First Covid lockdowns, then alcohol to your door: rise in young Victorians with liver diseases prompts fears

Rising numbers of young people are being hospitalised with severe, irreversible liver disease, as alcohol-related hospital admissions remain above pre-pandemic levels after peaking during Covid lockdowns.

A new Burnet Institute report, commissioned by the Foundation for Alcohol Research and Education (Fare), analysed nearly two decades of Victorian health data to examine the prevalence of alcohol-associated harm.

The study analysed 4,111 hospital admissions between 1 January 2017 to 30 June 2024, along with clinical data from 1 January 2010 to 30 June 2024.

When Covid lockdowns began in March 2020, treatment of alcohol-related hepatitis – a subset of liver disease – rose sharply, the data shows. They slowed after restrictions eased in late 2021.

But they have continued to be far above pre-pandemic levels.

The lead researcher, Prof Jessica Howell, said the rise correllated with a number of factors linked to the “overall stress” and “uncertainty” of lockdowns, although the report “can’t specifically tease out the causes”.

“Access to alcohol increased because you could get it delivered to your home,” she said. “So that really did lead to an escalation.”

While men made up the majority of cases, accounting for 62.5% of alcohol-linked hepatitis admissions, there was a “a sharp increase” among women.

Howell attributed the rise in excessive drinking to stress for women during Covid, “particularly on women who were primary caregivers, managing schooling, work and home.”

“A small proportion of women also were at home and at risk of being stuck in violent situations if they were enduring domestic violence. Lockdowns meant they couldn’t escape that.”

Rising numbers of young people affected

The data also revealed 14% of people admitted with alcohol-associated hepatitis statewide were aged under 35, and the report warned that a significant proportion of people with severe alcohol-related liver disease were under 40.

James O’Beirne, a professor of hepatology at Sunshine Coast university hospital and Griffith University, said he believed the trends could “undoubtedly” be identified in other states and territories with further research.

He has also noticed anecdotal evidence of such a trend in his work.

“Every week on the wards, we’ve got people under the age of 50 with very advanced liver disease and complications of cirrhosis.” O’Beirne said. “We’re seeing people being admitted in their 30s with severe liver disease.

“Women seem to be more susceptible to liver disease from alcohol than men because of their smaller body habitus.”

While the Burnet Institute’s findings appear to contradict other reports that show young people are drinking less overall, he said the previous research misses a key detail.

“While it’s true that younger people are drinking less alcohol across the board, there’s a subset of people who, unfortunately, are drinking a lot more. A small minority of young people are actually drinking huge amounts of alcohol.”

He said he also fears the changing drinking habits of young women “is leading to very advanced liver disease at an earlier age”.

“It’s well accepted that women are now drinking much more than they used to … there’s this concept of ‘wine o’clock’ that you see on social media, which I think is driving this normalisation of regular drinking,” he said.

Howell said the numbers “haven’t returned back to normal”, and fears they may not because “a new baseline of admissions for alcohol-associated hepatitis” has been set.

Fare’s chief executive, Ayla Chorley, said the report “brings to light that alcohol-related harm is very real”.

“Alcohol harm is on the streets, in front of nightclubs and pubs, and we’re now seeing it’s happening in the home,” she said.

Chorley said the findings highlighted the need for greater harm-reduction measures, including restrictions on alcohol availability, regulation and marketing.

“The alcohol industry has been very successful at individualising this condition, saying it’s an individual choice to drink responsibly … that discounts society’s expectations and cultural norms around alcohol consumption,” she said.

“People feel like: ‘Did I do something wrong? What is wrong with me? Why can’t I stop?’ And it is absolutely not on them. It is a harmful product. It is addictive by design and by its very nature.”