By A.J. Hostetler 

Alcohol kills some 141,000 Americans each year, and about a third of them had liver disease, according to the National Center for Drug Abuse Statistics. 

Both figures are growing as alcohol use rises, making it even more important that health care providers and families know what can be done to treat disorders and diseases associated with alcohol use. 

Alcohol use disorder (AUD) is a prevalent but preventable cause of death and disease, such as chronic liver disease. Terms such as alcohol abuse, alcohol addiction, and alcoholism are now classified under the umbrella of alcohol use disorder, and can be mild, moderate, or severe. 

AUD is the inability to control one’s drinking despite its negative health and social effects. People with alcohol use disorder often focus their lives around alcohol and consume increasingly greater amounts of alcohol and suffer withdrawal when drinking stops. 

Despite alcohol’s substantial and harmful health effects, most doctors don’t adequately assess their patients’ alcohol intake when they have the opportunity during an office visit, says Juan Pablo Arab, M.D., a liver specialist with VCU Health and director of alcohol sciences for the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health. Arab was the corresponding author of guidance for physicians to treat patients with alcohol use disorder that was published by the Lancet Gastroenterology & Hepatology. 

“We’re emphasizing a holistic, evidence-based approach to AUD management, one that helps to promote the awareness of integrated care and reducing the stigma of this disease,” Arab said.  

VCU Health News spoke with Arab about what you should know about liver health and alcohol use disorder and what to ask your doctor about it.  

What’s new in your research about alcohol and liver disease? 

Our paper highlights the importance of multidisciplinary teams for managing alcohol use disorder and alcohol-associated liver disease (ALD). We emphasize the collaboration between addiction specialists, hepatologists and mental health professionals. 

We also emphasize that there are both established pharmacological treatments like naltrexone and acamprosate, as well as newer treatment options, even in patients with advanced liver disease. 

There are newer screening tools, such as biomarkers like phosphatidylethanol, that offer more precise ways to monitor alcohol consumption, improving diagnosis and treatment outcomes. Finally, there are tailored approaches to take into account individual factors like liver disease severity, co-existing psychiatric conditions and socioeconomic barriers. 

How do you manage and treat alcohol use disorder?

 AUD is a treatable but chronic disease. Treatments include behavioral therapies, medications, and peer support systems like Alcoholics Anonymous or Sober Livers. 
 
Screening is important. Readily available questionnaires, such as the Alcohol Use Identification Test (AUDIT), can identify risky drinking early, helping to prevent severe complications. 

Patients need a multifaceted approach to restoring their health. Effective management involves combining therapies, addressing mental health issues, and ensuring proper nutrition, particularly for individuals with alcohol-related liver disease. 

But many people with AUD face stigma and lack access to specialized care. Greater public awareness and health policy is crucial in addressing these gaps. 

What should I ask my doctor about alcohol and liver disease? 

It’s important to be open with your health care provider about your lifestyle habits. If you are struggling with drinking, do not be afraid to ask for help. 

Here are some questions you can ask during a doctor’s appointment to learn more about liver disease and alcohol use disorder: 

• “How is my drinking affecting my liver, and what tests should I undergo to check for damage?” 
• “Should I or a loved one be screened for AUD? And how?” 
• “What treatments are available for AUD and which would be most suitable in my situation?” 
• “What medications are available to treat alcohol use disorder?” 
• “What resources are available to help with recovery, like therapy or support groups?” 

Where can I get help for alcohol use? 

 To learn more about options to treat AUD, talk to your primary health care provider or  
visit the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Treatment Navigator®, an online tool that offers help finding treatment.  

If your physician suspects that you might have liver damage, call VCU Health at 804-828-4060 for an appointment with a liver specialist. 

See how VCU’s Stravitz-Sanyal Institute for Liver Disease and Metabolic Health is making an impact

More health and wellness news