Illustration depicting man drinking and the effects on his liverBBC Three

I never imagined I'd be an alcoholic by the age of 25

The number of young people who are ruining their livers - and their lives - is on the rise

Vicky Spratt

It was in the middle of a bender at Berlin’s world famous nightclub Berghain that Alex*, now 31, realised he was out of control.

At the time, he was 25 and regularly drinking until he passed out. Thousands of people make the party pilgrimage to the former power station every weekend to dance to electronic music and briefly lose themselves. For Alex, that weekend in 2012 was a crucial wake-up call that, potentially, saved his life.

“I started drinking at 16 - the same time I came out as gay,” says Alex. “I thought I needed alcohol to be the person that I wanted to be. When I wasn’t drinking, I was very anxious. I didn't think I was an alcoholic because I had these type of 'rules': I'd eat salad, go to the gym every day, and hold down a good job. I didn't drink in the morning - unless - I hadn't been to bed.”

Despite making these 'rules' for himself, the warning signs were present that Alex's relationship with alcohol was having a negative impact on his life and his health. His messy benders were becoming more regular, and he had even started turning up for work still drunk. 

He increasingly felt like he couldn’t function without booze - whether that was on a big night out or during a quiet dinner with friends. And he regularly found himself out trailing the streets looking for somewhere he could still get a drink long after his friends had gone home.

"I developed a constant aching pain in my side," he says. “But I convinced myself that it was a pulled muscle from the gym.” He'd been to see a doctor six months before going to Berlin, but, once they started talking, Alex says he was "so embarrassed" he ended up asking about the symptoms of liver damage "for a friend". When the doctor said that, yes, what he was describing did sounded like liver damage, Alex cut the appointment short before being examined – and left.

Trapped in a state of denial, Alex carried on drinking, but that weekend, in the middle of the club surrounded by sweaty ravers, he says, “everything hit home”. He’d been drinking and taking drugs for three days straight, the hot ache on his right hand side was impossible to ignore, and he could no longer deny the emotional turmoil he was feeling. “I’d lost control,” he says. “I had become a stranger to myself; my entire life had started to rotate around drinking." 

When he got back to London, he went straight to his nearest Alcoholics Anonymous meeting. A friend, who happened to be a doctor, also expressed his opinion that it was likely that he was suffering with the early stages of liver disease, which can led to the fatal condition known as cirrhosis. This occurs when the liver becomes damaged by the chemicals in alcohol, which stops it from doing its job of clearing the body of toxins. The throbbing pain in his side was a red flag that this was something far more serious than a pulled muscle.

A man holds his side in painBBC Three

His friend told him to stop drinking immediately, which he did. And, although it wasn't easy, Alex says the the support of AA helped, although he is aware that it doesn't work for everybody. Horrified and ashamed that he had been ignoring his health for so long, Alex also says he knew subconsciously that his drinking was an issue. "It was only when I started going to AA that it really hit me. I’d been damaging my friendships and family relationships.”

The troubling thing about Alex's story is how relatable elements of it are. How many of us have had a boozy night out, taken things too far, felt hideous the next day and, maybe, even carried on? How many of us have then joked about “hair of the dog”? How many of us have woken up with a hangover and not remembered what happened, perhaps finding the only clues are a smashed phone screen and a cab receipt we can’t bring ourselves to look at?

But at what point does wanting another drink start to take its toll on our bodies and bank balances - and become an addiction? 

Dr Ben Sessa, a psychiatrist and drug researcher, says that it’s difficult to define alcohol dependence because how our body and brains react to sustained heavy drinking depends on many things, including our stature and genetic make-up. “Some people can drink a bottle of vodka every day and not experience the symptoms of dependency, while others can drink three pints a day and experience them,” he says.

In Britain, alcohol is ubiquitous. Sometimes, it’s even a rite of passage with getting totally wasted and pushing the limits of your body cast as an accepted part of growing up.

You might be thinking - “but we keep hearing that younger people are increasingly going off booze, right?” And, while it’s true that where once we read headline after headline lamenting "binge drink Britain" and the fact that excessive drinking appeared to be more widespread among young women, now we are just as likely to see articles about how young people are increasingly rejecting alcohol. The number of 16 to 24-year-olds who do not drink increased by 11% between 2005 and 2015, meaning that around a fifth of young people today are teetotal.

But, amongst Generation Z’s slightly older peers, millennials, who are currently in their late twenties and early thirties, there has actually been a sharp rise in cases of cirrhosis in recent years. Last year, Public Health England described chronic liver disease as a “silent killer of young adults”. 

This is something that 29-year-old Amy, knows all too well. Last February, her sister Carys died of complications associated with liver disease just before she turned 28. “It really shocked me how quickly she deteriorated,” Amy says. Carys started drinking seriously in her early twenties after a break up at uni, says Amy, and it slowly spiralled out of control.

Amy isn’t sure exactly how much her sister was drinking, but says it was “way above the recommended amount”, and adds that she would “put alcohol in fizzy drink bottles and hide her empty bottles from us".

An illustration of a brain with the word addictionBBC Three

During her mid-twenties, Carys went to rehab on more than one occasion but she wasn’t able to stop drinking. Her liver damage gradually worsened until, one-by-one, her organs started failing. “Two years before she passed away doctors told us that she was terminally ill,” says Amy. “They said nothing could be done to save her and told us that, going forward, it was just about managing her treatments.”

In the end, Amy says, Carys died in her sleep. “Her heart just stopped; it gave up because her organs were too weak.” But the two years leading up to this moment were not so peaceful.

Dr Sessa has noticed an increase in the number of young people with alcohol addiction at his practice, and believes the problem lies with a lack of public education around the perils of drinking, and the fact that alcohol is cheaper and more accessible than ever. “When I was growing up, you couldn’t get booze easily. Now it’s in every petrol station and corner shop,” he says. “People can buy six-litre bottles of high strength cider for £1.99 or multiple bottles of wine for a tenner."

It’s hardly surprising, then, that though young people say they drink less often, it seems that when they do drink, they do it to excess

But perhaps another factor is not only cheap booze but the fact that more young people in this country are going to university where, studies show, binge drinking is an ingrained and, sometimes, problematic part of the culture.

Last week, this issue hit the headlines again with the inquest into the tragic death of first-year Newcastle university student Ed Farmer, who died from the "toxic effects" of drinking excessive alcohol on an "initiation-style" bar crawl.

Dr Varuna Aluvihare, a consultant at King’s College Hospital’s Institute of Liver Studies, says that he’s noticed a similar trend. His clinic is “increasingly assessing people with irreversible liver damage in their twenties and thirties. It’s a disease that, until recently, we mostly saw in people in their fifties and sixties.”  

Indeed, in England today, the number of people who die early as a result of liver disease every year is actually increasing. And, alcohol abuse is the top cause of it across the UK. But for someone like Alex, who stopped drinking, there is hope.

An illustration of the stages of liver diseaseBBC Three

Dr Aluvihare explains that our liver, which recognises alcohol as a poison, contains enzymes that convert alcohol into other chemicals, including one toxic substance called acetaldehyde. “If you stop drinking as soon as you experience inflammation, forever, your liver can recover," he says. "But, the more you drink, the more toxic substances are made resulting in permanent damage to the liver and DNA."

Unlike Alex who managed to recover from the early signs of liver disease through abstinence, Amy's sister Carys sadly developed cirrhosis. However, she was not eligible for a transplant because regardless of how unwell a person is, the NHS will only consider a liver transplant for people who have developed complications of cirrhosis despite having stopped drinking - and Carys hadn’t stopped.

Towards the end, Carys was in and out of hospital. “She got weaker, her liver and kidneys were no longer functioning and she was jaundiced,” says Amy. “She was so lethargic and suffered internal bleeding, which was obviously very scary for all of us.”

Studies have found alcohol is more likely to cause chronic liver damage in women because they are generally “smaller in stature” and have “less body water”.

Despite this, Amy says most people didn’t realise the severity of Carys’ situation because she was so young, had gone to a good uni, and because she had a stable family. “People would think we were making a big deal out of it. My friends would say things like, ‘Oh she just had a big night out’. They didn’t understand that she was an addict”, she reflects.

Amy is still grieving. “Our parents used to call us ‘the girls’ because we were so close in age and I feel like part of me is missing now.” 

Dr Sessa says treating alcohol-related liver disease is about more than simply tending to the physical symptoms. “Alcohol acts on the brain to dampen and depress thoughts, emotions and behaviours,” he explains “this creates a pleasurable, soporific effect.” It is this effect that can be so appealing if you’re self-medicating with alcohol. “For me, alcohol became a way of not feeling anything,” says Alex. “Once I stopped drinking, all the emotional stuff I’d been pushing down suddenly surfaced.”

It’s dangerous because, regardless of why you’re drinking, if you drink regularly – every day – Dr Sessa explains that the “brain and body will build up a tolerance to the drug, which means higher doses are required to get the same effect".

According to both Alex and Amy, there is a stigma that surrounds alcohol addiction that urgently needs to be addressed. “There's a real lack of sympathy surrounding being an alcoholic,” says Amy. “Even though my sister was desperately ill, I didn't feel that I was able to share her illness with the people around me. I quickly learnt that if I opened up about it, people were eager to judge, which only made an already difficult time harder, so I stopped talking about it."

Adds Alex: “The issue is that people don’t question drinking in the way they question other things. There’s a huge conspiracy of silence surrounding it."

Comparing Instagram photos of himself before he stopped drinking with images of himself now, Alex notes: “I looked like a corpse. I just don’t know how I didn’t see it.”

Now that Alex is sober, he says he no longer feels the intense pain in his side, but he is yet to find out the current state of his liver. He’s hopeful that since he quit drinking the cells will have started to repair themselves

An illustration of a hand refusing a beer bottleBBC Three

Both Amy and Alex say that their experiences of alcohol addiction and its effects have completely changed the way they see drinking. Amy is not an alcoholic, but she doesn’t drink unless it’s “a glass of wine at a work function” and, even then, it’s a rare occurrence. “I think there’s a huge awareness of the dangers of smoking - because of the pictures of diseased organs on packets and the smoking ban - but I don’t think people see or understand the impact of alcohol abuse, unless they’ve seen it first hand."

So where does the solution lie? With increased awareness of how addictive alcohol can be? With challenging our perceptions of who an alcoholic is and what they look like? With more real talk about the physical and emotional repercussions of drinking?

Amy also thinks people need to “be more aware of addiction as well as the physical dangers of alcohol”, and says she is “sharing Carys’s story because people need to know.”  

For Alex, it's about keeping the mental health conversation around alcohol abuse going. “There is still some shame when it comes to talking about our emotions, for men especially," he says. "I think alcohol gives you the illusion of being connected to other people - regardless of whether you’re an alcoholic or not. But for some people it goes too far and becomes an addiction. Addicts tend to be unhappy people, and unhappy people can behave badly. I think that’s part of the problem. People don’t understand that and it makes them unsympathetic.”

It’s been six years since he last tasted alcohol. “I genuinely think I would be dead if I hadn’t stopped drinking,” he says. “My experience shows that once I start drinking, I can’t stop - and that leads me to a very dark place. While I now know that addiction is a disease, that’s not what keeps me sober. I’ve stayed sober because my life is just so much better without alcohol. I can’t even put it into words how much I want to keep it that way.” 

*names have been changed to protect identities

For help and support with alcohol abuse, click here 

This article was originally published on 30 October 2018.

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  • Comment number 19. Posted by Linda Oscar

    5 Nov 2018 11:01
    This comment was removed because it broke the rules. Explain
  • Comment number 18. Posted by Linda Oscar

    5 Nov 2018 11:01
    This comment was removed because it broke the rules. Explain
  • Comment number 17. Posted by Maths

    4 Nov 2018 10:39
    As with many similar issues, you can't simply apply one dimensional answers to multi-dimensional problems - especially where the human body is involved. And one of the more significant sentences in this story, receives no further analysis at all: "He’d been drinking and taking drugs for three days straight".

    Young people now have access to vastly more types of illegal (and legal) chemicals than ever before, most of which are trivially easy to obtain. So with most people drinking alcohol at some point in their life, do you think a GP is asking people if they've been shovelling MDMA into their body for the last ten years, or do you think their GP is asking them if they've ever drank alcohol?

    Then we have the more realistic scenario that involves the impact of both drinking alcohol and taking drugs. Or maybe drugs, alcohol and large quantities of energy drinks. Possibly include sustained creatine use for several years, or perhaps some other exercise-related chemicals - and then compound everything with one or more fad diets (or even starvation). Now where do we think organ damage will have originated from?

    I'm not trying to say alcohol addiction isn't potentially an issue for some people, but there are a lot more factors involved. And for most people, the best empirical evidence they have - themselves and those around them - simply doesn't support the story being told by the NHS and the media.
  • Comment number 16. Posted by Caz

    31 Oct 2018 15:18
    Dolly1001 I wish I could help you. Not that I have the answers that’s for sure but I’ve been there and had to work through giving up alcohol and getting sober myself on my own and it was so hard. I tried and failed many times and just ‘cause I’ve been successful for the last 23 months I know that it’s something I have to consciously do and fight for everyday as if I start again it will probably kill me.

    I hope you manage to do it and I’m sending you all the best wishes in the world. Please take care of you.
  • Comment number 15. Posted by ladynijo

    31 Oct 2018 14:23
    Like Amy, I lost a sibling to chronic alcoholism - my brother died when he was just 40. He had been drinking since his mid teens to cope with emotional problems, and although he dried out from time to time, it was a downhill struggle from his early 20s onwards. The worst bit for the bystander was the personality changes - he wasn't the bro I knew when he died.

    So I was kind of aware of the issues and in the back of my mind was maybe I had a problem too. But I very rarely got drunk, I didn't get paralytic on nights out, just a drink or three every night to wind down after work, or to relax of a weekend at home. I had a good job, I never drank in the morning or before 6pm or at lunch time, and I never had a hangover. So surely not me too?

    I reassessed my relationship with alcohol earlier this year when I developed a stitch in my side (yeah, the right side). I realised that I was losing my temper a lot when stressed, which in turn lead to more drinking in the evenings. I'd had a long term relationship breakdown, and I just thought, I better give this drinking thing a rest. Too much of a habit, too close to home.

    The good thing is that I gave up drinking completely for over 3 months without a problem. I'm not an addict, it wasn't actually a problem giving up. Giving up smoking was harder (I gave up smoking completely 20 years ago). And I don't have that nagging stitch in my side any more. I've not had liver function tests, so I don't know if I've damaged anything, but I feel fine. I felt OK before, but now I know I am. I didn't lose any weight, which is disappointing, but my skin is clearer, more hydrated, and overall, its a good feeling more in control and less on the edge.

    I've discovered different alternative drinks to alcohol to crack the habit of having something to drink, and yes there is stuff out there other than cola or sweet fruit drinks. Like Alex, I'm hoping I have got away with it.

  • Comment number 14. Posted by Tim

    31 Oct 2018 13:54
    Once you have gone down the slippery slope for many many years its very difficult to stop. I am now 60. In my case I love wine. So stopping is like giving up something that gives pleasure. But when your body begins to tell you enough is enough you know you have to do something. But what?
    AA didn't work for me.
    The 8 week programme by a local detox centre didn't work, as I couldn't take that amount of time off work.
    The doctor said he couldn't sign me off work by giving a false description of the reason. I reasoned with him that I would lose my job, despite whatever laws may exist that stated that would be illegal. Another way would be found to sack me.
    So you are left to your own devices.
    Setting deadlines to stop completely hasn't worked. Leaving feelings of guilt and shame.
    Cutting down has helped, & I am currently consuming half what I was. Eventually I want to have short periods with no alcohol, then increase those periods.
    But what I still struggle with is a future without a good glass of red, ..ever.
  • Comment number 13. Posted by Hello Frisco

    31 Oct 2018 13:46
    This is a good article. I think the other condition that young people binge drinking and older alcoholics face at an increasing rate is Pancreatitis. This story echoed my own experiences but my issue was acute episodes of Pancreatitis. People think their liver is going to be organ that suffers but it's all of your internal organs. Not least the hypersensitive pancreas. If you damage it, that's it in a lot of cases, it's damaged for life. I wouldn't wish the pain of an acute attack on anyone and if it becomes chronic, you are talking a degraded level of life quality and shortened life span. I wish more people were aware of the very real damage alcohol can do in the short term as well as the long term
  • Comment number 12. Posted by Dolly1001

    31 Oct 2018 13:43
    I wish there was somewhere I could go, someone I could speak to. tried a few times, one GP 'we don't deal with that sort of thing here' down his nose before he went to sleep during consultation. Another was lovely and sent me to a counsellor who was no use and kept demanding I write her a nice letter. I did, next appt, she said 'well I don't know what to do with you' another GP, 'you will be fine you managed 5 days', another GP was lovey, but by that time I had become terrified of NHS & so called professionals. The AA, I got demands for sex from the males, told by AA that it could not turn a man away, so I was turned away.

    Just where is safe for a woman to try to help herself?
    Nowhere on this gods earth for sure
  • Comment number 11. Posted by liesdamnlies

    31 Oct 2018 13:05
    It's easy to slip into it and it's a slippery slope. None of your drinking friends want you stop and you just don't listen to your non-drinking friends. Drinkers conspire to enable each other and make excuses for one another.
    One friend who is an alcoholic once said when comparing his drinking to another alcoholic ' I'm not an alcoholic because I've confronted my demons whereas he hasn't' ! Though clearly the end result is the same he had decided quitting wasn't a price worth paying. He's still alive just but his friend died aged 57.
  • Comment number 10. Posted by showoddydoddy

    31 Oct 2018 12:46
    I may not be as bad as Alex or some people in these comments but I do feel like I drink too much, too often. I too have developed rules, no drinking before noon at weekends, and I try to avoid it in the week but my wife and I will often have a cheeky wine or two or three after the kids have gone to bed. For several years now we have been taking part in Sober October and I've just completed it this year and I feel great. Lost a few pounds and saved a few pounds in the process. I feel like I've broken the cycle and the craving has gone. Let's hope I can make it last...