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| FEATURES | BY PROFESSOR ROGER WILLIAMS |
 Vinnie Jones with actress Claudia Aros in and advert for Bacardi  Professor Roger Williams |
The death rate from alcoholic liver disease has doubled in the last 10 years. There are more than 4,000 deaths annually from cirrhosis, the end-stage of liver disease. In the year 2000, according to the Chief Medical Officer’s Report, cirrhosis killed more men than Parkinson’s Disease and more women than cancer of the cervix. Excessive consumption of alcohol is also an important additional risk factor in many liver diseases, in particular in hepatitis C infection where the development of cirrhosis and, finally, liver cell cancer is more likely in somebody drinking excessively. It is estimated that 25 per cent of the population have abnormal liver blood tests and in a quarter of these the cause is too-high a daily alcohol consumption. It is also estimated that at any one time 15 per cent of medical beds in hospitals are occupied by patients with liver disease. The alcoholic patients with liver failure requiring admission to hospital represent some of the sickest patients seen, with failure of many other organs in association with the liver disease, and the percentage that do recover – no more than 20 per cent – may be in hospital for weeks or months. The greatest increase in alcoholic liver disease is in the younger adult age group and young women in particular are susceptible. Different body composition and different genetic make-up may be some of the factors involved in their susceptibility to alcohol. To see somebody in their late 20s or early 30s with end-stage liver disease, covered in blood spots, yellow-eyed, wasted, looking years older than their age and with the beauty of youth never to return, is the most depressing sight. What’s worse is knowing it is self-induced. Statistics abound, including the frequency of sustained heavy drinking, as well as frequent binge drinking in university students. It is essential that such persons see the need for control, for many of them continue with the same habits after leaving university. There is also considerable data available on the rising consumption of alcohol in this country unlike the main countries of Europe, where the amount drunk per person (per capita consumption) has fallen over the past ten years. The government is concerned with the rise in alcohol consumption, generally with all the untoward consequences of accidents, problems at work and so on, quite apart from the medical disease consequences. In 2002 a joint working party between the Cabinet Office and the Department of Health was set up to produce a National Alcohol Harm Reduction Strategy, with a report promised this summer. The NHS is already under great pressure with insufficient capacity to cope. The only measure that over the years has been shown conclusively to reduce alcohol consumption in a society is to decrease availability. This happens naturally in wars but otherwise is dependent on the licensing hours. The other major factor is through the cost of beverages and by raising taxes on alcohol, consumption can be reduced. But over the past five years taxes have not risen in parallel with affordable income and hours and availability of alcohol generally in public places has been made easier. On Wednesday July 23 a petition on behalf of the British Society of Gastroenterology, the British Association for Study of the Liver and the British Liver Trust was presented to the Cabinet Office at No 10 Downing Street. Five hundred of the 600 physicians in Gastroenterology and Hepatology in the UK, who are the principal carers for the burden of alcohol related liver disease in the NHS, signed the petition requesting that a health warning be printed on all alcohol products. It is only right that the public should know the alcohol content of products sold and the associated health risks of excessive consumption. There is no reason why we do not take the measures that are necessary to curtail the rise in alcohol consumption in this country and if we did the health of our people, and particularly vulnerable groups, would be greatly improved. Is there anything more to say? n Professor Roger Williams, CBE, is Director of the Institute of Hepatology, University College London. |
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