Binge drinking and rising liver disease in young folks

https://www.yalemedicine.org/stories/alcohol-liver/?utm_source=YaleToday&utm_medium=Email&utm_campaign=YT_Yale%20Today%20Alum%20no%20Parents_11-10-2020

Excerpt: For a young person who likes a busy social life, the COVID-19 pandemic has changed many things. But one thing that doesn’t seem to have changed much is the allure of alcohol, which—if anything—seems to have intensified. Bars and parties may no longer be an option, but there are Zoom happy hours, socially distanced gatherings, couple-time cocktails, or even drinking alone, all of which can lead to serious consequences—including liver disease, which doctors say is rising in younger people.

Albert Do, MD, clinical director of the Yale Medicine Fatty Liver Disease Program, reports that he regularly sees young patients with cirrhosis, which is the medical diagnosis for late-stage liver scarring caused by excessive use of alcohol. “The scary thing is that they're only in their 30s and 40s,” he says, noting that the chances of developing liver disease go up the longer a person has been drinking and is most common between the ages of 40 and 50. Other Yale Medicine doctors have diagnosed people with liver disease when they are still in their 20s.

It’s not only a worrisome development, but also perhaps a surprising one, given that the latest information shows that millennials (born 1981 to 1996) and Gen Zers (born 1997 to present) are drinking less than the generations before them—in fact, surveys show alcohol use has dropped steeply in these groups since the 1990s. But other studies show that deaths from alcohol-driven liver disease are highest among millennials: A study published in 2018 showed liver-related deaths rose 10% a year among those ages 25 to 35, while deaths from liver cancer doubled in this group. 

“The overall decrease in drinking is a big plus, but it doesn’t tell the whole story because drinking in young people can still be quite problematic,” says Federico Vaca, MD, MPH, a Yale New Haven Hospital emergency medicine physician and researcher.

Often, Dr. Vaca sees young people arrive in the emergency department (ED) seriously intoxicated—some who are so drunk they can barely walk or talk, he says. These young patients may or may not have a chronic alcohol use disorder [commonly known as alcoholism], he says.

What concerns him is that they are often seeking acute treatment in the ED after an episode of “binge drinking,” or even worse, “extreme binge drinking,” which carries a considerable risk for life-threatening alcohol poisoning. Binge drinking is most common among younger adults aged 18–34 years, according to the Centers for Disease Control and Prevention (CDC), and most people younger than 21 who drink have reported binge drinking as well.