The Scottish Government needs to urgently prioritise the early detection and treatment of liver disease, says a call to action from more than 70 organisations including royal colleges, alcohol and drug partnerships, charities and recovery groups.
The government should expand testing to detect liver disease in at-risk people in the community, says the collective – an approach proven to be ‘highly effective and cost-effective’. This would allow people to be identified sooner and given the right care and support, rather than waiting for the disease to become irreversible, it states.
The number of Scots living with chronic liver disease is projected to increase by more than 50 per cent by 2044, according to a recent report from Public Health Scotland (PHS) – equating to an additional 23,100 people. More than 70 per cent of chronic liver disease cases are caused by alcohol, with Scotland’s most recent alcohol-specific death figure the highest in 15 years.
Four years on from declaring alcohol deaths a ‘public health emergency’ the Scottish Government’s commitments to addressing the crisis have been delayed or paused, says the call to action. The number of people in treatment dropped by 40 per cent in the decade to 2021-22, the document states, with services reporting people presenting later and with more complex needs. Audit Scotland has also highlighted the lack of investment and focus on alcohol services, it points out.
In addition to increased testing, the collective also wants to see nurse-led alcohol care teams established in hospitals to identify people with alcohol problems and provide specialised support, as well as more funding for treatment services through a levy on alcohol retailers, and improved access to detox facilities – including within hospitals.
‘For too long we have seen deaths from alcohol continue to rise,’ said acting chief executive of Alcohol Focus Scotland, Laura Mahon. ‘We need concrete measures to prevent this. Time is running out for this government to demonstrate genuine results, so together with partners, we’ve provided a roadmap for delivery. Now we need to see clear leadership and investment. Earlier detection of liver damage is essential because of its life-saving potential. A number of these initiatives are already happening at a local level and could be scaled up and enable people with serious or potentially life-threatening alcohol problems to be identified sooner and supported more effectively, reducing their risk of experiencing further harm.’
It was also important to look at the bigger picture, she added. ‘People don’t just become unwell overnight. We are continually being fed the message that alcohol has an essential role in our lives, normalising drinking and influencing our consumption habits. We need to challenge this with well evidenced and cost-effective prevention measures adopted as part of a robust strategy for now and into the future.’
Meanwhile, the latest quarterly RADAR (Rapid Action Drug Alerts and Response) ​report from PHS shows a 17 per cent increase in suspected drug deaths in the three months to February 2025 compared to the previous quarter – at 251. The suspected drug death figures are based on the reports of police officers attending scenes of death, and are different from the official statistics published by National Records of Scotland. ‘As the availability and composition of substances change, so too does the profile of drugs contributing to harm,’ the report states. ‘There is an urgent need for coordination to improve Scotland’s ability and agility in responding to polysubstance use and a continually evolving drug market.’
Call to action available here
Rapid Action Drug Alerts and Response (RADAR) quarterly ​report April 2025 available here