Alcoholic liver disease is increasing among young people, especially women


When Austin Johnson was 29 years old, his liver was so damaged from excessive alcohol consumption that his doctors feared he would die.

For years, he had been saving almost an entire bottle of alcohol each night to calm his emotional distress. Everything in her life revolved around drink.

“It was normal for me to come home from work, get drunk, call my friends drunk, play video games drunk,” said Johnson, now 33. “It was to the point where he would fall asleep with the bottle in his hand. The pain literally went away when I had enough to drink.»

Then he started to feel sick, and not just because of the hangover. She was vomiting profusely and coughing up blood, the first signs of liver damage. Her doctor did blood tests on her and the results were terrifying.

“They said, ‘How do you keep walking? You have to go to an emergency room right now,’” Johnson recalled.

Austin Johnson in August 2019 when his eyes and skin turned yellow due to liver disease caused by years of heavy drinking.Courtesy of Austin Johnson

Cirrhosis, or severe liver disease, used to be something that mainly affected people who were middle-aged or older. Increasingly, alcohol-related liver disease is killing younger people in the US.

Johnson is part of a disturbing trend of men and women ages 25 to 34 experiencing serious, and sometimes fatal, liver damage related to their alcohol use. A study 2018 reported that between 2009 and 2016, deaths attributed to alcohol-related cirrhosis (scarring of the organ that can lead to its failure over time) had risen steadily, with the rise steepest among those in that age group.

The pandemic made it 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 study. report published March 2022 in Clinical Gastroenterology and Hepatology.

Again, there was a sharp increase among young adults, ages 25-34, especially among women.

Mortality rates increased each year for both sexes. While more men were still dying than women, the annual death rate was rising faster for women (37%) than for men (29%), according to the report, which drew data from the Centers for Disease Control and Prevention 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 the drinks have become more potent and people are «drinking more per unit volume,» Dr. Elliot Tapper, an expert in liver disease and a gastroenterology specialist at the University School of Medicine, told NBC News. of Michigan in Ann Arbor.

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

«We’re definitely seeing younger and younger patients coming in with what we previously thought was advanced liver disease seen in middle-aged patients, in their 50s and 60s,» Mellinger said.

Since 2018, Mellinger and the physicians in the Michigan Alcohol Improvement program have provided psychiatrists and addiction specialists to patients with liver disease. Early research from the clinic suggests that this approach is successful in preventing relapse.

“We show that health care utilization, how much [patients] were admitted to the hospital, how much they use the emergency room, all went down” between the six months before patients arrived at the program and the six months afterward, says Dr. Scott Winder, a program psychiatrist and an associate professor at the University . from the Michigan Medical School.

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 show that health care utilization, how much [patients] they went into the hospital, 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 see a psychiatrist, addiction specialist and liver specialist can make patients more motivated.

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

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

For example, the message to quit smoking becomes more powerful when a person is «shown scans of their liver,» he said. “It’s more motivating because it’s more tangible than saying in a vague way, if you quit smoking, 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 transplant.

“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 Institute for Surgery and Digestive Diseases.

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

Johnson has stopped drinking and is hopeful for a healthier future. The yellow color in his skin and eyes-a symptom of severe liver disease – it has disappeared.

«Either you’re going to be underground or you can do something about it,» he said. “They guided me on the right path to take the steps in my recovery.”

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