Liver damage from drinking was meant to be an older person’s disease. One in seven Victorians in hospital with it is under 35

Alcohol-related liver disease has long been thought of as the end point of decades of heavy drinking, something that arrives in a person’s 50s or 60s. A new Victorian report suggests that picture is out of date.

The report, released on Thursday by the Foundation for Alcohol Research and Education (FARE) and produced by researchers at the Burnet Institute, looked at 4,111 hospital admissions for alcohol-associated hepatitis in Victoria from 2017 to mid-2024. One in seven of those patients, 14 per cent, was under 35. About four in 10 were under their mid-40s.

Alcohol-associated hepatitis is not a slow ache. It is a sudden, severe inflammation of the liver that can cause jaundice and, in the worst cases, death. About 13 per cent of the patients in the study needed intensive care, and 4 per cent died.

Why are younger people getting so sick?

The clearest signal in the data is the pandemic. Admissions jumped in March 2020, when COVID restrictions began, and fell back only slightly afterwards. They remain well above pre-pandemic levels. Melbourne spent more than 260 days in lockdown, and the report points to research showing many people drank more through that stretch of stress, isolation and uncertainty.

That sits awkwardly next to another well-documented trend: young Australians, as a group, are drinking less than their parents did. Professor Jacob George, a liver specialist at the University of Sydney who was not involved in the report, said the two can both be true. While most young people are drinking less, he said, a smaller group is drinking more, including binge drinking.

How fast does the damage build?

Faster than the “decades of drinking” picture suggests. Among patients whose first scan showed no scarring of the liver, almost half had developed scarring within six years. Scarring is the road to cirrhosis, where the liver hardens and stops working properly.

Alcohol also shows up in cancer. The report found alcohol was a factor in 38 per cent of cases of the most common type of liver cancer in Greater Melbourne between 2018 and 2022, and people diagnosed with alcohol-related liver cancer were younger than those with other liver cancers.

Why are women faring worse?

Women make up about one in three alcohol-associated hepatitis cases in Victoria. The report’s lead author, Professor Jessica Howell, a gastroenterologist at St Vincent’s Hospital and head of the Burnet Institute’s hepatitis and liver cancer group, said women with the condition tended to be younger, frailer and more likely to need intensive care than men.

She linked part of that to body size and muscle mass, and suggested the extra caring and household load many women carried through the pandemic may have played a role. That last point is her theory; the study did not test it.

FARE chief executive Ayla Chorley criticised alcohol marketing aimed at women, and said doctors were now seeing people in their 30s die from alcohol-related liver disease.

What does the study not show?

It is a look back through hospital records from two Victorian patient databases, not a study that followed people over time. It can show who ended up in hospital and when; it cannot prove what drove the rise, or how many people are living with liver damage that has not yet landed them in hospital. Professor George said following patients over time would give more accurate data, and that he expected similar patterns in other states, though this report covers Victoria only.

Who is this about?

Rachel Allen’s son Dylan began struggling with alcohol at 18. He died in 2022 at 26 from alcohol-related liver disease, after several stays in rehab. She has spoken publicly about wanting earlier help and care without stigma for young people with alcohol dependence, and said better-coordinated, more compassionate care might have made a difference.

What should drinkers take from it?

Professor Howell’s message was practical: the liver can recover if damage is caught early, so anyone worried should talk to their doctor sooner rather than later. Small steps help, she said, such as swapping every second drink for water. She called stigma a “critical barrier” to people getting care.

FARE is calling for tighter controls on alcohol advertising and on rapid home delivery of alcohol, and Associate Professor Michael Livingston of Curtin University’s National Drug Research Institute said governments need evidence-based policies to cut alcohol harm and widen access to screening and treatment.

For free, confidential advice about alcohol, call the National Alcohol and Other Drug Hotline on 1800 250 015. For support, Lifeline is on 13 11 14.