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A dent in our sobriety

BMJ 2009; 338 doi: (Published 28 April 2009) Cite this as: BMJ 2009;338:b1737
  1. Debbie L Shawcross, senior lecturer and honorary consultant in hepatology, Institute of Liver Studies, King’s College Hospital, King’s College London
  1. debbie.shawcross{at}

    It began at last year’s conference of the British Association for the Study of the Liver. As I contemplated during the “symposium on alcohol” on how alcohol has ever so stealthily resulted in 4% of global deaths and disability I couldn’t help but chuckle to myself as I pondered the original meaning of symposium: a forum for men to debate, plot, and boast; in simple terms, an excuse to drink wine and have a party.

    It was difficult to understand why the audience all felt distinctly uncomfortable. After all, rarely a day passes by when, as hepatologists, we don’t see a patient whose psychological or physical wellbeing has been marred by alcohol. We know that the death rate from alcoholic liver disease has doubled in the past 10 years in the United Kingdom and that its incidence has risen eightfold in the under 35s as a culture of binge drinking has evolved among young people. We have all projected that the incidence of cirrhosis will increase exponentially and that there will be a 500% greater need for liver transplantation in the next decade.1 We have heard it all before. Yet as our anxiety was gradually eased by a glass of wine at the end of the symposium, a dent was left in our sobriety.

    A …

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