Heavy Drinking Doubles Liver Disease Risk in Two Decades

A recent study from Keck Medicine of USC reveals that Americans who engage in heavy drinking are now more than twice as likely to develop significant liver disease compared to two decades ago. Published in the journal Clinical Gastroenterology and Hepatology, the findings serve as a critical reminder of the escalating health risks associated with alcohol consumption.

The study’s lead author, Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist, emphasized that alcohol-related liver disease remains the leading cause of liver-related mortality in the United States. He stated, “These results are a major wakeup call to the dangers of drinking.”

Changing Demographics of Heavy Drinkers

The research highlights a shift in the demographics of heavy drinkers over the past two decades. Four specific groups are now more prevalent among heavy drinkers: women, adults aged 45 and older, individuals living in poverty, and those with metabolic syndrome. Metabolic syndrome, a cluster of conditions that increases the risk of heart disease, diabetes, and stroke, has been previously linked to a higher susceptibility to liver disease when combined with alcohol consumption.

“This comprehensive examination of heavy drinking demographics since the 1990s provides vital insights into which population groups may require more targeted interventions to reduce alcohol use,” Lee explained.

Despite these worrying trends, the study found that the overall average drinking rate in the United States remained stable prior to the COVID-19 pandemic. This suggests that factors beyond mere alcohol consumption levels, such as evolving health profiles and demographic changes, significantly contribute to the rising incidence of liver disease.

Study Methodology and Findings

Researchers utilized data from the National Health and Nutrition Examination Survey (NHANES), which evaluates the health and nutritional status of both adults and children in the U.S., covering the years from 1999 to 2020. The analysis focused on adults aged 20 and older who reported heavy drinking habits. The Centers for Disease Control and Prevention defines heavy drinking as eight or more drinks per week for women and 15 or more for men.

The study tracked the increase in significant liver disease, characterized by the formation of scar tissue in the liver that impairs its function, commonly resulting from excessive alcohol consumption. Lee asserted that these findings are essential for physicians, providing them with updated information to enhance patient care. He hopes the results will encourage more screenings and interventions for high-risk populations.

Jennifer Dodge, MPH, an assistant professor of research medicine and public health sciences at Keck School of Medicine of USC, also contributed as a co-author of the study. It was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism, grant number K23AA029752.

These findings build on Lee’s previous research, including a study from February 2025, which indicated that heavy drinkers with conditions like diabetes and high blood pressure faced double the risk of advanced liver disease. Another significant study from November 2024 revealed that heavy drinking increased during the peak of the COVID-19 pandemic and persisted for two years afterward.

This new research underscores the urgent need for public health initiatives aimed at curbing alcohol consumption, especially among populations at heightened risk for liver disease. The evolving landscape of alcohol use and its implications for health is a pressing concern that warrants immediate attention.