Drinking patterns, dependency and life‐time drinking history in alcohol‐related liver disease

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Abstract
Aims  To examine the hypothesis that increases in UK liver deaths are a result of episodic or binge drinking as opposed to regular harmful drinking.Design  A prospective survey of consecutive in‐patients and out‐patients.Setting  The liver unit of a teaching hospital in the South of England.Participants  A total of 234 consecutive in‐patients and out‐patients between October 2007 and March 2008.Measurements  Face‐to‐face interviews, Alcohol Use Disorders Identification Test, 7‐day drinking diary, Severity of Alcohol Dependence Questionnaire, Lifetime Drinking History and liver assessment.Findings  Of the 234 subjects, 106 had alcohol as a major contributing factor (alcoholic liver disease: ALD), 80 of whom had evidence of cirrhosis or progressive fibrosis. Of these subjects, 57 (71%) drank on a daily basis; only 10 subjects (13%) drank on fewer than 4 days of the week—of these, five had stopped drinking recently and four had cut down. In ALD patients two life‐time drinking patterns accounted for 82% of subjects, increasing from youth (51%), and a variable drinking pattern (31%). ALD patients had significantly more drinking days and units/drinking day than non‐ALD patients from the age of 20 years onwards.Conclusions  Increases in UK liver deaths are a result of daily or near‐daily heavy drinking, not episodic or binge drinking, and this regular drinking pattern is often discernable at an early age.