Leah Miller

What Are Steroids? Anabolic-androgenic steroids belong to a class of drugs known as appearance- and performance-enhancing drugs (APEDs).1 These drugs may be referred to as anabolic steroids, androgens, steroids, roids, or juice.1,2 They mimic the effects of testosterone, which is a male sex hormone, so they can stimulate muscle growth and male sexual characteristics.1 They can also lead to feelings of well-being and greater bone strength.1 Steroids are sometimes used medically to treat low testosterone, delayed puberty, and muscle loss associated with various conditions.1 Other types of APEDs include human growth hormone (HGH), insulin-like growth hormone (IGH), and ergo/thermogenics such as xanthines, sympathomimetics, and thyroid hormones.1 Corticosteroids are another type of steroids, but they aren’t like anabolic steroids and are used only as prescription medications.3,4 This type of medication works to reduce inflammation in the body. It is often used to treat disorders of the immune system, arthritis, asthma, or skin conditions.3,4 They work by mimicking hormones created by your adrenal glands, reducing inflammation and the activity of your immune system.3,4 Anabolic steroids can be abused to enhance appearance by gaining muscle and decreasing body fat for aesthetic purposes, or to improve performance in competitive sports such as weightlifting and football.1,5,6 When steroids are abused, they are taken at much higher doses than those used medically.5 They can be taken as oral pills, injections into muscles, or gels or creams that are absorbed into the skin.2,5,6 Patterns of Steroid Abuse Steroid abuse can occur in various patterns:1,2,6,7 Cycling is when steroids are used for a certain length of time, then stopped for a while, and restarted. Stacking is when more than one type of steroid is used, often combining steroids that are taken orally and injected. Pyramiding is when steroids are taken in a cycle lasting 6-12 weeks. The drugs are gradually increased for the first half and then gradually decreased for the second half, followed by a period where no steroids are used. Plateauing is when the dosage and/or the types of steroid are staggered, overlapped or substituted, so the person avoids becoming tolerant of a single type of steroid. Are Steroids Addictive? APEDs such as steroids are addictive, and it is possible to develop a substance use disorder after using them.1,2,5,6 Studies suggest that approximately 32% of people who misuse anabolic steroids develop a dependence on them.1 Unlike other substances of abuse, steroids generally do not cause a high or feelings of euphoria.1,2 Yet people who are addicted to steroids may continue to use them even after experiencing negative physical or mental health side effects. They may prioritize workouts over other activities, devote significant amounts of time and money to steroids, and struggle to cut down or stop using without success. They may also experience tolerance and symptoms of withdrawal when trying to stop.1,2,6 Side Effects of Steroid Abuse A range of side effects are associated with steroid use and misuse. They can be mild or escalate to severe and life-threatening.1,2 Abusing steroids can have serious health risks, some of which can be permanent.5 Side effects and health risks of steroid misuse can include:1,2,5,6,8 Cardiovascular issues, including blood clots, damage to arteries, enlarged heart, high blood pressure, high cholesterol, and increased risk of heart attack and stroke. Decreased functioning of the immune system, making you more likely to get sick. Hormonal issues for men including decreased testicle size, infertility, male-pattern baldness, reduced sperm production, and increased risk for testicular and prostate cancer. Increased risk of contracting hepatitis or HIV/AIDS and damage to the veins if shared needles are used to inject steroids. Kidney problems, which can cause swelling of the hands and feet, possible kidney failure, and an increased risk of developing kidney cancer. Liver problems such as jaundice, tumors, liver damage, the development of blood-filled cysts throughout the liver (peliosis hepatitis), and increased risk of liver cancer. Musculoskeletal issues including stunted growth (if steroids are used by adolescents) or increased risk of injury to tendons and ligaments. Psychiatric issues such as aggressive behavior, anxiety, depression, impaired judgment, irritability, mania, mood swings, hallucinations, and/or delusions. Skin problems including severe acne or cysts, increased oil production on the scalp or skin, and the possibility of developing abscesses at injection sites. Can You Drink Alcohol While Taking Steroids? Use of anabolic steroids is associated with a higher risk of alcohol and illicit drug use, and, in general, those dependent on anabolic steroids may have a greater risk of substance abuse during their lifetime.9 If you are unable to stop drinking while taking steroids that are prescribed, you may be demonstrating a loss of control over alcohol use, which is a symptom of alcohol use disorder (AUD).10 It may be helpful to better understand the signs of alcohol use which can lead to an AUD. Some signs indicating that someone may be struggling with alcoholism include:10,11,12,13 Alcohol use interferes with completing responsibilities at home, school, or work. Continuing to drink after it has created or worsened problems within relationships. Developing a tolerance (the need to consume significantly more alcohol to get the same effects). Experiencing withdrawal symptoms if you cut back significantly or try to stop drinking altogether. Inability to stop drinking, even after it has caused or worsened physical or mental health problems. Spending a lot of time getting, drinking, or recovering from the effects of alcohol. Trying unsuccessfully to cut back or stop drinking. An AUD can only be diagnosed only by a health professional, so if you feel you or a loved one may be struggling with alcohol abuse, you may want to speak to your doctor or a mental health professional to be formally assessed for an AUD.11,13 [vob-aktify-cta title="Does your insurance cover treatment for steroid and/or alcohol abuse?" subtitle="Check your coverage online or text us your questions for more information"] Steroid and Alcohol Withdrawal When you take a substance like alcohol regularly, your body becomes used to its presence. Eventually, you require it to function normally.14 This is known as physical dependence, and individuals who’ve become dependent on a substance may experience symptoms of withdrawal when you stop taking it.14 Excessive drinking for women is the consumption of 4 or more drinks in a 2-hour period or having at least 8 drinks a week.15 For men, it is having 5 or more drinks in a 2-hour period, or at least 15 drinks weekly.15 If you drink excessively, you may be at higher risk of developing an alcohol use disorder.15 Experiencing withdrawal symptoms is one of the signs of an alcohol use disorder.10 These symptoms can range from mild to severe and life-threatening. Because of this, undergoing detox from alcohol under medical supervision can provide a more comfortable and safe experience while ridding your body of alcohol’s toxins.17-16 Some mild symptoms of alcohol withdrawal include anxiety, depression, fatigue, lack of appetite and mood swings.10,11,12,13,16 More serious symptoms may include hallucinations, seizures, tremors or delirium tremens (rare).10,11,12,13,16 Symptoms of Steroid Withdrawal Steroid misuse may also cause withdrawal symptoms when you stop taking them.1,2,5 Some symptoms of withdrawal from anabolic steroids include:1,2,5,6,8 Anxiety. Depression that can be severe and lead to suicidal thoughts and attempts. Exhaustion. Impaired focus and concentration. Lack of appetite. Loss of strength. Restlessness. Trouble sleeping. Treatment for Steroid Abuse and Alcoholism Like other substance use disorders, alcoholism is not a curable condition, but it can be treated effectively with behavioral therapies, medications, mutual support groups and ongoing aftercare support.13 Detox from alcohol should be done only in a medically supervised environment so that staff can monitor your condition and provide medication and treatment to manage your symptoms.17 For steroids, withdrawal symptoms can be eased by slowly tapering the dose. During alcohol detox, medications may be administered to ease symptoms of withdrawal. For alcohol, long-acting benzodiazepines such as Valium (diazepam) or Librium (chlordiazepoxide) can be used in slowly tapering doses to manage withdrawal symptoms effectively and reduce the risk of dangerous complications.17 After you have completed detox, effective treatment will address the underlying factors that have contributed to addiction. One such factor may be muscle dysmorphia, a male body image disorder, which may play a role in steroid use.1,2,13 Behavioral therapy and medications can help you learn coping skills, develop healthy habits, improve communication skills, avoid relapse and high-risk situations, manage symptoms of depression if present, improve muscle dysmorphia, build a support group, and resist cravings.1,13 Research has shown that treatment for alcohol use disorder can be extremely effective. Around 1 in 3 people who receive treatment for alcohol use disorder display no symptoms after a year, and a significant number report major reductions in drinking and alcohol-related consequences.13 Seek Treatment for Addiction If you or a loved one is struggling with substance abuse and want to learn more about your treatment options, American Addiction Centers (AAC) can help. AAC is a nationwide provider of addiction treatment centers and believes everyone should have access to the highest quality care when it comes to recovery from drugs and/or alcohol. Our facilities offer evidence-based therapies and approaches to addiction treatment while providing unique medical capabilities to ensure you or your loved one has the best chance at a successful recovery. Call our admissions navigators at [phone] any time of day to discuss treatment, learn more about what your insurance covers and how to take the first step toward a life free of drugs and alcohol. [accordion title="Treatment"] Aftercare Alcoholics Anonymous (AA) Alcohol detox Alcohol rehab centers Therapy Frequently Asked Questions (FAQ) [/accordion][accordion title="Alcoholism"] Alcoholism Co-Occurring Mental Disorders Comorbid Health Complications Effects of Alcohol How to Help An Alcoholic Interventions Mixing Alcohol and Other Substances Pregnancy Professions and Alcoholism Relapse Prevention [/accordion][accordion title="Helping someone you love"] Helping an Alcoholic Boyfriends Brothers Children Family members Fathers Friends Getting sober Girlfriends Grandparents Husbands Mothers Parents Partners Sisters Teens Wives [/accordion] [sources] [1]. National Institute on Drug Abuse. (2018). Steroids and other appearance and performance enhancing drugs (APEDs) research report. [2]. National Institute on Drug Abuse. (2018). Anabolic steroids DrugFacts. [3]. U.S. National Library of Medicine. (2021). Steroids. [4]. National Health Service. (2020). Steroids. [5]. U.S. National Library of Medicine. (2021). Anabolic steroids. [6]. National Health Service. (2018). Anabolic steroid misuse. [7]. National Institute on Drug Abuse. (2018). How are anabolic steroids used? [8]. Alcohol and Drug Foundation. (2020). Anabolic steroids. [9]. Tonya Dodge, Margaux F. Hoagland. (2021). Anabolic androgenic steroids, antisocial personality traits, aggression and violence. Drug and Alcohol Dependence, Vol 221. [10]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). [11]. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder. [12]. U.S. National Library of Medicine. (2021). Alcohol use disorder (AUD). [13]. National Institute on Alcohol Abuse and Alcoholism. (2021). Treatment for alcohol problems: Finding and getting help. [14]. National Institute on Drug Abuse. (2017). Tolerance, dependence, addiction: What’s the difference? [15]. Centers for Disease Control and Prevention. (2021). Alcohol use and your health. [16]. U.S. National Library of Medicine. (2021). Alcohol withdrawal. [17]. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131.[/sources]   ...

When seeking alcoholism treatment, the first thing people may want to know is “how much does alcohol rehab cost?” This can play a role in whether people who need treatment decide to receive it, although some people may not realize all of the options available to help pay for care.1 The cost of alcohol addiction treatment can vary by state, facility, location, amenities and more, making it difficult nail down one exact price.2 Programs can range from no-cost at some facilities to over $100,000 for a 3-month stay at a luxury inpatient facility.3,4 For most people, the amount you’ll pay for treatment will be dependent upon what is covered by insurance or what you are able to pay out-of-pocket. Learn more about the cost of alcohol rehab centers, what factors affect the price tag, what insurance may cover and how to discuss your treatment options. Factors Affecting the Alcohol Rehab Cost A wide array of factors can affect the alcohol rehab cost, including the setting or type of treatment program you attend.2,6 Treatment settings can include, but are not limited to:2,5,7 Inpatient rehab: where you stay at the facility full-time while receiving treatment. Since this type of program involves receiving room and board as well as staff supervision around the clock, it tends to be more expensive than other types of rehab. These programs generally last about a month and involve both group and individual counseling sessions. Many programs offer detox, family counseling sessions, psychiatric care, and on-site self-help meetings. Partial hospitalization programs (PHPs), which offer group counseling sessions and individual sessions that may meet for at least 20 hours per week, depending on your unique needs. This type of care offers high levels of support and structure without requiring you to live on-site at a facility, reducing the cost of treatment. Outpatient rehabs generally require patients to attend weekly scheduled group and individual counseling sessions during the day while allowing you to go home at night. This form of care typically costs significantly less than other forms of treatment. This level of care offers different levels of intensity and can be adjusted according to your needs and your treatment progress. Some outpatient facilities also offer detox and address co-occurring physical or mental health disorders. Insurance coverage can play a major role in the overall cost of alcohol treatment. If you have health insurance, opting for a facility that is covered by your plan can significantly reduce how much treatment will cost.6 For people without health insurance coverage, facilities may offer sliding scales based on your income, scholarships, or payment plan options to make treatment more affordable.3,6 The length of time you spend in treatment also plays a part in determining the cost of care; longer periods of treatment involve higher costs, especially when you attend an inpatient program. Treatment programs that provide multiple services—such as detoxification, care for co-occurring mental or physical health disorders, and medication-assisted treatment (MAT)—may cost more than programs offering therapy alone. Does Insurance Cover Rehab for Alcohol Addiction? All Marketplace health insurance plans include coverage for substance use disorder and mental health treatment services as essential health benefits.8 While the specific levels of coverage can vary depending on which plan you have and what state you live in, all plans available through the Marketplace must offer coverage at comparable levels to what is provided for medical health conditions.8 These plans also can’t refuse coverage if you have a pre-existing substance use disorder.8 Further, The Mental Health Parity and Addiction Equity Act (MHPAEA) is a federal law that requires the majority of health insurance plans to offer equivalent levels of coverage for mental health and substance use disorder treatment as they do for the treatment of physical health conditions.9 Types of Alcohol Rehab Although what is covered can vary, some services that may be included in your plan include: Detox. Inpatient treatment programs. Partial hospitalization programs (PHP). Intensive outpatient programs (IOP). Standard outpatient programs. Medication-assisted treatment (MAT). Individual counseling. Family therapy. How Much Does Rehab Cost Out-of-Pocket? Depending on what type of insurance you have (private or government-funded), there still may be certain things that you’ll have to pay for out-of-pocket. Typically, you’ll likely be responsible for the following alcohol rehab cost: Premiums: The annual or monthly cost to have insurance. Deductibles: This is the amount you’ll have to pay before coverage starts. Copays: The reduced fee paid in order to be seen by a doctor or to get service. Lifetime limitations: Certain insurance plans may only offer coverage up to a certain amount before leaving the remainder to be paid by the policyholder. Does Medicare Cover Alcohol Rehab? Medicare does cover an array of services to treat alcohol and drug use.10,11,12 If you have Medicare, you are covered for screenings to determine if you have an issue with alcohol use, which can be beneficial in preventing addiction or help you access treatment earlier than you might have otherwise.10,12 In order for Medicare to pay for your care, a treatment provider must determine that the treatment is medically necessary; services must be received through a Medicare-approved provider or facility, and you must follow a plan of care that is created by a treatment provider.11 However, there may be more limits imposed on treatment for substance use disorders than its coverage for other types of services.12 When the following 3 conditions are met, Medicare coverage of treatment services can include:11,12 Education about the diagnosis of alcohol use disorder (AUD) and how it is treated. Therapy sessions. Medications that are administered while you are in the hospital or a doctor’s office, such as those used to manage acute withdrawal symptoms. Structured Assessment and Brief Intervention (SBIRT) services that can be offered in a doctor’s office or outpatient setting. This treatment involves screening to identify how severe your substance use is to decide the best level of care for you. You’ll undergo a brief intervention to gather information and help you increase your motivation to make positive changes about your alcohol use, as well as a referral to further treatment if it is necessary. Aftercare services, which can involve follow-up after discharge from the hospital or a treatment program. Types of Medicare Plans Different parts of Medicare cover different types of alcohol use disorder care, provided that they are approved.11,12 Inpatient alcohol rehab programs are covered by Medicare Part A while outpatient alcohol rehab programs are covered by Medicare Part B.11,12 Medication-assisted treatment may be covered by Part A during inpatient treatment, or Part D when medications are prescribed through an outpatient facility.11,12 Your cost, including copayments or coinsurance, depends on whether you have met your deductible for the year, what type of plan you have, and whether the provider or facility is covered by Medicare.11,12 Types of Alcohol Treatment Centers In order to make treatment more accessible, there are various types of facilities to meet a range of needs. These can include: [accordion title="Standard rehab facilities"] Many private treatment centers accept health insurance and may require you to pay for the full cost of treatment if you don’t have health insurance. Some of these facilities adjust fees based on what you can pay or make treatment more affordable through grants or scholarships.3 Since standard treatment programs generally have higher levels of funding, they may offer additional accommodations that aren’t available at programs with limited funding. Individualized treatment can be offered through increased staff members caring for smaller numbers of patients, as well as by providing training in cutting-edge techniques, medication-assisted therapy, or alternative therapies such as creative arts therapies or animal-assisted therapy.2 Some programs offer additional amenities such as private rooms, workout facilities, meditation, yoga, meals prepared by chefs, acupuncture, aromatherapy, or massage. [/accordion] [accordion title="Low-cost treatment facilities"] These facilities receive state and federal funding, allowing them to provide care at greatly reduced rates.5,13 This type of program makes treatment more accessible to people with no insurance or who wouldn’t be able to afford treatment with their insurance coverage.5 Limited sources of funding often means that these programs can provide only bare-bones services and amenities such as shared rooms, basic meals, detox, therapy sessions, and treatment that is less tailored due to the higher numbers of patients and lower numbers of staff.2 However, these programs are typically closely monitored by state agencies and utilize only therapy techniques that have been extensively studied and shown to be effective. [/accordion] [accordion title="No cost - government or state-funded rehab centers:"] These programs are entirely funded by state and federal sources and provide treatment at no cost to you.5,13 This makes it accessible to people who have no insurance coverage or aren’t able to pay for treatment.5 However, this type of program typically has long waitlists and offer only basic services and amenities, similar to what is available at low-cost treatment facilities.2 Programs that are funded by the government are typically overseen by state agencies and can use only effective therapies that have been thoroughly studied. [/accordion] Verify Your Insurance Coverage for Alcohol Rehab Alcohol.org is a subsidiary of American Addiction Centers (AAC), a nationwide provider of addiction treatment centers. We understand that making the decision to seek treatment for addiction isn’t easy; and therefore, we accept many insurance plans and can work with you so that finances aren’t a roadblock to recovery. Our team operates an alcohol detox hotline that is available 24/7 to answer your questions about treatment and help you understand what may be covered under your insurance. All calls are 100% confidential and there is no obligation to make a decision right away. We can be reached at [phone] Or, call one of our facilities directly to speak with an insurance specialist who can help you navigate the specifics of your policy. [vob] [accordion title="American Addiction Centers (AAC)"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Alcohol treatment near me"] Arizona California Colorado Florida Georiga Illinois Indiana Kentucky Maryland Massachusetts Michigan Mississippi Nevada New Jersey New York North Carolina Ohio Oklahoma Oregon Pennyslvania Rhode Island Tennessee Texas Washington Wisconsin [/accordion][accordion title="Insurance"] Aetna Blue Cross Blue Shield Cigna Humana Kaiser Permanente United Healthcare Veterans [/accordion][accordion title="Detoxification"] Alcohol detox Inpatient alcohol detox Outpatient alcohol detox [/accordion][accordion title="Rehab"] Alcohol rehab centers Alcohol rehab centers near me 28 day alcohol rehab 30 day alcohol rehab 60 day alcohol rehab 90 day alcohol rehab Choosing a rehab center Court-ordered rehab Dual diagnosis rehab Executive rehab Extended care rehab Free rehab High profile rehab Holistic rehab programs Paying for rehab Luxury rehab Mens rehab Nature based rehab Private rehab Residential Rehab State funded rehab Teen rehab Veterans rehab Womens rehab [/accordion] [accordion title="Helping someone you love"] Helping an Alcoholic Boyfriends Brothers Children Family members Fathers Friends Getting sober Girlfriends Grandparents Husbands Mothers Parents Partners Sisters Teens Wives [/accordion] [sources] [1]. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. [2]. Center for Substance Abuse Treatment. (1997). A guide to substance abuse services for primary care clinicians. Treatment Improvement Protocol (TIP) Series, No. 24. [3]. Substance Abuse and Mental Health Services Administration. (2019). Paying for treatment. [4]. Business Insider. (2011). 9 Extravagant rehab centers for the rich and famous. [5]. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (Third edition). [6]. National Institute on Alcohol Abuse and Alcoholism. (2021). Treatment for alcohol problems: Finding and getting help. [7]. American Society of Addiction Medicine. (2015). What are the ASAM levels of care? [8]. Healthcare.gov. (n.d.). Mental health and substance abuse coverage. [9]. Centers for Medicare and Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA). [10]. Medicare.gov. Mental health and substance use disorder services. [11]. Medicare Interactive. (2021). Treatment for alcoholism and substance use disorder. [12]. Center for Medicare Advocacy. (2021). Medicare coverage of mental health and substance abuse services. [13]. Center for Substance Abuse Treatment. (2000). Integrating substance abuse treatment and vocational services. Treatment Improvement Protocol (TIP) Series, No. 38. HHS Publication No. (SMA) 12-4216. [/sources] ...

Drinking and Progressive Liver Disease The liver serves several vital functions in our bodies. It aids in digestion and helps metabolize and clear toxins from the blood. The liver is also where alcohol and many medications are broken down so they can clear our bodies.11 Chronic alcohol use can contribute to the development of alcohol-related liver disease (ALD). ALD follows a progression of conditions that starts with alcoholic fatty liver disease. Fatty liver disease is caused by a buildup of fat in the liver, and is typically classified as caused by alcohol or if the cause is non-alcohol related—such as obesity or diabetes. It is possible to stop or reverse alcoholic fatty liver disease by stopping alcohol use.11 With the continued use of alcohol, however, ALD will progress to alcoholic hepatitis, a state of inflammation that begins to damage cells in the liver. Continued consumption of alcohol further damages the liver and progresses to the final stage of ALD. End-stage ALD is called cirrhosis of the liver, and is characterized by irreversible scarring, a decline in liver function, and will eventually lead to liver failure and death. The three stages of liver disease include:11 Fatty Liver. Alcoholic fatty liver disease is caused by a buildup of fat in the liver. Relatively mild fatty liver (or hepatic steatosis) may be asymptomatic and can develop even with moderate patterns of alcohol consumption, though heavy drinking increases the likelihood. It is possible to stop or reverse this condition with continued abstinence from alcohol. Alcoholic hepatitis. Continued drinking can lead to chronic liver inflammation, known as alcoholic hepatitis. Symptomatic hepatitis may include some jaundice and an enlarged liver. More advanced disease may include anemia and coagulation problems. Attempts to manage alcoholic hepatitis may include alcohol abstinence, nutritional support, and in some cases, corticosteroid therapy. If drinking continues, the condition may become progressively severe, with chronic inflammation eventually leading to irreversible necrosis of liver tissue. Cirrhosis of the liver. Cirrhosis of the liver occurs when hepatic fibrosis and scar tissue become extensive, potentially resulting in portal hypertension and a shrunken, non-functioning liver. Cirrhosis of the liver is irreversible. However, quitting alcohol can stop it from getting worse. Symptoms of Alcohol-related Liver Disease Many people who have been diagnosed with alcohol-related liver disease  do not show symptoms in the early stages of disease.6 Symptoms commonly appear only after severe liver damage has already occurred, although some people do show nonspecific symptoms in earlier stages of disease.5,8  At its various stages of progression, some signs and symptoms of ALD can include:2,5,8 Yellow tint to the skin and/or to the white of the eyes. Loss of appetite (anorexia). Weight loss. Fever. Liver enlargement (early ARLD). Abdominal pain/discomfort. Weakness Skin that is intensely itchy. GI bleeding. Easy bruising. Swollen or distended abdomen (ascites). Edema of lower legs and feet. Blotchy red discoloration on the palms of the hands. Small or shrunken liver (later stage ARLD) Characteristic changes on blood tests (serum transaminases). Portal hypertension caused by high blood pressure in the liver. Esophageal varices, which means that veins in the esophagus are enlarged. Variceal rupture and hemorrhage Hepatic encephalopathy, which may include confusion and marked changes in behavior. Imaging evidence (CT, MRI, ultrasound) of characteristic changes such as liver nodularity and enlarged spleen. Risk Factors for Alcohol-related Liver Disease ALD is associated with chronic and heavy alcohol use. However, even occasional binge drinking—consuming between 4 and 5 alcoholic drinks within a 2-hour period—can lead to a buildup of fat in the liver and increase the risk of developing alcoholic steatosis as the first stage of alcoholic liver disease.1,5 Other factors that may influence an individual’s risk of alcoholic liver disease include:1,6,7,8 Drinking Patterns. Drinking 40 to 80 grams ethanol/day by males (roughly 3 to 6 standard drinks) and 20 to 40 grams/day (1.5 to 3 standard drinks) by females for 10 to 12 years has been a predictor of more severe cases of ALD in past studies.1 Weight. Obesity can contribute to fatty liver disease and may be correlated with alcohol related liver damage. Concurrent health issues. Medical comorbidities such as hepatitis B and C can make alcohol-related liver disease progress faster. Genetics. Studies suggest that there may be a genetic component to alcohol-related liver disease. Genetic vulnerability may explain why a relative minority of heavy drinkers develop liver problems. Age. Older adults may be more likely to show signs of liver damage. Gender. Women are at increased risk of developing alcohol-related liver disease than men are due to potential metabolic and body composition differences that result in higher average blood alcohol concentrations from comparable amounts of alcohol being consumed. Smoking. Cigarettes have been linked to an increased risk of developing alcoholic cirrhosis, and can impair liver functioning. Other substances. If you take prescription medications, over-the-counter drugs, or even supplements, this can affect your liver. Additionally, these can also interact with each other, alcohol, or other drugs to further damage your liver. Diagnosing Alcohol-related Liver Disease It is always important to be honest with your doctor about your use of alcohol and other substances, as it can have a major impact on your health. Since alcohol-related liver disease can be tough to detect in some cases, your doctor may want to conduct some testing in order to confirm their suspicion based on your symptoms and history of alcohol use, or rule it out as a potential diagnosis.2 In order to diagnose alcohol-related liver disease, your doctor may do the following:2,4,5,8 Exam. The doctor will talk to you about your symptoms, your drinking, your eating habits, and conduct a physical examination, paying attention to your abdomen and your extremities. This is to identify any causes that can cause or contribute to your symptoms, and determine which part of your body is affected. Bloodwork. Certain blood markers can be analyzed to assess how well your liver is functioning. If liver disease is already present, it can give your doctor an indication of the severity or progression of the disease. Blood tests can also check for viral diseases that could additionally complicate issues, such as hepatitis. Imaging. This can be used to rule out other issues, such as obstructions in the bile ducts or tumors, which can cause similar issues, and it can give your doctor a better idea of what kind of liver disease you have, if any. Imaging that is commonly used can include ultrasound, a CT scan, an MRI scan, and/or abdominal ultrasonography, which are able to gather images of your liver. Liver biopsy. If your doctor reasonably suspects that you have alcoholic cirrhosis, but can’t confirm it any other way, they may conduct a biopsy, where a thin needle is inserted into your liver and some cells are removed to be looked at under a microscope. This can help your doctor understand how severe the disease is, and allow them to understand how best to treat you. Procedures. If your stomach has become very swollen (ascites), the doctor may draw out some of the fluid to examine it, evaluate what it is from, and relieve the pressure you may be feeling because of it. When portal hypertension, enlarged esophageal blood vessels, and the potential for upper gastrointestinal tract bleeds are an issue, endoscopic examination may be necessary. [accordion title="Treatment"] Aftercare Alcoholics Anonymous (AA) Alcohol detox Alcohol rehab centers Therapy Frequently Asked Questions (FAQ) [/accordion][accordion title="Alcoholism"] Alcoholism Co-Occurring Mental Disorders Comorbid Health Complications Effects of Alcohol How to Help An Alcoholic Interventions Mixing Alcohol and Other Substances Pregnancy Professions and Alcoholism Relapse Prevention [/accordion][accordion title="Helping someone you love"] Helping an Alcoholic Boyfriends Brothers Children Family members Fathers Friends Getting sober Girlfriends Grandparents Husbands Mothers Parents Partners Sisters Teens Wives [/accordion] [sources] Osna, N.A., Donohue, T.M., & Kharbanda, K.K. (2017). Alcoholic liver disease: Pathogenesis and current management. Alcohol research: Current reviews, 38(2), 147-161. Torruellas, C., French, S.W., & Medici, V. (2014). Diagnosis of alcoholic liver disease. World journal of gastroenterology, 20(33), 11684-11699. National Institute on Alcohol Abuse and Alcoholism. (2021, April). Understanding alcohol use disorder. Patel, R., & Mueller, M. (2021). Alcoholic liver disease. Treasure Island, FL: StatPearls Publishing. National Health Service. (2018, August 10). Alcohol-related liver disease. Schuppan, D., & Afdhal, N.H. (2008). Liver cirrhosis. Lancet, 371(9615), 838-851. Roerecke, M., Vafaei, A., Hasan, O.S.M., Chrystoja, B.R., Cruz, M., Lee, M., … Rehm, J. (2019). Alcohol consumption and risk of liver cirrhosis: A systematic review and meta-analysis. American journal of gastroenterology, 114(10), 1574-1586. Jackson, W. (2021, May). Alcohol-related liver disease. American Liver Foundation. (n.d.) Nonalcoholic fatty liver disease (NAFLD). Saberi, B., Dadabhai, A. S., Jang, Y. Y., Gurakar, A., & Mezey, E. (2016). Current management of alcoholic hepatitis and future therapies. Journal of clinical and translational hepatology, 4(2), 113–122. American Liver Foundation. (2017). Alcohol-Related Liver Disease [/sources] ...