According to the results of a new study, Americans who drink alcohol heavily are more than twice as likely to develop significant liver disease compared to two decades ago. The study, authored by researchers from Keck Medicine of USC, was published in the peer-reviewed journal Clinical Gastroenterology and Hepatology.  Moreover, the study results reveal that this increase appears to be driven by four high-risk groups: women, adults aged over 45 years, and people living in poverty, and those with metabolic syndrome.

“Alcohol-related liver disease is the main cause of liver-related death and these results are a major wakeup call to the dangers of drinking,” said Dr. Brian P. Lee, a hepatologist and liver transplant specialist with Keck Medicine and lead author of the study, in a press release.

As part of the research, the scientists analyzed data from the National Health and Nutrition Examination Survey, which evaluates the health and nutritional status of U.S. adults and children, covering the years 1999 to 2020, which is the latest period with complete data.

Specifically, they evaluated the overall rise in significant liver disease, a stage marked by scar tissue formation that impairs liver function and is often linked to heavy alcohol use. The research focused on the demographic and health profiles of adults aged 20 years and older who drank heavily, defined by the CDC as eight or more drinks per week for women and 15 or more for men.

Moreover, the research also found that average alcohol consumption in the U.S. remained steady over the two decades preceding the COVID-19 pandemic, indicating that the rise in liver disease may be driven by factors other than drinking volume, such as shifts in health and demographic profiles.

“These findings — the first comprehensive look at the demographics of heavy drinking and their relation to liver disease since the 1990s — provide important new information about which population groups may need more intervention to curb alcohol use and may also explain the rise in liver disease over the years,” said Dr. Lee.  “Our results show that the makeup of the American public with heavy alcohol consumption has changed compared to 20 years ago.”

Furthermore, Dr. Lee said he hopes that these findings will equip physicians with updated insights to improve patient care and encourage more screenings and interventions for high-risk groups. Importantly, the results expand on his earlier research, including a study showing that heavy drinkers with diabetes, hypertension, or increased waist circumference faced twice the risk of advanced liver disease, and another study that found heavy drinking spiked during the peak of the COVID-19 pandemic and remained elevated for two years.