Alcohol Awareness Month: Right time to start ‘shaping youth’s attitudes’ on drinking
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April is Alcohol Awareness Month, an annual campaign intended to boost awareness of the heavy burden that alcohol misuse places on affected individuals and their families, as well as its adverse impact on their health and society.
“It is also a good time to talk to teens about drinking and to equip them with the knowledge to handle situations involving alcohol,” George F. Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism, said in a related blog. “Even teens who would not normally be tempted to drink alcohol may be drawn in by certain social situations, so don’t assume they have all the facts they need to resist peer pressure. Parents and trusted adults can play a meaningful role in shaping youth’s attitudes toward drinking.”
With more than 178,000 alcohol-related deaths in the U.S. each year, alcohol represents a leading preventable cause of death, according to NIAAA data. More than 200 disease- and injury-related conditions are associated with alcohol use. People who misuse alcohol have a greater risk for liver disease, heart disease, depression, stomach bleeding, stroke and cancer of the oral cavity, esophagus, larynx, pharynx, liver, colon and rectum.
Additionally, out of the 98,457 liver disease deaths among individuals aged 12 years and older, 46% 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%.
In recognition of Alcohol Awareness Month, Healio recaps the latest news and research concerning alcohol-related issues, including significant statistical updates, alcohol’s impact on liver disease and up-to-date guidelines for managing alcohol-related liver disease.
Q&A: Surge in ‘sober curious’ movement could yield lasting health benefits
While the CDC estimated that excessive alcohol use contributed to approximately 178,000 U.S. deaths each year from 2020 to 2021, an emerging lifestyle trend may help counter those statistics in the years ahead.
A recent survey from NCSolutions showed that more than 40% of Americans — especially younger Americans — are trying to drink less alcohol as the “sober curious” movement gains popularity. Read more.
Annual deaths from excessive alcohol use increased by nearly 30% from 2016 to 2021
The average number of deaths from excessive alcohol use increased by 29.3% from 2016 to 2021, with an age-standardized rise in death rate from 38.1 to 47.6 per 100,000 population, according to data in Morbidity and Mortality Weekly Report.
“Deaths from causes fully attributable to alcohol use have increased during the past 2 decades in the United States; rates were particularly elevated from 2019 to 2020, concurrent with the onset of the COVID-19 pandemic,” Marissa B. Esser, PhD, of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues wrote. “A comprehensive assessment of changes in deaths from excessive alcohol use that includes conditions that are fully and partially attributable to alcohol can guide the rationale for and implementation of effective prevention strategies.” Read more.
Annual cost of alcohol-associated liver disease projected to reach $66B by 2040
Researchers have estimated that annual costs associated with alcohol-associated liver disease will climb from $31 billion in 2022 to $66 billion in 2040 — a 118% increase — with costs among women accounting for 43% of the total expenditure.
“With alcohol-associated mortality rising over the previous decades and significant consumption increases during the COVID-19 pandemic, the economic burden of ALDs can be expected to grow,” Jovan Julien, PhD, a postdoctoral fellow at Massachusetts General Hospital Institute for Technology Assessment, and colleagues wrote in American Journal of Gastroenterology. “Although economic burden has begun to be studied, current economic losses are unavailable. In addition, future trends in economic burden have yet to be fully evaluated.” Read more.
Nearly 90% of liver transplant center websites still use alcohol-stigmatizing language
A “vast majority” of liver transplant centers use stigmatizing language, such as “alcoholic” or “alcohol abuse,” when describing patients with alcohol use disorder and alcohol-associated liver disease on their websites, researchers reported.
“Our team embarked on this investigation driven by both professional observations and personal experiences in the field of liver transplantation, particularly at a time when alcohol-associated liver disease (ALD) has become the leading indication for liver transplants,” Wei Zhang, MD, PhD, director of the Alcohol-Associated Liver Disease Clinic and transplant hepatologist at Massachusetts General Hospital, told Healio. “Despite this, the pervasive stigma surrounding ALD significantly hinders many patients’ ability to receive a lifesaving transplant.” Read more.
Threefold higher rate of cirrhosis, HCC linked to alcohol overconsumption in MASLD
Around 17% of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) have or will be diagnosed with alcohol-related disease, which research shows is associated with a threefold higher rate of developing cirrhosis or cancer.
“For the diagnosis of MASLD, one must exclude alcohol overconsumption as an etiology,” Patrik Nasr, MD, PhD, adjunct associate professor in the division of diagnostics and specialist medicine at Linköping University, and colleagues wrote in Clinical Gastroenterology and Hepatology. “However, recent studies have highlighted that undisclosed alcohol consumption may be more common than previously considered. ... How common this is in real-life practice and the impact such misclassification might have on prognosis is unknown.” Read more.
Pre-pandemic ED visits for alcohol-related hepatitis rose by 4.4% among younger patients
An analysis of ED utilization from 2016 to 2019 revealed an increase in visits for alcohol-associated hepatitis, particularly among patients aged 25 to 44 years, as well as an increase in disease severity.
“Alcohol-associated hepatitis (AH) is the most severe form of liver disease on the spectrum of ALD with high short- and long-term mortality and morbidity,” Shreya Sengupta, MD, of the department of gastroenterology, hepatology & nutrition at the Cleveland Clinic, and colleagues wrote in Alcohol Clinical & Experimental. “Several studies have shown an increase in prevalence of ALD and AH in the U.S., U.K. and Canada, with 0.83% of all hospital admissions in the U.S. related to AH.” Read more.
Early intervention critical, before ‘significant clinical toll’ from excessive alcohol use
Alcohol use disorder has a huge impact on liver health. Regardless of whether patients have other primary etiology for liver disease, alcohol — even in minimal amounts — can worsen liver outcomes.
In 2011, hepatitis C virus infection was the most common indication for liver transplantation, accounting for nearly 25% of all transplants done in the U.S. However, since the advent of highly effective direct acting antivirals, HCV as the primary indication for LT dropped to 5% in 2021. Instead, ALD has quickly become the dominant reason for patients needing LT, accounting for nearly 40% of all transplants in 2021. Read more.
Women with concurrent MASLD, alcohol-related liver disease have 83% higher risk for death
Women with concurrent MASLD and alcohol-related liver disease had an 83% greater risk for all-cause mortality than men and those with ALD alone had 160% greater risk, data showed.
“Steatotic liver disease is a major and increasingly prevalent condition that is likely an underlying precursor to many conditions, including those involving the heart,” Susan Cheng, MD, MPH, lead study author and director of the Institute for Research on Healthy Aging at Smidt Heart Institute, said in a Cedars-Sinai press release. “We are paying even more attention to steatotic liver disease because we are seeing how it tracks closely with established cardiovascular risk factors such as hypertension, high cholesterol and diabetes.” Read more.
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 ALD.
“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.
References:
- NIAAA. April is Alcohol Awareness Month. https://www.niaaa.nih.gov/news-events/announcement/april-alcohol-awareness-month#:~:text=April%20is%20Alcohol%20Awareness%20Month%2C%20an%20opportunity%20to%20update%20your,individuals%2C%20families%2C%20and%20communities. Published March 27, 2024. Accessed April 3, 2024.
- Alcohol Awareness Month: Raising Awareness about the Dangers of Alcohol Use Among Teens. https://www.niaaa.nih.gov/about-niaaa/directors-page/niaaa-directors-blog/alcohol-awareness-month-raising-awareness-about-dangers-alcohol-use-among-teens. Published March 27, 2024. Accessed April 15, 2024.
- NIAAA. Alcohol and the Human Body. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-and-human-body. Accessed April 3, 2024.
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