Dry January campaign aims to make ‘first step’ toward abstinence less daunting
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Each January, Alcohol Change UK runs Dry January, a post-holiday campaign that encourages people to abstain from alcohol for 31 days at the beginning of the year and drink more healthily year-round.
Benefits of abstaining from alcohol for a month include lower blood pressure, reduced diabetes risk, lower cholesterol and reduced levels of cancer-related proteins in the blood, according to study data cited by Alcohol Change UK. In addition to these health benefits, 86% of people who participate in Dry January save money.
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“We know that taking the first step can feel daunting,” Richard Piper, chief executive officer of Alcohol Change UK, said in a press release. “However, 67% of people who take part in Dry January and access our free tools and resources have a completely alcohol-free month, compared to just 33% of those trying to go dry on their own.”
The charity encourages participants to download their Try Dry app, which can be used to set goals, track progress and monitor well-being during Dry January.
In recognition of Dry January, Healio has gathered the latest news and research on alcohol use and its effects on the liver, including new guidelines for management of alcohol-associated liver disease, risk factors for cirrhosis and updates in the treatment of alcohol use disorder.
ACG publishes new guideline for management of alcohol-associated liver disease
A new clinical guideline published in the American Journal of Gastroenterology underscored the need to overcome barriers to alcohol use disorder treatment and expand multidisciplinary care for patients with alcohol-associated liver disease.
“I think the most important reason why the American College of Gastroenterology wanted to revise this guideline is there has been impetus and recognition that control of the risk factor of alcohol use disorder seems to be the way forward in managing and controlling the magnitude and burden of this disease,” Ashwani K. Singal, MD, MS, FACG, FAASLD, AGAF, guideline author and professor of medicine at the University of Louisville, told Healio. “The second reason is that we wanted to bring out a stronger recommendation to consider early liver transplantation in these patients.” Read more.
Binge drinking, genetic predisposition linked to sixfold higher risk for cirrhosis
Heavy binge drinking and high polygenic risk score were associated with a sixfold higher relative excess risk for alcohol-related cirrhosis, with the presence of diabetes mellitus further increasing the risk, researchers reported.
“Many studies that look into the relationship between liver disease and alcohol focus on the volume of alcohol consumed,” Linda Ng Fat, MSc, PhD, senior research fellow in epidemiology and public health at University College London, said in a university press release. “We took a different approach by focusing on the pattern of drinking and found that this was a better indicator of liver disease risk than volume alone.” Read more.
Researchers advise limit of 7.4 grams of alcohol per day in early steatotic liver disease
Researchers recommended that patients with steatotic liver disease who are at a lower risk for advanced cirrhosis should consume no more than 7.4 grams of alcohol per day, the equivalent of a half a 12 oz. beer or half a glass of wine.
“A recent update in nomenclature, steatotic liver disease (SLD), encompasses all fatty liver diseases confirmed by histological or radiological evidence, irrespective of etiology,” Yee Hui Yeo, MD, of Cedars-Sinai Medical Center in Los Angeles, and colleagues wrote in JAMA Network Open. “While individuals with severe SLD should abstain from alcohol, little evidence exists for acceptable alcohol intake for patients with early stages of SLD who are disinclined toward complete abstinence.” Read more.
Risk for cirrhosis 50% higher in young women after first episode of alcoholic hepatitis
Female adolescents and young adults have higher rates of liver-related mortality and a 50% higher risk for cirrhosis and decompensation after surviving their first presentation of alcoholic hepatitis, according to data presented at The Liver Meeting.
“Hospital admissions for alcoholic hepatitis are increasing and more so in adolescents and young adults than in other age groups, and recent data has also suggested that rates for liver transplantation for alcoholic hepatitis are rising faster in this age group,” Jennifer A. Flemming, MD, FRCPC, MAS, associate professor of medicine and public health sciences at Queen’s University, said during her presentation. “It’s also been shown that sex differences exist, and the susceptibility to hepatic injury from alcohol and gender differences in alcohol use and engagement and alcohol use disorder treatment have also been observed.” Read more.
Naltrexone improves liver-related parameters, decompensation in alcohol use disorder
Oral naltrexone 50 mg safely improved alcohol use-related parameters and decompensation, and also reduced cravings, over 1 year among patients with alcohol use disorder and compensated cirrhosis, according to a presenter at The Liver Meeting.
“Naltrexone is a pure opioid receptor antagonist with good efficacy in noncirrhotics,” Mohit Kumar Varshney, MD, DM, addiction psychiatrist at the Alcohol Use Disorder Clinic at the Institute of Liver and Biliary Sciences, said at the meeting. “But because of concerns of hepatic toxicity, there is reluctance. The gap in the literature is that there is no effective FDA-approved drug for cirrhosis, there is reluctance on the part of both patient and physicians and there was no double-blind study on naltrexone.” Read more.
Infection mitigation during pandemic may have benefited AH patients treated with steroids
Mortality rates were consistently lower in patients with severe alcohol-associated hepatitis treated with steroids during vs. before the COVID-19 pandemic, suggesting infection mitigation may have benefited this population.
“Rising rates of alcohol use disorder and alcohol-associated hepatitis were observed during the COVID pandemic,” Samer Gawrieh, MD, professor of clinical medicine at Indiana University School of Medicine, told Healio. “Infection mitigations measures were widely used and included limited patients contacts with visitors, universal masking and emphasis on hand hygiene.” Read more.
Treatment for alcohol use disorder linked to lower odds for mortality in patients with ALD
A diagnosis of and treatment for alcohol use disorder after a hospital encounter for alcohol-associated liver disease correlated with lower odds for mortality, according to a presenter at the ACG Annual Scientific Meeting.
“In recent years, particularly in the United States, there has been an increased incidence of and mortality from alcohol-associated liver disease,” Elizabeth Harris, MD, a first-year GI fellow at Marshall University, said during her presentation. “A number of studies have shown that many patients with alcohol-associated liver disease... do not actually receive any treatment for their underlying alcohol use disorder.” Read more.
‘Downstream effects’ of alcohol use disorder swell in wake of COVID-19
With alcohol-related disease still on the rise after surging during the COVID-19 pandemic, an expert at the ACG Annual Scientific Meeting discussed treatment options, including liver transplantation, for patients with alcoholic hepatitis.
“You have to realize alcoholic liver disease, especially alcoholic hepatitis, is increasing,” Stanley M. Cohen, MD, FACG, professor of medicine and medical director of hepatology at Case Western Reserve School of Medicine, said during his presentation. “Keep it in your mind as part of your history.” Read more.
References:
- Alcohol Change UK. Dry January. https://s3.eu-west-2.amazonaws.com/sr-acuk-craft/documents/Dry-January-More-than-one-in-four-people-want-to-cut-down-on-their-drinking-in-2024-2.pdf. Accessed Jan. 4, 2024.
- Alcohol Change UK. Why do Dry January? https://alcoholchange.org.uk/help-and-support/managing-your-drinking/dry-january/why-do-dry-january-1/why-do-dry-january. Accessed Jan. 5, 2024.
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