Alcohol-related liver problems escalate in Wisconsin, especially for women, young people

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Deaths from liver diseases that result from consuming too much alcohol are escalating dramatically in Wisconsin, and even more alarming, such diseases are showing up more in younger people.
The numbers mirror national trends described in a June 11 study in JAMA Open Network, which found a "significant acceleration" in alcohol-associated liver disease deaths during and after the COVID-19 pandemic. Nationwide, such deaths increased nearly 9% annually between 2018 and 2022.
In Wisconsin, deaths from cirrhosis of the liver — one of several liver diseases tied to alcohol consumption — rose 35% between 2019 and 2023, according to data from the Centers for Disease Control and Prevention.
It's well-documented that Americans began drinking more during the pandemic, and coupled with Wisconsin's deeply entrenched drinking culture, experts worry about the toll they're seeing on people's physical health. Alcohol-related deaths generally, which include myriad other causes besides liver problems, increased three-fold in Wisconsin between 1999 and 2020, a January analysis from the Journal Sentinel found.
But experts say multidisciplinary treatment, reduced stigma around alcohol use disorder, and a renewed emphasis on education and prevention could improve the situation.
"I think the narrative often in Wisconsin is just, 'Oh, we're just big drinkers,' and that's all there is," said Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin. "The message is not that you can't drink at all. It's more, really think about it, and just drink less."
More: Wisconsin's alcohol-related deaths more than tripled since 1999: See the data
U.S. dietary guidelines for alcohol urge people of drinking age to limit consumption to one drink or fewer per day for women and two drinks or fewer per day for men.
When people consume significant amounts of alcohol over a prolonged period of time, fat begins to turn up in the liver, and then scar tissue, which can lead to cirrhosis, said Dr. Rita German, a transplant hepatologist at UW Health in Madison. Many times, German said, liver disease symptoms such as jaundice, fever and confusion don't show themselves until the disease has progressed, making it harder to treat.
Nearly 3,000 Wisconsinites died from alcohol-related liver diseases from 2019 to 2023, CDC data show. The large majority — 2,072 — were from cirrhosis.
Deaths from most types of liver diseases due to alcohol consumption increased in those years, including alcoholic fatty liver and alcoholic hepatic failure in addition to cirrhosis. Deaths from alcoholic hepatitis fell slightly.
Busalacchi called the numbers a huge concern. Most of these deaths are preventable, she contended.
Doctors used to think of alcohol-related liver diseases as affecting people past middle age, German said. But increasingly, that age is dropping. At UW Health's multidisciplinary clinic for patients with such diseases, she said, the average age is now 45, and she's treated some as young as 25.
More: Alcohol-related deaths in Wisconsin tripled since 1999. Will a new warning from the surgeon general slow the trend?
That may seem to conflict with recent research showing young people, particularly Gen Z, drinking less. But while some are cutting back, those who do drink are drinking more heavily, Busalacchi said. And while alcohol use among Wisconsin high schoolers has generally decreased in recent years, more than one in 10 reported binge drinking in the last 30 days on the state's most recent Youth Risk Behavior Survey, done in 2023.
The JAMA study noted, in particular, increases in alcohol-related liver disease deaths among adults ages 25-44. Deaths among women also increased disproportionately. Women absorb more alcohol into their bloodstream because they're generally smaller than men and because women's bodies have less gastric alcohol dehydrogenase, the enzyme that breaks down alcohol in the stomach, German said. Thus, they're at greater risk for liver damage.
The Medical College of Wisconsin's liver transplant team reports younger and younger women needing transplants due to alcohol consumption, Busalacchi said.
More: US to drop guidance to limit alcohol to one or two drinks per day, sources say
To catch alcohol-related liver diseases earlier, German said, it's critical that patients be forthcoming about their alcohol use at the doctor's office. And for that to happen, she said, doctors must view alcohol use disorder for what it is — a disease, not a personal failing.
People who are concerned about their alcohol consumption may also request an ultrasound of their liver, German said. From there, they can begin treatment if need be.
She also sees the benefits in treatment that is comprehensive. At UW Health's clinic, patients not only see doctors like German who attend to the liver, but addiction specialists and counselors to treat underlying mental health conditions that can drive alcohol use. The clinic has treated between 250 and 300 people since it began in 2021.
If it's caught in time, fat and scarring in the liver can be reversed by abstaining from alcohol, German said.
Busalacchi's work continues to focus on changing societal perceptions on drinking culture. She sees encouraging signs around the state from communities that are offering more education about the consequences of excessive drinking, especially for youth. Some are taking a harder stance on age compliance checks for alcohol sales.
Madeline Heim covers health and the environment for the Milwaukee Journal Sentinel. Contact her at 920-996-7266 or [e-mail].
This article originally appeared on Milwaukee Journal Sentinel: Wisconsin deaths from alcohol-related liver diseases sharply rise