Are you ‘connecting the dots’ with patients during Alcohol Awareness Month?
Click Here to Manage Email Alerts
April is Alcohol Awareness Month, an annual campaign originally created to raise awareness about alcoholism and the impacts of alcohol on health — and a month-long opportunity to open a dialogue on the topic with patients.
The theme once again for this year’s event is “Connecting the Dots: Opportunities for Recovery,” which stands as an important reminder of the role health care providers play in educating patients on the possible risks associated with alcohol consumption and the prevalence of alcohol use disorder in the United States.
According to the National Institute on Alcohol Abuse and Alcoholism, more than 140,000 people die as a result of alcohol misuse in the U.S. each year and remains one of the leading causes of preventable deaths. Over 200 disease- and injury-related conditions can be attributed to misusing alcohol. The NIH estimates that approximately 10.5% of children in the U.S. live with a parent who has alcohol use disorder with alcohol contributing to approximately 18.5% of all emergency department visits.
Additionally, of the 100,530 liver disease deaths among individuals aged 12 years and older, 47.4% involved alcohol. In 2019, 50.3% of cirrhosis deaths were related to alcohol. Alcohol-associated cirrhosis was highest among adults 25 to 34 years old at 80.9%.
According to the NIAAA, there is a higher risk for liver disease, heart disease, depression, stroke and stomach bleeding among those who misuse alcohol, as well as increased risk for cancers of the oral cavity, esophagus, larynx, pharynx, liver, colon and rectum. Healio has been following the latest news and research specifically on the impact of alcohol use on the gastrointestinal tract and liver diseases; to help do our part to spread awareness, we have compiled a list of recent alcohol-related articles.
Non-heavy alcohol use, total weekly consumption linked to fibrosis, NASH
Non-heavy alcohol consumption was associated with fibrosis and at-risk nonalcoholic steatohepatitis, prompting researchers to suggest that current fatty liver disease categorization as alcoholic or nonalcoholic may be “misleading.”
“Although the link between heavy drinking and chronic liver disease is well-accepted, there is no current consensus on how non-heavy alcohol use affects liver health,” Brooke A. Rice, MD, internal medicine specialist at Boston Medical Center and Boston University School of Medicine, told Healio. “We demonstrated that even non-heavy alcohol consumption is associated with liver fibrosis and at-risk NASH, which both predict long-term liver-related morbidity and mortality.” Read more.
Roux-en-Y tied to increased risk for hospitalization related to alcohol-use disorder
Roux-en-Y gastric bypass was associated with an increased risk for alcohol-use disorder-related hospitalization compared with sleeve gastrectomy and a weight management program, according to research published in JAMA Surgery.
“Restrictive procedures, such as sleeve gastrectomy or gastric banding and mixed restrictive or malabsorptive procedures, such as Roux-en-Y gastric bypass, are effective in promoting weight loss and reversing underlying metabolic comorbidities, but they may induce differential alterations in alcohol metabolism,” Nadim Mahmud, MD, MS, MPH, MSCE, assistant professor of medicine and epidemiology at University of Pennsylvania Perelman School of Medicine, and colleagues wrote. Read more.
Alcohol use disorder risk higher for teens who undergo metabolic, bariatric surgery
Nearly half of adolescent patients who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy had increased alcohol use and were at risk for alcohol-related harm and problems within 8 years of surgery, according to study results.
“We undertook this investigation for two reasons: First, literature suggests that adults who undergo Roux-en-Y gastric bypass and vertical sleeve gastrectomy are at increased risk for alcohol use disorders,” Gretchen E. White, PhD, assistant professor of medicine, epidemiology and clinical and translational science at the University of Pittsburgh School of Medicine, told Healio. “Second, alcohol is the most widely abused substance for American youth and alcohol use is often initiated during adolescence.” Read more.
New-onset alcohol use disorder spiked in first 3 months of COVID-19 pandemic
Patients diagnosed with COVID-19 during the first 3 months of the pandemic had a twofold higher risk for developing alcohol use disorder, likely driven by anxiety and fear surrounding the pandemic, according to new research.
“Alcohol use disorder (AUD) affects both the individual and society,” Veronica R. Olaker, BS, of the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University School of Medicine, and colleagues wrote in JAMA Network Open. “The patient is at risk for disorders of the liver, pancreas, brain, gut, cardiovascular system, immune system and musculoskeletal system. In 2019, the CDC estimated the annual cost of AUD at $249 billion, including lost workplace productivity, medical care, accidents and criminal justice system costs. For all these reasons, reports of increased AUD diagnoses during the COVID-19 pandemic are particularly concerning.” Read more.
Sustained alcohol abstinence benefits even advanced cases of alcohol-related cirrhosis
Abstinence from alcohol was associated with reduced risk for hepatic decompensation and mortality among patients with alcohol-related cirrhosis, regardless of disease stage, according to results in Clinical Gastroenterology and Hepatology.
“Our results clearly show that all patients with alcohol-related liver cirrhosis who maintain sustained abstinence from alcohol not only suffer complications of liver cirrhosis significantly less frequently, but also live considerably longer — even in the case of pronounced portal hypertension," Benedikt Silvester Hofer, MD, of the division of gastroenterology and hepatology at the Medical University of Vienna, said in a related press release. Read more.
Prednisone bests anakinra, zinc for 90-day survival in severe alcohol-related hepatitis
Prednisone induced a higher 90-day survival rate and lower incidence of acute kidney injury compared with anakinra and zinc sulfate in patients with severe alcohol-associated hepatitis, according to late-breaking data.
“Alcohol-associated hepatitis (AH) is an acute clinical syndrome resulting from heavy and sustained alcohol consumption. Severe AH has a 90-day mortality rate of up to 30%, and treatment with corticosteroids improved 30- but not 90-day survival,” Samer Gawrieh, MD, associate professor of medicine at Indiana University School of Medicine and gastroenterology specialist at IU Health Physicians & Digestive Disorders, said at The Liver Meeting. “Anakinra, an IL-1 inhibitor, reduced alcohol-induced hepatic steatosis, alanine transaminase and inflammatory cytokines in a mouse model of AH, and it also demonstrated efficacy signals in phase 2 study, but there are no large trials comparing anakinra to standard of care.” Read more.
- Reference:
- National Institute on Alcohol Abuse and Alcoholism: Alcohol's Effects on Health: Research-based information on drinking and its impact: https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-and-human-body