Doctors say excessive drinking during the COVID-19 pandemic is leading to a spike in alcohol-related liver disease and the need for transplants.
Transplant centers across the United States are reporting that more patients are in need of new livers than ever before, sometimes twice as many as before the pandemic.
In fact, alcohol-related liver disease has surpassed other conditions such as hepatitis C and fatty liver disease as the leading cause of liver transplantation.
Demographics have also changed. Historically, patients requiring liver transplantation have been older men in their 60s. Now, patients who need transplants are typically in their 20s and 30s, and the number of women needing transplants has increased.
Doctors tell ABC News it’s yet another unintended consequence of the COVID-19 pandemic, and they want to reduce the stigma so patients feel supported when getting the help they need.
“A nationwide phenomenon”
“This is a nationwide phenomenon that has seen a significant increase in alcohol consumption since the pandemic, including harmful drinking related to liver disease, which has led to an increase in hospitalizations of patients with alcohol-related liver injury,” said Dr. Penn Liver Transplant Medicine said director Marouf Hotet.
“A subset of these patients do have advanced liver damage, and we cannot improve liver function with drug therapy alone,” he continued. “So this has really led to an increase in referrals for liver transplantation in patients with alcohol (related) liver disease, especially since the pandemic.”
At University of Colorado Health University Hospital, about 40% of patients screened weekly for alcoholic liver disease needed a transplant before the pandemic. Currently, 80% to 90% of patients with alcohol-assisted liver disease who are screened weekly require a transplant.
Dr. Elizabeth Pomfret, chief of surgery at the hospital, said this is the highest number of patients with alcohol-related liver disease needing transplants she has ever seen in her career.
Traditionally, patients with liver disease due to alcoholism had to abstain from alcohol for a period of time and undergo professional counseling before they could be considered suitable candidates for a liver transplant, she added. However, patients often seek help when their condition is already severe.
“What we saw during COVID-19 and subsequently is that these patients are often so ill that they don’t have time for counseling and abstinence,” she said. “They do have life-threatening disease and if they don’t get a transplant, they will It’s impossible to survive, so we have to completely change the way we approach things.”
That means quickly getting patients on the transplant list and working with experts in addiction medicine, inpatient rehabilitation, outpatient rehabilitation, psychiatry and social work to address their severe alcohol abuse.
“Centers, including ours, are more willing than ever to accept patients for transplant who have a recent history of alcohol consumption,” Dr. Robert Cannon, chief of liver transplant surgery at the University of Alabama at Birmingham, told ABC. news. “Ten years ago, no one would transplant patients if they had consumed alcohol within the past six months. Now, more than 85 percent of centers will transplant patients who have recently consumed alcohol.”
Why drinking is on the rise
Doctors say there are many reasons why the pandemic may be causing Americans to drink more.
Hotett said the coronavirus-related stress many people are experiencing — including fear of contracting the virus and financial pressures — and being quarantined may lead to increased drinking.
Another reason, Pomfret said, is that drinking culture has changed during the pandemic, making drinking outside of evenings or weekends normal.
“There’s also a culture of coping with things by doing Zoom cocktail hours and Zoom cooking classes…so I think people in general often find that they’re drinking a lot more than they normally would,” she said. “They might drink during the work day, but they generally don’t do that.”
The stigma of alcohol-related liver disease
A woman in her 30s who received a transplant at UC Health and asked to remain anonymous told ABC News that she had been drinking in the months before the pandemic, but that after the lockdowns happened, she felt Easier to accept.
“Drinking was more acceptable and more socially acceptable at the time,” she said. “Drinking… would be a distraction. It would be a fun thing to do… and I was sad and I only drank when I was sad. I was self-medicating.”
She said she stopped drinking in early 2021 and began seeking help from a therapist.
However, she started to get sick after she stopped drinking and continued to do so for several months until she was transferred to UCHealth in November 2021, where she was diagnosed with liver cancer about a month later. She received a liver transplant in December 2022.
“It’s intimidating. Having to admit a mistake, having to own something that you’re embarrassed and ashamed of,” she said. “But I never felt judged when I was there, which is important, and it was that non-judgmental attitude… that helped me stay on the right path and helped me realize that other people believed in me that I couldn’t Tell you how much “you have helped in my recovery. “
Doctors say there is a stigma for patients with liver disease caused by drinking, which may prevent some from seeking help for fear of being stigmatized.
“I think we’ve learned and realized that alcohol use disorder is a disease, just like cancer or any other disease, that it’s treatable and trying to move away from concerns about ethics,” Cannon said. “Efforts to reduce That stigma goes a long way toward getting patients into treatment and getting them to help.”
Another challenge, Hoteit added, is the lack of mental health resources and substance abuse assistance resources to get patients the help they need.
“Everyone deserves a second chance,” he said. “If we get rid of the stigma and focus on actually addressing this issue as a health care issue, it’s possible to help more patients.”