It’s a pretty well-established fact that drinking a lot of alcohol isn’t good for you. But disturbing findings from a new study may have many young people rethinking their drinking habits.
The study, published in the BMJ, analyzed death certificate data collected between 1999 and 2016 from the Vital Statistics Cooperative and population data from the U.S. Census Bureau that was compiled by the CDC WONDER platform (the CDC’s Wide-ranging Online Data for Epidemiological Research). The University of Michigan researchers found that annual deaths in the U.S. from cirrhosis, a chronic liver disease, increased 65 percent during that time period to 34 ,174 in 2016.
Among those deaths, 765 were among people in the 25- to 34-year-old age group.
From 2009 to 2016, there was a significant increase in cirrhosis-related deaths among millennials, and researchers say this was driven by alcohol-related liver disease.
During this time period, there was a 10.5 percent annual increase in the average cirrhosis-related deaths among people in the 25- to 34-year-old age group. The "vast majority" of cirrhosis deaths in millennials were brought on by alcohol, study co-author Neehar D. Parikh, M.D., an assistant professor of gastroenterology at the University of Michigan, tells SELF. The study's researchers analyzed alcohol-related liver disease specific death codes and noticed that they increased at a similar rate as the cirrhosis deaths in patients in that age group, he says.
“The fact is that an increasing number of people were dying of alcoholic cirrhosis during this time, and the only way to do that in your 20s is with incredible alcohol abuse,” lead study author Elliot B. Tapper, M.D., an assistant professor of gastroenterology at the University of Michigan, tells SELF.
Dr. Parikh says that he and Dr. Tapper decided to do the study after noticing that their group of patients was different from what it had been in the past. “We noticed we had younger patients that were presenting with liver disease, mostly alcoholic liver disease,” he says. That’s a trend other doctors have noticed as well: “I’ve definitely seen an increase in younger patients with cirrhosis,” Anton Bilchik, M.D., Ph.D., a professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California, tells SELF.
Any death from alcoholic cirrhosis is preventable, which makes any number of deaths from the disease upsetting. But it’s important to point out that we’re still talking about a low number of deaths overall. Those who died from alcoholic cirrhosis were not patients who stayed within the Dietary Guidelines for Americans recommended limits of having up to one drink a day for women and up to two drinks a day for men, or even those who went a little above that, Dr. Tapper says. “In order to die of alcoholic cirrhosis, you have to drink an amount of alcohol that is so far beyond what you would call risky drinking,” he says. “This is not someone who accidentally had three drinks a night when they should have had less.”
The study didn’t examine why this is happening among millennials, but there are some theories.
One possibility is that millennials are drinking differently than young people have in the past. For instance, some of the alcohol they’re abusing may simply have a higher alcohol content than other forms that have been abused in the past by young people, like preferring craft beer over light beers, Dr. Parikh says.
A binge-drinking culture among young people could also play a role, Dr. Tapper says, along with the hesitancy among some people to seek treatment for an alcohol addiction or to even realize that they have a problem with alcohol. That said, plenty of people still do. Neeraj Gandotra, M.D., Chief Medical Officer of Delphi Behavioral Health Group, tells SELF that he's been "surprised" to see more young people coming into his facility for alcohol detox. "Usually, the characterization is an older middle-age male, but now we are seeing a different demographic of individuals in their 20s after having developed alcohol dependence earlier in life," he says.
The researchers also noticed that this increase in alcoholic cirrhosis came after the stock market crash in 2008, which could imply that stress is a major factor. But again, this isn’t just having a glass of red after a particularly tough day at work—it’s consistently relying on alcohol to help get you through rough and stressful times. “It’s really important to not use alcohol as a stress reliever,” Dr. Bilchik says. “Young people need to find other, healthier ways to alleviate stress like getting regular exercise.”
Nonalcoholic fatty liver disease, a condition that happens when more than 10 percent of the liver's weight is fat, is also increasing in millennials and can lead to cirrhosis, Dr. Bilchik points out. It's currently estimated that between 30 and 40 percent of adults in the U.S. have the condition, per the National Institute of Diabetes and Digestive and Kidney Diseases.
It’s important for you to know the symptoms of cirrhosis, and to take an honest look at your own drinking habits.
Cirrhosis is a late-stage scarring of the liver caused by many forms of liver diseases and conditions, like hepatitis, fatty liver disease, and chronic alcoholism, the Mayo Clinic says. Cirrhosis happens in response to damage to your liver—each time your liver is damaged, it tries to repair itself, the organization explains. And, in the process, scar tissue forms. Over time and with more damage, it becomes hard for the liver to function, and this damage can’t be undone.
Cirrhosis usually has no signs of symptoms until the liver damage is intense, the Mayo Clinic says, which is why it’s so important to keep your drinking habits in check throughout your life.
When people do have symptoms of cirrhosis, they generally include fatigue, bruising and bleeding easily, having itchy skin, jaundice, fluid buildup in your abdomen, loss of appetite, nausea, swelling in your legs, weight loss, confusion, drowsiness, and slurred speech, spider-like blood vessels on your skin, and redness in the palms of your hands, the Mayo Clinic says.
Some of these symptoms are admittedly a little vague. Many young people who see the doctor for symptoms caused by alcohol-related liver disease aren’t totally upfront about their drinking habits at first, and they may not even be honest with themselves about it, Dr. Bilchik says. The problem is, that can take even longer to help get to a diagnosis. “That’s one of the problems,” Dr. Bilchik says. “It’s usually only after intense interrogation that they admit to taking large amounts of alcohol.”
If you know your drinking habits have been less than healthy and are worried about the state of your liver, your doctor should be able to run some tests.
Cirrhosis is usually detected through a routine blood test or checkup, the Mayo Clinic says, but your doctor can order a liver function test (which checks your blood for excess bilirubin, a product of red blood cells breaking down, as well as for certain enzymes that may indicate liver damage), kidney function test (which checks your blood for creatinine), test for hepatitis B and C, and your international normalized ratio (which determines your blood’s ability to clot). You may even need an MRI, CT scan, biopsy, or ultrasound.
While cirrhosis isn’t reversible, your doctor can recommend some lifestyle changes that should help prevent or reduce further damage.
“The main point is that these deaths are entirely preventable,” Dr. Bilchik says. “This is a very disturbing trend.”
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