City medics’ alarm at surge in alcoholic liver disease

Today, The Press can reveal the shocking state of serious alcoholism in our city - with some drinkers now dying of liver disease while still in their 30s and 40s.

And alarming new statistics show the number of women and young people who are deemed by medics to have serious drink problems has risen rapidly in the space of only three years.

Phyl Driffield, manager of the community addictions team at Bootham Park Hospital, York, said: "Ten years ago, 75 per cent of our referrals would have been male, now it is 50/50 male and female.

"These are referrals from health professionals for people they feel are drinking at dangerous levels."

It was not uncommon for those sent to the addictions team to be drinking a litre of spirits in one day, she said.

Figures show the number of women referred there rose by nearly two-thirds, from 130 to 210, between 2003 and 2006.

That was the same level of increase for referrals of young people under the age of 29, which rose from 47 in 2003 to 75 three years later.

The number of male drinkers referred to the service remained roughly the same over the same timescale, from 283 in 2003 to 282 in 2006.

The number of patients with end-stage liver disease in York hospital also more than trebled in three years.

The rise in drinking problems continued over this period, despite the horrifying nature of liver disease and alcohol addiction being highlighted in the media through the struggles and, eventually, the death of former footballer George Best in 2005.

Today, one senior consultant blamed the culture of drinking and cheap booze offers for the rise in patients with alcoholic liver disease who end up on his ward.

Dr Alastair Turnbull, a consultant gastroenterologist - gut and liver specialist - at York hospital, said he was now seeing up to 100 new patients with alcoholic liver disease on his ward every year, a number which has seen a significant rise over the past decade.

At any time, there were on average between two and five people on the ward with liver disease brought on by drinking - about twice as many as there were ten years ago.

Even more alarmingly, about a third of these patients were relatively young - still in their 30s and 40s - a proportion that had also grown over the past ten years.

He said: "It represents a tragedy for families in the York area, because it's not just one person's death, it's the impact on their family.

"I have sat with many grieving parents who have seen their children die of advanced liver disease, who have attempted to support them over years of problem drinking.

"The same goes for spouses; husbands and wives who have experienced the real sharp end of problem drinking abuse, and then witnessed the sad end when someone is admitted to hospital in the middle of the night vomiting blood."

Dr Turnbull said he and medical colleagues were worried about the levels of serious drinking in York.

Of particular concern to him was easy access to spirits in pitchers of mixers and discount cards that encouraged even higher levels of consumption.

Many might also not realise they could fall prey to liver damage after a sustained period - about five years - of relatively conservative levels of alcohol consumption, which might equate to four pints of beer a day.

"We are not against drinking, but we are worried about the prevalence of really serious drinking," he said.

"We are all worried about the number of patients under our care with advanced liver disease, many of them young and many of them dying prematurely as a result of their alcohol abuse.

"We are seeing people die as young as 30 and 40, or less, directly from liver disease.

"The culture, particularly in York, is to go out and do the Micklegate run, say, and, unfortunately, some of the licensed premises don't behave in a way that fosters responsible drinking because they offer incentives for cheap drinking.

"York is a relatively affluent and well educated area, but we're seeing more deaths and more people with really severe liver disease than perhaps one might expect.

"Liver disease is no respecter of educational background or income. It seems to be affecting people of all backgrounds.

"Alcohol is so readily available and it's relatively cheap, it's not seen as being as harmful as it really is. It's a major public health issue.

"There's barely a system in the body that isn't affected by alcohol. It's not until you have developed very serious liver damage that you know anything is wrong.

"Unlike your heart or your lungs, you don't get symptoms from liver disease until it's very serious.

"We try to give people the wherewithal to stop drinking, but in the meantime, you've got to go on picking up the pieces."

The message comes following a warning in The Press in November that alcoholism in York had swamped the city's Alcohol Advice Service. The service was receiving 90 referrals a month on average, with clients waiting in a queue of up to three months to be treated.

Alcohol - a national picture

THE Department of Health has released the following statistics relating to alcohol consumption:* It is estimated that alcohol-related diseases currently cost the NHS £1.7billion a year.

* 70 per cent of all weekend night-time admissions to A&E departments are linked to alcohol.

* Since the 1970s, alcohol consumption has risen by 50 per cent.

* Britain is one of the worst countries in Europe for binge drinking.

* Cirrhosis of the liver has gone up ten-fold since the 1970s.

The Royal College of Physicians has the following classifications for levels of drinking, in alcohol units per week:

* A sensible drinker; 21 units or less for a man, 14 or less for a woman.

* A moderate drinker; 15 to 21 units for a man, 11 to 14 for a woman.

* A very heavy drinker: 50 or more units for a man, 35 or more for a woman.

* Male binge drinkers are classified as drinking ten or more units in a single session; seven or more for a woman.

The trade

TREVOR KING, president of York and District Licensed Victuallers' Association, said growing numbers of people drinking at home were more of a problem than those going out to pubs.

"Pubs have been promoting responsible drinking over the past couple of years, in conjunction with the Government," he said. "You'll find most pubs now take (it) very seriously. We can get fined now for serving drunks.

"I wouldn't put this in our court any more. What a lot of people are doing now is drinking at home - drink which is available from the supermarkets. Most alcoholics do a lot of their drinking at home."

The patient

JOHN* suffers from alcoholic liver disease.

The 56-year-old from Selby said he feared his condition may see him end up in a wheelchair soon. He has been in and out of York hospital for a few years now because of his long-term alcoholism, where he is fed through a drip to give much-needed nourishment to his feeble frame.

John said he had been drinking since he was a teenager, but the amounts he consumed grew steadily until he was putting away five pints and a couple of bottles of wine every day.

Three years ago, the severe damage he had done to his liver became suddenly apparent when he suddenly vomited a lot of blood.

Today, both his body and his marriage have been wrecked by drink.

He said: "I've been totally honest all the way along the line, I'm here by my own fortune, I can't blame anyone here, I can't say anyone twisted my arm and made me drink the drink.

"The amount of resources that are spent on folk like me, I do feel guilty that it could be projected in a different direction, towards the folk who haven't done it to themselves."

John warned other people not to go down the same road as he had.

"One glass of sherry at Christmas is harmless, in fact one glass of wine per day is supposed to be very good for you, but if you turn that into a bottle per day, that's when it becomes a problem," he said.

* Not his real name

What is alcoholic liver disease?

THERE are three stages to alcoholic liver disease.

The first is a fatty liver - a side effect of the liver breaking down alcohol into carbon dioxide and water.

This condition can be reversed if a patient stops drinking too much.

The next stage is alcohol hepatitis, where the liver becomes inflamed.

Patients at this stage can die of liver failure.

Those who carry on drinking can develop the third stage of liver disease; cirrhosis.

This is when the organ becomes permanently scarred and knobbly.

The condition cannot be reversed.

Some patients with long-term liver disease can vomit blood.

This is brought on by increased blood pressure which causes veins in the lower end of the gullet to swell and bleed.

Source: British Liver Trust * The York Alcohol Advisory Service is available on 01904 652104.