Liver disease is a major public health challenge. Anyone involved in acute medicine will fully appreciate the emerging epidemic of liver disease. In contrast to the progress made in improving outcomes in heart disease and stroke, mortality from liver disease has risen dramatically over the past 20 years. Alcohol-related liver disease continues to account for the vast majority of liver related hospital admissions– between 2001 and 2022 alcohol-related liver disease hospital discharges increased by 42%. Patients with alcohol-related liver disease stay in hospital on average three times longer than patients hospitalised for non-alcohol related problems. Alcohol related liver disease accounted for over 45000 hospital bed days in 2022 in Ireland. Epidemiological data on the economic impact of alcohol related liver disease in Ireland is limited. In Northern Ireland, Alcohol related liver disease is now the second highest contributor to years of working life lost. The mean age of death from alcohol related liver disease is just 57 years.
Addressing the burden of alcohol-related liver disease requires a multifaceted approach. Firstly, policy change is required to reduce alcohol related harm at a societal level. The implementation of the public health alcohol bill is a positive first step. This has the potential to address the principle modifiable drivers of alcohol related harm – price and availability. The benefits of such an approach have been seen in Scotland where minimum unit pricing (MUP) was introduced in 2018. Although it is too early to appreciate to the full effects of MUP, alcohol-specific death rates have risen more slowly in Scotland compared the rest of the UK since MUP was introduced.
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