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Alcoholic Liver Disease: Current Mechanistic Aspects with Focus on Their Clinical Relevance
Open AccessArticle

Global Burden of Alcohol Use Disorders and Alcohol Liver Disease

by Jürgen Rehm 1,2,3,4,5,6,7,* and Kevin D. Shield 1,3,5
1
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada
2
Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
3
Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 1P8, Canada
4
Institute of Medical Science, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
5
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5T 2S1, Canada
6
Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany
7
Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow 119992, Russia
*
Author to whom correspondence should be addressed.
Biomedicines 2019, 7(4), 99; https://doi.org/10.3390/biomedicines7040099
Received: 3 November 2019 / Revised: 9 December 2019 / Accepted: 10 December 2019 / Published: 13 December 2019
(This article belongs to the Special Issue Alcoholic Liver Disease: Diagnostics and Therapeutics)
Alcohol use is a major risk factor for burden of mortality and morbidity. Alcoholic liver disease (ALD) and alcohol use disorders (AUDs) are important disease outcomes caused by alcohol use. We will describe the global mortality and burden of disease in disability-adjusted life years for ALD and AUDs, based on data from the comparative risk assessment of the World Health Organization for 2016. AUDs have a limited impact on mortality in this assessment, since alcohol poisonings are almost the only disease category directly attributable to AUDs; most other alcohol-related deaths are indirect, and the cause which directly led to the death, such as liver cirrhosis, is the one recorded on the death certificate. Burden of disease for AUDs is thus mainly due to disability resulting from alcohol use. In contrast to AUDs, ALD is one of the major lethal outcomes of alcohol use, and burden of disease is mainly due to (premature) years of life lost. Many of the negative outcomes attributable to both AUDs and ALD are due to their interactions with other factors, most notably economic wealth. To avoid alcohol-attributable morbidity and mortality, measures should be taken to reduce the AUDs and ALD burden globally, especially among the poor. View Full-Text
Keywords: alcohol; burden of disease; mortality; alcohol use disorders; alcoholic liver disease; poverty; disability-adjusted life years; interaction alcohol; burden of disease; mortality; alcohol use disorders; alcoholic liver disease; poverty; disability-adjusted life years; interaction
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Rehm, J.; Shield, K.D. Global Burden of Alcohol Use Disorders and Alcohol Liver Disease. Biomedicines 2019, 7, 99.

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