Doctors and a national alcohol charity are calling for the Scottish government to implement take action to prevent alcohol harms as new analysis estimates there will be a 54% rise in people living with chronic liver disease by 2044.

The call comes as Public Health Scotland (PHS) has today published a report on the burden of chronic liver disease across Scotland, revealing modelling that suggests an additional 23,100 people will be living with the disease in 2044, compared to 2019.

With over 70% of cases caused by alcohol, Chair of doctors’ group Scottish Health Action on Alcohol Problems (SHAAP), says this underlines the “severity of the public health emergency” facing Scotland.

Dr Alastair MacGilchrist believes the response must be proportionate to the scale of this emergency:

“Today’s estimate by PHS predicts that by 2044, there will be a rise of over 50% in chronic liver disease in Scotland, placing a huge burden on our already-struggling NHS.

“Such an increase in liver disease is not inevitable. Public health measures to reduce alcohol consumption will help. Minimum unit pricing is already reducing the level of harm, but the Scottish government needs to do more such as restrict alcohol marketing.

“There are many missed opportunities to intervene to reduce heavy alcohol intake before liver damage occurs.”

The PHS report points to the need for prevention at all levels – outlining how both reducing the numbers who become ill and preventing people’s liver disease from getting worse can save lives, and reduce the quality-of life-impacts and risk of early death.

It also details how projected increases in prevalence and disease burden are likely to increase demand for services in the future, alongside how early diagnosis and intervention may reduce this impact.

A “silent killer”

With Scotland reporting 1,277 deaths in 2023 from alcohol – almost four a day – last year saw renewed calls for a public health levy to tax alcohol retailers for the harm they cause.

Deputy Chief Executive of charity Alcohol Focus Scotland Laura Mahon says today’s report emphasises that Scotland is “in the grip of an alcohol emergency” which will only worsen without intervention:

“Alcohol-specific deaths have reached a 15-year high. Alcohol-related liver disease is responsible for most of these deaths, with 805 people lost to this disease in 2023.

“It is a silent killer, which can affect people over the long-term, often showing no obvious symptoms until it’s too late. Just regularly drinking over 14 units per week increases your risk of developing liver disease. 

“It doesn’t have to be this way. Each of these deaths is entirely preventable, and there are a range of well evidenced and cost-effective prevention measures available which could be adopted.”

“Not only would these measures save thousands of lives, they would also substantially reduce the financial pressures on our health service, ultimately delivering better healthcare for everyone.”

Around three in ten liver disease cases are not caused by alcohol. These include non-alcoholic fatty liver disease, viral hepatitis, autoimmune liver diseases, and genetic or metabolic disorders.

While Alcohol Focus is again urging the government to increase restrictions on alcohol marketing and introduce clear health warning labels on alcohol products as part of a comprehensive alcohol strategy.

Other measures Ms Mahon points to include increasing the use of non-invasive liver scans to support early detection, providing care and support to earlier that helps people address their liver problem and where needed their alcohol use.

SHAAP’s Dr MacGilchrist echoes these calls for action, saying Scotland must “make early detection routine”:

“Like cancer, liver disease is often silent until it has reached an advanced, incurable stage, and so, just like cancer, early detection is vital.

“We now have the tools to do this and early detection of liver disease in at-risk individuals such as heavy drinkers needs to become routine practice.

“Today’s PHS figures are a call to action. If we introduce public health preventative measures and make early detection and treatment of both heavy drinking and liver disease routine, we can prevent this huge rise in liver disease. But we need to act now.”

Read more: Scotland can lead tailored alcohol policy; MSPs debate new approach to prison alcohol care; Charity: Tax alcohol retailers for the harm they cause; Barriers remain in accessing residential rehab; Smashing stigma to save lives in Scotland; Analysis: drugs and alcohol in Scottish health survey