The epidemiology of harmful alcohol use and associated liver-related outcomes among adolescents and young adults in Ontario

Alcohol is the most common psychoactive substance used by Canadians and causes substantial harm and healthcare costs. Over the past decade in Canada, adolescents and young adults (AYAs: aged 13-39 years) have been shown to be disproportionally affected by alcohol misuse. Of particular concern, studies show that young adults are being more often diagnosed with alcohol-associated cirrhosis than in the past. Identification of at risk AYAs and developing interventions focused on alcohol abstinence and management of alcohol-related complications is necessary to reduce current and future disease burden. To do this, a clear understanding of the epidemiology, geographic distribution, and characteristics of the population at risk are needed along with the appreciation of sex-specific differences and the influence of social determinants of health (SDOH), changes in governmental alcohol policy, and the COVID-19 pandemic. Our overarching goal is to provide population-level data necessary to develop a framework for alcohol-related policy change and inventions specifically targeting AYAs in Canada. This project will use population-level administrative healthcare data from Ontario to describe the epidemiology of harmful alcohol consumption among AYAs between 2000-2021 and how changes in governmental alcohol policy and the COVID-19 pandemic have impacted harm in this group. We will also evaluate how sex-specific differences contribute to the development of liver-related complications in AYAs with alcoholic hepatitis. Finally, we will identify groups of AYAs based on their patterns of healthcare utilization to inform the development of interventions. Our team brings expertise in hepatology, epidemiology, and addictions/mental with extensive experience using population-level healthcare data to provide new knowledge required to develop a framework for alcohol policy change and interventions with an ultimate goal to decrease the burden of alcohol-related disease among Canadian AYAs.