‘Alcogenic society’: Australian hospitals see steep rise in severe alcohol-related disease

One quarter of intensive care resources in a major regional tertiary hospital have been used to treat critical illness directly related to alcohol consumption, a Queensland physician claims.

The intensive care physician told Guardian Australia he was alarmed at the steep rise in cases of severe, end-stage alcohol-related disease he has seen “in just a couple of years” at the hospital.

“I have never seen so many jaundiced and confused 40 and 50-year-olds dying of liver failure,” he said.

Alcoholic liver disease usually develops in severity over time in those who continuously drink. Acute alcoholic hepatitis can develop suddenly, causing liver failure and death.

“For the past 12 months, the occupancy of ICU resources attributable to direct alcohol related critical illness is, at times, using up 25% of available resources,” the physician, who did not wish to be named, said.

“That means a quarter of a tertiary teaching hospital ICU bed spaces, ventilators and life supports are being used by patients with alcohol-related illness including alcohol-related trauma and violence, self-poisoning including alcohol ingestion, chronic liver disease, pancreatitis, bleeding, and seizures. This is about 10 times the critical care burden attributable to Covid, on average, over the last three years at the hospital.”

He said other hospitals were also experiencing a similar burden. During the third Covid wave in 2021, a peak of 195 intensive care unit beds in Australia were being used by Covid patients, compared with 38 cases in intensive care beds on 25 October 2022.

“Alcohol-related critical illness is about 10% of ICU beds on average, year in year out, or about 200 ICU beds occupied beds every day,” he said. “Occasionally, it peaks at 25% in a single hospital on a given day, and some places like Alice Springs have a very high amount most days.”

The physician said he felt compelled to speak out after the release of Australian Bureau of Statistics deaths data on Thursday which revealed alcohol-induced deaths are at their highest rate in 10 years. These deaths are being driven by conditions that can be caused by long-term drinking such as trauma, late-stage liver disease, neurodegenerative diseases and heart failure.

Alcohol-induced deaths in the ABS data are those definitively caused by excessive alcohol use, and do not include deaths that are alcohol-related, such as in cases where alcohol is a contributing factor but not the only factor.

There is a perception that serious alcohol disease does not develop until after 70, the physician said.

“But it takes you out well before that,” he told Guardian Australia.

“We’re seeing people younger than 60 who drink heavily, and perhaps without noticing they have gone from ‘functioning’ to experiencing symptoms which will baffle them. They have fewer friends, and they get socially isolated. There are fewer breaks in their drinking, they become more prone to getting infections and trauma. They go from having cirrhosis [liver scarring] to liver failure.”

He said that the social effects of Covid, that led to some people increasing their drinking, was one factor driving serious illness. He was also concerned about online deliveries that bring alcohol at any time of day, and loyalty programs that target people with advertising and rewards for buying alcohol, which he said “are very effective and make this an increasing problem”.

On Monday, a perspective written by public health researchers and published in the Medical Journal of Australia, described how Australian women age 45 to 64 are drinking more alcohol than ever before, “… more than previous generations of women in this stage of life, and more than any other age group of women currently,” the authors wrote.

“Alcohol, combined with their age, puts midlife women at increased risk of breast cancer.” Breast cancer was the most common cancer affecting women in Australia, with alcohol accounting for 10% of diagnoses, they wrote.

“We live in an ‘alcogenic’ society in Australia where alcohol is everywhere,” the piece said.

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