### Rising Alcohol Consumption and Liver Disease Amidst COVID-19: Persistent Pandemic Fallout

Recent research has shown that the surge in alcohol consumption in the United States, spurred by the COVID-19 pandemic, continues unabated, leading to a worrying increase in alcohol-related liver disease and fatalities. Despite hopes for a post-pandemic decline, the reality, as observed by Dr. Brian Lee, a transplant hepatologist at the University of Southern California's Keck School of Medicine, illustrates a different picture. "We had definitely seen a rise in patients with liver failure," said Dr. Lee, emphasizing the severe clinical implications of excessive alcohol use.

The study, led by Dr. Lee and published on November 12 in the Annals of Internal Medicine, utilized data from the National Health Interview Survey, which was managed by the U.S. Census Bureau. This comprehensive research included nearly 25,000 respondents in 2018, approximately 31,000 in 2020, and close to 27,000 in 2022. Findings indicated a continuous rise in alcohol consumption in 2020, which persisted slightly upward in 2021 and 2022.

Diving into the specifics, 69.3% of Americans reported some alcohol use in 2022, which marked an increase from 69% in 2020 and 66.34% in 2018. More troubling is the rise in heavy drinking, with almost 6.3% of respondents in 2022 identifying as heavy drinkers, up from 6.13% in 2020 and 5.1% in 2018. Notably, white Americans experienced the highest increase in heavy drinking rates, climbing to roughly 7.3% in 2022 from about 5.7% in 2018 and 7.1% in 2020. In terms of gender, women overtook men in heavy drinking, with 6.45% compared to 6.1% among men.

The health risks associated with such consumption levels are significant. The National Institute on Alcohol Abuse and Alcoholism classifies heavy drinking for women as consuming four or more drinks on any day or eight or more weekly, and for men, it is five or more drinks daily or 15 or more weekly. Dr. Lee warned, "If you're drinking more than one drink per day as a woman, you can be at risk for having liver disease."

Although the study did not delve into the exact causes behind the heightened alcohol consumption, Dr. Lee offered several hypotheses. Pandemic-related disruptions, such as job losses and routine changes, have likely played a substantial role. "We know that alcohol is used as a coping mechanism for stress. What starts as a habit can become addictive or a substance disorder," he explained.

Dr. Jagpreet Chhatwal, director of the Institute for Technology Assessment at Massachusetts General Hospital, concurred, highlighting additional stresses like financial insecurity and work pressures that may contribute. He also noted the broader societal normalization of drinking as exacerbating the issue.

Alarmingly, data from the U.S. Centers for Disease Control and Prevention revealed that alcohol-related deaths surged during the pandemic, with over 49,000 deaths in 2020 alone. During the height of the pandemic, an average of 488 deaths per day were linked to excessive alcohol consumption, representing a more than 29% increase from the periods 2016-17 to 2020-21.

Moving forward, Dr. Lee stressed the need for effective interventions and policies to curb this dangerous trend. He advocated for more stringent measures like heavier taxation on alcohol and restricted sale hours, alongside better public messaging regarding the risks of overconsumption. "People need to know what is harmful alcohol use and what it does to your body," he said, encouraging medical professionals to discuss alcohol use with patients openly and nonjudgmentally.