Alcohol-related liver disease deaths are spiking – and that too faster in a few groups, including women, young adults, and Indigenous people, according to a new study. The research, published in the journal JAMA Network, shows that between 2018 and 2022, deaths from alcohol-associated liver disease, or ALD, rose nearly 9 per cent every year – as compared to 3.5 per cent between 2006 and 2018.

According to doctors, this rise is mostly due to higher drinking of alcohol during the COVID-19 pandemic, which also led to other long-term deadly health issues like obesity and high blood pressure.

The study, conducted across the United States, used death certificates to track deaths from alcohol-associated hepatitis and cirrhosis – two very serious liver conditions that lead to inflammation and infections. According to the study findings, even the indigenous communities were hardest hit. Among American Indian and Alaska Native adults, cirrhosis deaths reached 33 per 100,000 people in 2022, the highest of all racial and ethnic groups studied. Deaths due to hepatitis doubled in these groups. “The pandemic itself came under control, but the disparities that came with it continued and lingered,” said Dr Nasim Maleki, a psychiatry professor at Harvard Medical School who reviewed the findings.

People between the ages of 25 and 44 had the biggest yearly increase in deaths from alcohol-associated hepatitis between 1999 and 2022.

According to experts, women are more susceptible to alcohol-related liver issues than men due to a combination of physiological and biological factors. These include differences in body composition, alcohol metabolism, and hormonal influences. Also, biologically, women's bodies are not able to break down alcohol like men's bodies – and so, even a little drinking has a bigger impact on their organs over time.

Also, women have a higher percentage of body fat compared to men, and since alcoholic drinks are distributed in body water, a higher fat content leads to higher blood alcohol concentrations for the same amount of alcohol consumed. Women also produce less alcohol dehydrogenase – an enzyme in the stomach that breaks down alcohol, resulting in more alcohol reaching the liver.

The current guidelines suggest women should not take more than one alcoholic drink a day, while men can go for at least two.

Alcoholic liver disease refers to a range of liver disorders caused by excessive alcohol consumption. It progresses from fatty liver to alcoholic hepatitis and eventually cirrhosis, the most severe and irreversible stage.

While ALD is common, it is also preventable. Many people – both men and women who consume alcohol heavily – progress through these disease types over time:

Steatotic (fatty) liver

Steatotic liver is the build-up of fat inside the liver cells. It leads to an enlarged liver. Steatotic liver is the most common alcohol-induced liver problem.

Alcohol-associated hepatitis is an acute inflammation of the liver. There is death of liver cells, often followed by permanent scarring.

Alcohol-associated cirrhosis is the destruction of normal liver tissue. It leaves scar tissue in place of the working liver tissue. In this situation, the liver may stop working correctly.

The liver is a large organ that sits up under the ribs on the right side of the belly (abdomen). The liver:

Helps filter waste from the body

Makes bile to help digest food

Stores sugar that the body uses for energy

Makes proteins that work in many places in the body. For example, proteins that use blood to clot.