Doctors at the University of Southampton have found that most patients with severe alcohol-induced liver disease do not have a dependence on alcohol, as generally previously believed. These findings are at odds with current strategies to combat the increase in alcohol related deaths which are targeted at those with alcohol dependency. Alcoholism disease.
In a study of thirty four patients with severe ALD (Alcohol-Induced Liver Disease), the team found that only 9 per cent showed evidence of severe alcohol dependence. They were more likely to be employed, married or in a stable relationship, and to drink with family, friends or work colleagues - a pattern which often escalated into heavy drinking.
This compared with the control group of thirty four patients known to have alcohol dependence, who were more likely to drink alone, to be unemployed and unattached. The trigger for heavy drinking was likely to be a traumatic event and/or depression.
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"The majority of patients presenting with alcoholic liver disease appear to be heavy controlled or social drinkers, leading relatively controlled lives, perhaps not feeling that their drinking is a major health issue until they are diagnosed with end-stage liver disease, at which point the liver has been damaged to the extent that only 30 per cent will be long term survivors. Alternatively, if drinking spirals out of control as a result of dependence, subjects are more likely to seek treatment at an earlier stage, and therefore survive for longer." said Dr Nick Sheron, consultant hepatologist and senior lecturer at the University of Southampton.
"The high mortality from severe ALD at first presentation means that there are limited options for reducing deaths. The current government focus on binge drinking and on alcohol dependency will miss many patients who will later die from ALD. The documented rise in liver deaths so far is very worrying but does not include the impact of more recent changes in drinking patterns, particularly in women. Unless something is done fairly urgently, we predict a continued rise in deaths from ALD over the next 10 years, most particularly in young and middle aged women," concludes Dr Sheron.
Professor Ian Gilmore, Chairman of the Royal College of Physicians' Alcohol Committee said: "The Royal College of Physicians welcomes this important piece of research which dispels the myth that all patients with alcoholic liver disease are alcoholics or dependent drinkers. Because alcoholic cirrhosis is such a silent killer, the first signs may come when it is already too late. This emphasises the importance of early detection of problem drinkers in the NHS and the availability of advice and support to help people cut down on their drinking."