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Dr. Elizabeth Pomfret, chief of the division of transplant surgery at UCHealth, has seen a lot of liquor-addled livers during her 33-year career. In the past, most of them belonged to patients in their late 50s or 60s who had permanently scarred the organ after years of heavy drinking. Recently, however, Pomfret’s patients are trending younger. Decades younger.
The culprit? COVID-19 culture, which normalized daytime boozing to cope with the anxiety that accompanied the pandemic. Imagine, Pomfret says, a mom who suddenly finds herself responsible for not only her career and personal life but also her children’s educations—all under the pressing uncertainty of isolation. It’s not surprising that she seeks to unwind with a bottle of wine, especially when she sees everyone else doing the same thing online. “Often,” Pomfret says, “the family wasn’t aware that the person was drinking like that.”
The stats back her up: In 2020, Colorado’s alcohol tax revenue jumped by 12 percent, and from 2019 to 2022, the state’s DUI-related deaths shot up by 62.5 percent. Data presented at the 2022 American Association for the Study of Liver Diseases conference ranks Colorado among the top six states for Alcohol-related Liver Disease (ARLD) mortality. Nationally, the ARLD mortality rate climbed by more than 17 percent yearly from 2019 to 2021, dwarfing the 3.5 percent annual increase during the previous decade. People between the ages of 25 and 44 experienced the sharpest rise.
Consequently, transplant needs due to ARLD have grown exponentially since the early days of COVID-19, Pomfret says, and the demand is creating a supply issue (currently, 172 people are waiting for a new liver in Colorado). On the plus side, livers, like kidneys, can come from both deceased and living donors, but the latter face inherent surgical risk, large incisions, and lengthy recovery times. Pomfret and her team recently performed Colorado’s first robotic living donor liver operation, a more precise procedure that results in less recovery time for the donor, hopefully bolstering supply in coming years.
In the meantime, the surge of acute ARLD has forced a change in the dynamic of care: Rehab, social support, and abstinence used to be required criteria to even get on the transplant waitlist. Now, patients are arriving too ill to wait. “How do we build [these treatments] on the back end now and get these people the support they need?” Pomfret says. “It’s really put an enormous burden on the health care system.”
Tips to Prevent Alcohol-Related Liver Disease
We spoke with Dr. Vanessa Rollins, a UCHealth psychologist, to discover how to protect your liver and curb your drinking.
1. Assess your intake: Begin by taking the Alcohol Use Disorders Identification Test (AUDIT), a screening tool created by the World Health Organization that’s available online. If you score an eight or above, Rollins suggests seeking care at an addiction treatment center.
2. Start counting: If you pass the AUDIT but have more than 14 drinks a week for men and seven for women, you fail the U.S. Centers for Disease Control and Prevention guidelines for alcohol consumption. Booze is never good for you, but this level of consumption is associated with more health risks, such as cirrhosis.
3. Try going without: Dry January has become a popular trend in recent years, but you don’t have to wait until the New Year to take 31 days off the sauce. By the end of the month, Rollins says, your mood, energy, and sleep habits are likely to improve, while studies have shown that Dry January participants drink less than their counterparts over the long term.
4. Have a strategy: In social situations, decide in advance to alternate between alcohol and soda, or maybe replace some beers with nonalcoholic varieties. Whatever scheme you employ, start keeping a diary of your drinking so you can keep track of your progress (or lack thereof).
5. Seek outside help: Rollins suggests enlisting online aid for additional support. The website of the national nonprofit Moderation Management features 31 “tools” to help you, such as buddying up with another risky drinker who wants to cut back.