It is estimated that 25% of the adult population regularly drink more than the recommended limits for alcohol (14 units/week in women, and now 14 units/week in men).

In general you need to consume >100 units/week for more than ten years to develop cirrhosis but there are many exceptions. Thus, we see young women who have developed cirrhosis more rapidly whilst consuming 50 units/week. There is wide genetic variability and only 20-25% of subjects who drink excessive alcohol develop liver disease.

However, alcohol misuse causes significantly increases mortality from cardiac disease, stroke, various cancers or pancreatic disease. Thus, alcohol misuse is associated with a much lower survival than normal, but mainly through other causes of death rather than liver disease per se.

As Clinical Lead for the Alcohol Care Team at the Royal Free London Foundation Trust, which now includes Barnet and Chase Farm Hospitals we see a lot of patients with alcohol misuse or alcohol related liver disease. We provide a caring non-judgemental environment for the care of our patients. People drink for many reasons such as anxiety, social, or because of past trauma. Some have established habits that are triggered by certain situations. Clearly to overcome addictive behaviour these issues have to be dealt with, and to this end we have also established a transpersonal integrative psychotherapeutic counselling service for our patients who would benefit from such treatments. I have good links with a number of psychotherapists who could offer counselling to overcome such barriers to recovery.