Chronic heavy alcohol consumption may result in ARLD, which is a major cause of advanced liver disease and liver-related mortality worldwide.[1]Jophlin LL, Singal AK, Bataller R, et al. ACG clinical guideline: alcohol-associated liver disease. Am J Gastroenterol. 2024 Jan 1;119(1):30-54.
https://journals.lww.com/ajg/fulltext/2024/01000/acg_clinical_guideline__alcohol_associated_liver.13.aspx
http://www.ncbi.nlm.nih.gov/pubmed/38174913?tool=bestpractice.com
According to the Centers for Disease Control and Prevention, in the US, around 17% adults binge drink (have four or more drinks [women] or five or more drinks [men] on an occasion) and around 6% adults drink heavily (have eight or more drinks [women] or 15 or more drinks [men] in a week).[2]Centers for Disease Control and Prevention. Alcohol use. [internet publication].
https://www.cdc.gov/alcohol/index.html
Chronic alcohol consumption is a significant cause of mortality, morbidity, and social problems, and accounted for approximately 2.6 million deaths worldwide in 2019.[3]Axley PD, Richardson CT, Singal AK. Epidemiology of alcohol consumption and societal burden of alcoholism and alcoholic liver disease. Clin Liver Dis. 2019 Feb;23(1):39-50.
http://www.ncbi.nlm.nih.gov/pubmed/30454831?tool=bestpractice.com
[4]World Health Organization. Fact sheet: alcohol. Jun 2024 [internet publication].
https://www.who.int/news-room/fact-sheets/detail/alcohol
In 2020-2021, excess alcohol consumption led to approximately 178,000 deaths and reduced the average lifespan by 24 years.[2]Centers for Disease Control and Prevention. Alcohol use. [internet publication].
https://www.cdc.gov/alcohol/index.html
An increase in ARLD prevalence has been noted since 2014, with an accelerated increase observed during the COVID-19 pandemic.[1]Jophlin LL, Singal AK, Bataller R, et al. ACG clinical guideline: alcohol-associated liver disease. Am J Gastroenterol. 2024 Jan 1;119(1):30-54.
https://journals.lww.com/ajg/fulltext/2024/01000/acg_clinical_guideline__alcohol_associated_liver.13.aspx
http://www.ncbi.nlm.nih.gov/pubmed/38174913?tool=bestpractice.com
The highest increase in prevalence of alcohol use disorder and ARLD was noted in younger adults, women, and minorities.[1]Jophlin LL, Singal AK, Bataller R, et al. ACG clinical guideline: alcohol-associated liver disease. Am J Gastroenterol. 2024 Jan 1;119(1):30-54.
https://journals.lww.com/ajg/fulltext/2024/01000/acg_clinical_guideline__alcohol_associated_liver.13.aspx
http://www.ncbi.nlm.nih.gov/pubmed/38174913?tool=bestpractice.com
One US modelling study of high-risk alcohol drinking patterns suggests that age-standardised deaths due to ARLD are expected to increase from 8.2 per 100,000 person-years in 2019 to 15.2 per 100,000 person-years in 2040.[5]Julien J, Ayer T, Bethea ED, et al. Projected prevalence and mortality associated with alcohol-related liver disease in the USA, 2019-40: a modelling study. Lancet Public Health. 2020 Jun;5(6):e316-23.
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30062-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/32504584?tool=bestpractice.com
In 2022, the US National Survey on Drug Use and Health reported that 28.1 million adults aged ≥18 years (10.9% of this age group) had alcohol use disorder.[6]Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2018 national survey on drug use and health. 2019 [internet publication].
https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
[7]National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. Alcohol facts and statistics. Jun 2024 [internet publication].
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Of these, 16.6 million were men (13.2% of men in this age group).[6]Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2018 national survey on drug use and health. 2019 [internet publication].
https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
[7]National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. Alcohol facts and statistics. Jun 2024 [internet publication].
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
In the UK, in 2022, 50.3 hospital admissions per 100,000 population (27,419 admissions) for ARLD were reported, which is 65% higher than those reported in 2012 (16,571 admissions).[8]Office for Health Improvement & Disparities. Liver disease profiles, July 2023 update. Jul 2023 [internet publication].
https://www.gov.uk/government/statistics/liver-disease-profiles-july-2023-update/liver-disease-profiles-july-2023-update
In England, in 2020, liver disease and liver cancer together caused 2.5% of deaths; almost half of these deaths occurred in those of working age (aged 15-64 years).[9]Office for Health Improvement & Disparities. Liver disease: applying all our health. May 2022 [internet publication].
https://www.gov.uk/government/publications/liver-disease-applying-all-our-health/liver-disease-applying-all-our-health
ARLD alone caused more than 50,000 years-of-life lost in 2020. Mortality rates for ARLD in people aged <75 years have increased by almost 45% between 2001 and 2020.[9]Office for Health Improvement & Disparities. Liver disease: applying all our health. May 2022 [internet publication].
https://www.gov.uk/government/publications/liver-disease-applying-all-our-health/liver-disease-applying-all-our-health
One systematic review and meta-analysis found that the prevalence of ARLD and proportions of alcohol-attributable cirrhosis and hepatocellular carcinoma are lower in Asia, compared with western countries.[10]Xu H, Xiao P, Zhang F, et al. Epidemic characteristics of alcohol-related liver disease in Asia from 2000 to 2020: a systematic review and meta-analysis. Liver Int. 2022 Aug;42(9):1991-98.
https://onlinelibrary.wiley.com/doi/10.1111/liv.15312
http://www.ncbi.nlm.nih.gov/pubmed/35593004?tool=bestpractice.com
Alcohol-related hepatitis is a less common stage of ARLD having high mortality, with population level estimates of annual incidence at 25-45 per 100,000 person-years.[11]Thursz M, Lingford-Hughes A. Advances in the understanding and management of alcohol-related liver disease. BMJ. 2023 Nov 20;383:e077090.
https://www.bmj.com/content/383/bmj-2023-077090.long
http://www.ncbi.nlm.nih.gov/pubmed/37984967?tool=bestpractice.com