Guia para doenças hepáticas ligadas ao consumo de álcool deverá dobrar em 20 anos
Os pesquisadores dizem que os planejadores e os formuladores de políticas precisam procurar intensificar os programas de intervenção e melhorar o tratamento
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)
Com o consumo de alto risco a aumentar em todo o país, os especialistas preveem que o custo anual do tratamento da doença hepática associada ao álcool, ou ALD, mais do que duplicará nas próximas duas décadas, aumentando de 31 mil milhões de dólares em 2022 para 66 mil milhões de dólares em 2040.
O relatório recentemente divulgado foi liderado por Jovan Julien, pesquisador de pós-doutorado na Harvard Medical School , e Jagpreet Chhatwal, diretor do Instituto de Avaliação de Tecnologia do Massachusetts General Hospital. Retrata um cenário sombrio: uma crise econômica e de saúde pública e um alerta para os planeadores e decisores políticos.
“A ideia de beber tornou-se normalizada na nossa cultura”, disse Julien, principal autor do relatório, “e, portanto, o fardo, tanto em termos de custos de saúde como econômicos, tornou-se algo a que nos tornamos insensíveis”.
Mas os danos e as mortes são evitáveis, disse Chhatwal, professor associado da Harvard Medical School.
“Podemos reduzir substancialmente tanto o fardo da doença como o fardo econômico”, disse Chhatwal. “Precisamos de intervenções e ações a nível político para combater a doença e os seus custos crescentes.”
A chave envolveria abordagens multifacetadas para evitar que as pessoas atingissem um nível de consumo excessivo de álcool crónico ou regular. O Instituto Nacional de Abuso de Álcool e Alcoolismo define o consumo excessivo de álcool como quatro doses por dia e 14 por semana para homens e três por dia e sete por semana para mulheres.
“Os números de mortes por causas relacionadas ao álcool e por overdose de opioides não estão distantes um do outro.”
— Jagpreet Chhatwal, diretor do Instituto de Avaliação de Tecnologia
As diretrizes dos Centros de Controle e Prevenção de Doenças recomendam que os adultos evitem beber completamente ou o façam com moderação, tomando no máximo dois drinques por dia para homens ou um para mulheres.
O país deve preparar-se para o impacto da doença hepática causada pelo consumo excessivo de álcool, disse Chhatwal. O documento estimou que de 2022 a 2040 os custos totais atingirão 880 mil milhões de dólares: 355 mil milhões de dólares em custos directos relacionados com cuidados de saúde e 525 mil milhões de dólares em perda de trabalho e consumo econômico. “Esse não é um número pequeno, de forma alguma”, disse ele.
Mas o número de mortes por causas relacionadas ao álcool também não é pequeno. De acordo com o Instituto Nacional de Abuso de Álcool e Alcoolismo, 140.000 pessoas morrem todos os anos nos EUA devido ao consumo excessivo de álcool. Esses números são comparáveis aos da crise dos opiáceos, disse Chhatwal. O CDC relatou 106.699 mortes por overdose de drogas em 2021.
“Os números de mortes por causas relacionadas ao álcool e por overdose de opioides não estão distantes um do outro”, disse Chhatwal. “Beber é socialmente aceitável e as drogas não, por isso não ocorre às pessoas que beber possa ser prejudicial. Mas é claramente prejudicial.”
O relatório prevê que, se persistirem as tendências de consumo de alto risco, em 20 anos cerca de 956.000 pessoas morrerão anualmente de ALD. Entre eles estarão percentagens mais elevadas de mulheres e jovens, uma vez que os casos entre essas populações estão a aumentar a um ritmo mais rápido. Na verdade, espera-se que a percentagem de custos de ALD associados às mulheres que bebem aumente em quase 50% nas próximas duas décadas.
Custos anuais projetados relacionados ao álcool nos EUA
Durante a pandemia, o consumo de álcool aumentou com confinamentos, políticas relaxadas para entrega de bebidas alcoólicas e pessoas trabalhando em casa. Muitos que antes bebiam moderadamente tornaram-se bebedores de alto risco. Um estudo anterior mostrou que os dois anos da pandemia resultarão em pelo menos 8.000 mortes adicionais por causas relacionadas com o álcool na próxima década.
Para Julien, uma das principais conclusões do estudo é o aumento do consumo excessivo de álcool entre mulheres e jovens durante a COVID.
“Esse aumento no consumo de bebidas pode ter impactos residuais ao longo da vida”, disse Julien. “E assim, tanto para os próprios consumidores como para os decisores políticos, que estão a elaborar políticas que terão impacto nas pessoas ao longo da sua vida, é importante considerar quais são as intervenções potenciais que podem reverter ou controlar algumas destas mudanças nos comportamentos que estes indivíduos em particular coortes tiveram.”Chhatwal disse que os líderes políticos e de saúde pública deveriam considerar programas para aumentar a conscientização sobre os efeitos do consumo de alto risco e o desenvolvimento de terapias eficazes para tratar doenças hepáticas avançadas.
“Há um estresse subjacente na sociedade”, disse Chhatwal. “Precisamos pensar em como reduzir esse estresse porque ele é parcialmente responsável pelo consumo de alto risco. Algumas pessoas veem a bebida como um mecanismo de enfrentamento, mas não deveria ser um mecanismo de enfrentamento. Deve haver abordagens multifacetadas para enfrentar esta crise de consumo de álcool.”
A mortalidade precoce, devido à ALD e outras doenças evitáveis, é prejudicial para as famílias, as comunidades e a sociedade em geral, disse Julien. Estudos como o deles visam apresentar evidênciaseconômicas às autoridades de saúde e aos decisores, que têm a responsabilidade de agir.
“Quantificamos, de certa forma, alguns dos encargos econômicos e de saúde decorrentes da doença hepática associada ao álcool”, disse Julien. “Tentamos quantificar alguns dos impactos, mas há muitos outros aos quais não conseguimos definir um número específico. E embora a economia disto capte alguns aspectos quantificáveis da perda de vidas, não capta o buraco que resta numa comunidade quando alguém morre precocemente, particularmente devido a uma doença difícil e devastadora, que é a doença hepática em fase avançada.”