor, have developed a new type of program that combines immediate medical care for liver disease with mental health and of addictions.

“We’re definitely seeing younger and younger patients arriving with what we previously thought was advanced liver disease seen only in middle-aged, 50- and 60-year-old patients,” Mellinger said.

Since 2018, Mellinger and the Michigan Alcohol Improvement Program Physicians have been providing psychiatrists and addiction specialists to patients with liver disease. Early research from the clinic suggests that this approach can prevent relapses.

“We have shown that health care utilization, how much [patients] were hospitalized, how much they use the emergency room, everything decreased “between the six months before patients came to the program and the six months afterward,” says Dr. Scott Winder, program psychiatrist and associate professor at the University of the Faculty of Medicine of Michigan.

Austin Johnson with his parents, Philip and Kathy Johnson, in November 2022, following his treatment at the University of Michigan.
Austin Johnson with his parents, Philip and Kathy Johnson, in November 2022, following his treatment at the University of Michigan.Courtesy of Austin Johnson

“We have shown that health care utilization, how much [patients] they were hospitalized, how much they use the emergency room, it all went down,” between the six months before patients entered the program and the six months afterward, Winder said.

Addiction experts not associated with the Michigan program say having a patient seen by a psychiatrist, addiction specialist, and liver specialist can provide more motivation for patients.

Simply telling patients they have severe liver disease and will die if they don’t stop drinking isn’t enough, said Dr. Henry Kranzler, Benjamin Rush professor of psychiatry and director of the Center for Studies of Addiction at the University’s Perelman School. of Pennsylvania. of Medicine.

“There has to be a real thoughtful and concerted plan,” Kranzler said.

For example, the message to quit becomes more powerful when the person “is shown scans of their liver,” he said. “It’s more motivating because it’s more tangible than vaguely saying, if you stop things will get better. ”

Dr. Shreya Sengupta, a gastroenterologist who trained at the University of Michigan, was so convinced of the value of the Michigan team’s approach that she started a similar program at the Cleveland Clinic, where she specializes in hepatology and liver transplantation .

“We try to address abuse disorder and liver disease at the same time,” said Sengupta, medical director of the multidisciplinary alcohol program at the Cleveland Clinic’s Digestive Disease & Surgery Institute.

Fortunately, for younger patients, if they stop drinking alcohol, there’s a much higher chance of full liver function recovery, Tapper said.

Johnson has stopped drinking and hopes for a healthier future. The yellow color of the skin and eyes, a symptom of severe liver disease, disappeared.

“You’ll either stay underground or you can do something about it,” she said. “They guided me on the right path to take the steps of my recovery.”

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