Four in 10 Victorians in hospital with alcohol hepatitis were under 46, and one in three is a woman

Alcohol-associated hepatitis is the kind of illness most people picture in a 60-year-old who has drunk heavily for decades. In Victoria, four in 10 of the people sick enough to be admitted to hospital with it were younger than 46.

That is the headline finding of a report by the Burnet Institute, commissioned by the Foundation for Alcohol Research and Education (FARE) and released on Thursday. It tracked 4,111 admissions for alcohol-associated hepatitis, a serious inflammation of the liver caused by drinking, across Victoria from January 2017 to June 2024. Fourteen per cent of those patients were under 35.

What else did the report find?

The pandemic left a mark that has not faded. Admissions climbed sharply when restrictions began in March 2020, in a state where Melbourne spent more than 260 days in lockdown, and they have stayed above pre-pandemic levels since. FARE says admissions of men are now more than double pre-COVID rates.

Women make up about one in three cases. Lead author Professor Jessica Howell, a gastroenterologist at St Vincent’s Hospital Melbourne and a liver cancer researcher at the Burnet, has said women with the disease tended to be younger and frailer than men and more likely to end up in intensive care. Part of the reason is biology: women generally have less body mass, especially muscle, to process alcohol.

The damage also moves fast. Almost half the patients whose first scan showed no liver scarring had developed scarring within six years. And in Greater Melbourne, alcohol contributed to 38 per cent of cases of the most common type of liver cancer between 2018 and 2022, with alcohol-related liver cancer striking younger people than other forms.

“Our data clearly show the multiple ways that alcohol can cause severe liver disease,” Professor Howell said.

What does it not show?

This is a look back through hospital records. It counts people who were admitted, so it says nothing about people living with liver damage who never reached a ward, and it cannot show why admissions rose. Lockdown drinking, home delivery and extra caring loads on women have all been suggested, but they are explanations, not findings. Professor Jacob George, a liver researcher at the University of Sydney who was not involved, has said a study that follows patients over time would give a more accurate picture.

It also sits alongside a different trend: young Australians as a group are drinking less than earlier generations did, but a smaller group is drinking more, including binge drinking.

Who is paying the price?

For Rachel Allen, the numbers are personal. Her son Dylan died of alcohol-related liver disease in 2022, aged 26, and she now campaigns for better treatment for young people with alcohol dependence. “Dylan’s life mattered,” she said.

FARE chief executive Ayla Chorley said the report matched what doctors are seeing, including people in their 30s dying of the disease. “This data tells us that reducing alcohol use significantly reduces harm,” she said.

What do the researchers want done?

FARE wants tighter rules on alcohol advertising and on rapid home delivery, which FARE says a federal inquiry has already recommended addressing. Associate Professor Michael Livingston of Curtin University’s National Drug Research Institute in Perth said it was “a critical time to implement evidence-based policies at the population level”, and called for better screening and treatment in clinics.

What does this mean for me?

Australia’s drinking guidelines say healthy adults should have no more than 10 standard drinks a week and no more than four on any one day. Early liver damage often has no symptoms, so anyone worried about their drinking or their liver should talk to their doctor. Free, confidential advice is available any time from the National Alcohol and Other Drug Hotline on 1800 250 015.