Deaths due to alcohol-associated liver disease (ALD) are climbing at an alarming rate across the United States, with certain groups being disproportionately affected. A new study published on June 11 in JAMA Network Open found that ALD-related deaths rose nearly 9% each year between 2018 and 2022—more than double the rate of increase seen from 2006 to 2018.Experts believe this sharp uptick is partly linked to increased alcohol consumption during the COVID-19 pandemic. Other contributing factors include chronic conditions like obesity and hypertension, which can worsen liver health. “It puts numbers to what we’re seeing in the hospital, in the clinic,” said Dr. Brian Lee, a liver specialist at Keck Medicine of USC, in a report to STAT News.Worsening Trends Among Women and Indigenous PopulationsWhile men still experience more deaths from ALD—17 per 100,000 in 2022—women’s death rates have risen more sharply. In 2022, 8 out of every 100,000 women died from alcohol-related liver disease, a significant jump from 3 per 100,000 at the beginning of the study period. Women’s mortality rate grew at approximately 4.3% per year—almost twice the rate seen in men.The study also revealed a devastating impact on Indigenous communities. American Indian and Alaska Native adults had the highest cirrhosis death rate in 2022, at 33 per 100,000 people. Additionally, alcohol-associated hepatitis deaths in these groups more than doubled between 2010 and 2022.Dr. Nasim Maleki, a psychiatry professor at Harvard Medical School, noted that although the pandemic has eased, its long-term effects—particularly in marginalized communities—are still unfolding. “The pandemic itself came under control, but the disparities that came with it continued and lingered,” she said.Young Adults at Higher Risk Than BeforeA particularly troubling trend is the increase in alcohol-associated hepatitis deaths among people aged 25 to 44. This condition can develop quickly and is marked by symptoms like fatigue, jaundice, and liver pain—even in individuals who haven't been heavy drinkers for long.Liver experts warn that the worst effects of pandemic-related drinking might still be ahead. “Alcohol-related cirrhosis takes time to develop. So we may not see the true extent of the consequences until five, probably 10, years from now, which is very concerning,” said Dr. Robert Wong of Stanford University.Why Women Face Unique RisksOne reason for the sharper rise among women lies in biology. Cisgender women metabolize alcohol differently than cisgender men, which means their organs may suffer more damage from lower levels of alcohol consumption over time. That’s why current federal guidelines recommend no more than one alcoholic drink per day for women, compared to two for men.“You’d be surprised by how shocked people are when they hear that drinking more than two drinks per day is considered heavy drinking by federal definitions,” Dr. Lee added.Public Health Response and the Way ForwardIn 2021, over 12,000 deaths from “unspecified liver cirrhosis” were linked to excessive drinking, although that may not always be evident from death certificates. Marissa Esser, who previously led the alcohol program at the U.S. Centers for Disease Control and Prevention, highlighted this hidden toll before the program was disbanded earlier this year.The American Medical Association is now calling for more public education on alcohol’s risks, including its link to breast cancer. It is also urging clearer labeling on alcoholic beverages to help consumers make informed choices.Though some data suggests a slight drop in alcohol use since its peak in 2020, it remains uncertain whether this will reduce deaths in the coming years. For now, ALD continues to be the leading reason for liver transplants in the U.S., and alcohol-associated hepatitis is the fastest-growing cause.