“I think what we saw was the tip of the iceberg,” said Dr. Christina Waite, medical director for psychiatry at Premier Health’s Miami Valley Hospital. “I think there’s much more to come.”
There were 23,172 alcoholic liver disease deaths in the U.S. in 2018, according to provisional CDC data, making it a rate of 7.1 deaths per 100,000 residents. The rate increased to 9.0 deaths per 100,000 residents in 2020 and then 10.0 in 2021, representing 29,505 deaths in 2020 and 33,098 deaths in 2021.
Nationally, alcoholic liver disease deaths peaked in 2021, before decreasing to 30,874 deaths in 2022, according provisional CDC data.
Statewide, Ohio also saw a peak in 2021 with 1,085 alcoholic liver disease deaths, according to preliminary data from the Ohio Department of Health. This was up from 724 deaths occurring in Ohio in 2018, 753 deaths in 2019, and 944 deaths in 2020.
Analysts say the pandemic may have caused some people to turn to consuming alcohol out of boredom. In Ohio, state liquor agencies sold $1.74 billion of high-proof liquor in 2022, up 8.3% compared to the $1.57 billion in 2018.
“They could no longer go out and do things recreationally,” said Dr. Rukan Ahmed, a Kettering Health primary care physician in Springfield. He added people also could have used alcohol to cope with the stress of the pandemic.
“It definitely worsened the prevalence of depression and anxiety and related illness,” Ahmed said.
Other options for coping were reduced during the shutdowns of the pandemic while stress increased, Waite said. The way people exercised, shopped, and gathered all changed. People who were already vulnerable also had to change the way their interacted with their health providers and therapists, Waite said.
Locally, some counties saw a peak in 2022. In that year, 69 Montgomery County residents died from alcoholic liver disease, more than double the deaths the county saw in 2019, at 33 deaths, according to Ohio Department of Health data.
| County | 2018 | 2019 | 2020 | 2021 | 2022 |
|---|---|---|---|---|---|
| Auglaize | 5 | 2 | 1 | 0 | 3 |
| Butler | 28 | 21 | 25 | 23 | 34 |
| Champaign | 7 | 1 | 4 | 6 | 3 |
| Clark | 13 | 18 | 19 | 19 | 13 |
| Darke | 0 | 1 | 1 | 5 | 3 |
| Greene | 6 | 9 | 14 | 13 | 13 |
| Miami | 4 | 7 | 6 | 6 | 12 |
| Montgomery | 28 | 33 | 40 | 57 | 69 |
| Preble | 1 | 2 | 2 | 7 | 5 |
| Shelby | 1 | 3 | 7 | 1 | 5 |
| Warren | 5 | 6 | 12 | 14 | 15 |
Other counties experienced slight increases in the number of deaths of residents from alcoholic liver disease, including Butler County, which had 34 deaths in 2022, compared to 28 deaths in 2018 and 21 in 2019, according to ODH data. Clark County increased to 19 deaths in both 2020 and 2021, before dropping back to 13 last year. Greene County saw either 13 or 14 deaths each of the past three years, after having only six in 2018 and nine in 2019.
Alcohol, when heavily consumed, impacts the functions of the gastrointestinal system, including the liver, gallbladder, and pancreas.
“When people drink, especially to excessive levels, that entire system is thrown under the bus, and the liver does not function quite right,” Ahmed said.
There are different stages to alcoholic liver disease, the first of which is fatty liver disease, which is the buildup of fat inside the liver cells and leads to an enlarged liver, according to John Hopkins Medicine.
The next phase is alcoholic hepatitis, where the liver starts swelling and getting inflammation. The swelling and inflammation then leads to scarring and cirrhosis of the liver, which is the final phase of alcoholic liver disease. The damage from cirrhosis is irreversible.
Additional impacts to the gastrointestinal system can include increased incidents of gallstone, which can lead to people needing to have their gallbladders taken out, Ahmed said. It can also cause pancreatitis, which is inflammation of the pancreas and can lead to severe ramifications.
“It can hurt every aspect of a person’s life, their organs, their nutritional status, predispose them several kinds of disease,” Ahmed said. “It can harm their professional pursuits, their careers, their interpersonal relationships. While many utilize (alcohol) responsibly, so to speak, it is unfortunately very commonly misused in excess, and it can lead to some pretty significant health issues.”
Alcohol also impacts the rest of the body.
“The brain is affected over time,” Waite said. Alcohol consumption triggers the release of dopamine, the feel-good chemical in the brain, Waite said. The more a person drinks, though, the more the body adjusts, which causes a person to consume more alcohol to reach that euphoric state.
People who have concerns about their alcohol consumption can talk to a primary care doctor or other health provider to get screened for alcohol use disorder, which is the inability to control drinking.
“One of the benefits of going to a health care provider, a primary care provider, is that we don’t judge them. We just focus on trying to get them the help they need,” Ahmed said.
Doctors can help their patients understand if they have alcohol use disorder, as well as how to treat it safely. It can be dangerous to quit alcohol cold turkey, Ahmed said, saying it is best to wean off alcohol. Medications like naltrexone can also be prescribed to help patients with this disorder. Inpatient and outpatient treatment options are also available.
The U.S. Substance Abuse and Mental Health Services Administration also offers a national helpline at 1-800-662-HELP (4357) that is free and confidential, with treatment referral and information services for individuals and families facing mental and/or substance use disorders.
Staff Writer Eric Schwartzberg contributed to this story.
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