More bad booze news: Liver disease deaths are rising, especially among young

livercancer-300x173Summer tipplers may want to steer away from that second glass of  sangria, or rethink that next round of beers.  That’s because there’s yet more bad news about Americans and booze abuse: Liver disease deaths are spiking, with fatalities tied to cirrhosis jumping by 65 percent between 1999 and 2016, while those connected with liver cancer doubled in the same time span.

Americans 25- to 34-years-old saw the steepest increases in alcohol-related liver disease, with the number of annual deaths in seven years, as studied by Michigan experts, nearly tripling.

“Alcohol misuse and its complications” is striking down a new generation of Americans, Elliot Tapper, a University of Michigan liver expert and lead author of a newly published study on liver cancer, told the Washington Post.

The work by Tapper and Neehar D Parikh of the VA Ann Arbor Healthcare System concurred with grim data just published by the federal Centers for Disease Control and Prevention (see graphic above) showing:

Age-adjusted death rates for liver cancer increased during 2000–2016 for non-Hispanic white, non-Hispanic black, and Hispanic adults but decreased for non-Hispanic Asian or Pacific Islander adults. Death rates for liver cancer increased from 2000 through 2016 for age groups 65–74 and 75 and over. In 2016, the District of Columbia had the highest age-adjusted liver cancer death rate …

The CDC also reported that:

Liver cancer (including intrahepatic bile duct cancer) was the ninth leading cause of cancer death in 2000 and rose to sixth in 2016. Although death rates for all cancer combined have declined since 1990, a recent report documented an increasing trend in liver cancer death rates during 1990–2014.

Tapper and other experts quoted in media reports blamed rising liver illness, particularly among younger Americans, on alcohol abuse, notably drinking to deal with despair over economic issues and a seeming lack of opportunity, some of this related to the Great Recession. This theory is rooted in drinking and liver disease starting to spike in 2009, as jobs and the economy plummeted.

But as the New York times noted, “Cirrhosis, irreversible scarring of the liver, has many causes, including alcohol consumption, obesity, nonalcoholic fatty liver disease and hepatitis. Cirrhosis can lead to liver cancer and liver failure, both of which can be fatal.”

Obesity, the CDC says, afflicts 39.8 percent or more than 93 million Americans, while thousands annually get infected with hepatitis in it’s various forms, including the A type (~4,000 cases annually), B form (~3,000 cases), and C variety (~3,000 cases).

Public health officials have warned for some time that American’s cannot ignore alcohol’s harms, even as the nation struggles with crises involving opioids and other addictive and destructive drugs. A recent study found that Americans’ overall drinking increased by 11 percent between 2002-2013, with roughly 75 percent of all respondents reporting that they had consumed alcohol within the last year. It jumped 30 percent for Asian Americans and 22.4 percent for seniors.

Experts called the sharp increase in liver disease deaths among younger Americans startling and disturbing. This has not become a major source of mortality among those ages 25 to 34, increasing in actual number from 259 deaths in 1999 to 767 in 2016. But the annual percentage spike and the overall rate rise distressed experts, who also noted that treating young patients who succumb to liver diseases is an unhappy, unpleasant experience for all.

In my practice, I see the harms that patients suffer while seeking medical services, as well as the damage that can be inflicted on them when they’re involved in alcohol-related vehicle and motorcycle wrecks. After years of declining, deaths and injuries on the nation’s roads and highways have increased sharply. The esteemed National Academies of Sciences, Engineering, and Medicine studied the 10,000 deaths per year attributed to alcohol impairment and motoring. The experts called these road fatalities, which are increasing in number, “entirely preventable,” and recommended tough ways to reduce booze-related deaths. They have recommended that a new national sobriety standard should be put in place.

The National Institutes of Health recently saw its prestige, credibility, and integrity damaged when it agreed to launch a $100-million study on alcohol and its harms, a work that started with an unsupported tilt toward seeing moderate consumption as beneficial. Later, the New York Times showed that the proposed 10-year, randomized clinical trial that aimed to recruit 7,800 participants at 16 sites around the world, had been unduly and inappropriately shaped and funded by the alcohol industry.

The agency, as critics have noted, pulled out of the controversial research but it hasn’t gotten its act together sufficiently to provide clearer, more evidence-based counsel to the taxpaying public about booze use. As one website described the argument by a behavioral scientist about drinking: “Alcohol’s health benefits hard to prove, but harms are easy to document.”

To be sure, America experimented once — unsuccessfully — with blue-nosed Prohibition and trying to cut out all alcohol consumption. That doesn’t mean that as individuals, especially as parents, adults, and role models, we can’t all look at ourselves in the mirror and dry up a lot. We could change and save lives in doing so, especially if we ensure that young people get habituated from the get go to forego drinking and driving.

If you need further persuasion, read the accounts by Tapper and other specialists who treat youthful alcohol abusers who abruptly discover they’ve got advanced liver disease and face a tortuous end, no matter medicine’s many advances in treating cancer.

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