Professionals who drink as a reward for a hard day’s work can go down a ‘slippery slope’, warns Dr John Ryan
A leading liver specialist is seeing patients as young as 19 who are coming in with cirrhosis of the organ. Professor John Ryan says it is “shocking” he is dealing with young people daily who have severe liver damage.
Dr Ryan gave the warning as he welcomed the introduction of minimum unit pricing for alcohol, a measure that sets a legal floor price for the cost of drinks such as beer and whiskey.
Legislation in force since early this month means an average bottle of wine cannot be sold for under €7.40, while a can of beer must cost at least €1.70.
Dr Ryan, who works at Dublin’s Beaumont Hospital, also spoke of the high proportion of professionals, many of them women, who have late-stage liver disease after their daily habit went down a “slippery slope”.
Speaking to the Sunday Independent, he said: “Hospitals such as the Mater and Beaumont both service disadvantaged areas and we are seeing very, very young people coming in with liver disease. It is related to alcohol.
“I see people coming in their 20s who are yellow with signs of liver failure. I also see people in their 30s right up to their 80s. Every age group is accounted for.
“But you have a lot of people who are young, in their 30s, who are parents, mothers, who are professionals and they come in with severe liver damage and cirrhosis all from alcohol. It’s not just the stereotypical image people have of someone who has a problem with alcohol.”
Dr Ryan, who has worked in the field for 15 years, said professionals were using alcohol as a reward for work and some found their use increases over time.
“It’s a slippery slope and I would see that a lot where they didn’t realise they were getting into trouble and they are professional people,” he said.
“They put it down to the fact that they have had a hard day’s work and they deserve to relax, and ‘of course you do’ but then maybe leave it at a glass of wine in the evening. When it goes from two glasses, to half a bottle then a full bottle, that’s a recipe for disaster.”
During Covid, the number of women turning up at A&E with alcohol-related problems doubled.
Referring to the Body Mass Index measure of weight-height ratio, he said: “They are more susceptible because of their BMI so if they start drinking more heavily than before then they are more likely to have acute health problems related to it.”
On his younger patients, Dr Ryan said they are turning to alcohol due to depression or isolation or boredom, which then becomes a daily pattern.
He said that although he “wholeheartedly” welcomes the new law on alcohol pricing, the Government should ring-fence the tax for community-based solutions.
“Ask ourselves why people are drinking excessively and direct it towards alcohol care teams in the hospital and community alcohol services,” he said.
Since 1970, deaths due to liver disease have risen 400pc. Although 90pc of liver disease is preventable, people are often diagnosed when it is too late for lifestyle changes or intervention.
Dr Ryan says liver disease is usually a silent killer and may not even show in blood tests. “You could have severe liver disease and cirrhosis and you wouldn’t know and your blood tests would not really show it until it’s quite advanced. So people coming in with yellow eyes and jaundice — that’s the very late stage and they might only have a 50pc chance of living two years. You wouldn’t feel any particular symptoms like tiredness or pain until it’s very, very advanced.”
For those concerned about liver damage due to drinking, Dr Ryan recommends seeing a specialist familiar with the interpretation of ultrasound and blood tests. “They might conduct a biopsy or a FibroScan — a non-invasive assessment for cirrhosis or liver scarring,” he said.