it's the alcohol company's job to identify new markets and market very aggressively to women. with alcohol deaths at their highest since records began, i want to reveal the situation in the uk's hospitals... the current kind of tsunami of liver disease that we're seeing, our health services are not going to be able to cope. ..and meet those who almost paid the ultimate price. i was told that i had lessl than 36 hours left to live. at the time, i was living my best version of my life. - where i ended - was at death's door. as a fit and active 31—year—old, i just assumed everything was fine. does it suit you to do us live later?

about 9:45? excellent. i'd worked hard to develop in my career as a bbc journalist. i had a fun and hectic social life as a student and in my twenties... what does a pig say? oink, oink! ..and then i became a new mum to a beautiful wee girl. i had a young child. i was absolutely exhausted — and no wonder. but even so, i made an appointment with my gp and i went in for some blood tests. i had no idea this meeting would be such a major turning point. there is actually a little screen of bloods that gps do quite often called tired all the time. tatt we call it. but one of the tests in that screen is liver function. and that was the one that was abnormal in your case. in a healthy person, this figure should be less than a0. mine was 213. i thought, so let's get you up

to the hospital and get the proper imaging done, see what's really going on here. in february, i came here to the new victoria hospital in glasgow, where the test results revealed a shocking diagnosis. in patients who've got liver conditions, we try and exclude other types of problems such as autoimmune, viral, hereditary conditions, and these were excluded. and we also did another test called a fibroscan test. so a normal score should be less than seven, above 12 or so it would feel to be cirrhosis. your score was 10.2. so it did show quite severe significant scarring present. to understand what had caused my level of scarring, what conclusion did you come to? in your case, we worked out, we felt this was most likely to be alcohol and, if you continued to drink, then i was worried that you were going to go on and develop cirrhosis of the liver. so the most important thing for you at that time was to stop drinking.

i had been diagnosed with arld, alcohol—related liver disease. it had been caughtjust below the threshold for permanent damage. i remember walking through this park and feeling shellshocked and quite numb. i was 31, a young professional with a good job, a good career, a family, a home, you know, a vibrant social life. the guidelines for both men and women say you shouldn't drink more than 1a units a week. that's about six glasses of wine. on nights out with friends, we probably all exceeded that. but it was social drinking. i wasn't drinking every day. it was frightening and ifelt shame. i rememberthinking, "god, i can't believe i've done this to myself." i want to dig into the facts

around alcohol—related liver disease. i can't be alone. there must be other people going through this. they call liver disease a silent killer. there are no symptoms in the early stages, and seven in ten people won't know that there's anything wrong with them until they turn up at a&e. and that is terrifying. in front of me are the numbers and the statistics and the graphs that are indicating to me that there is a rising problem that nobody is talking about. across the uk, alcohol—specific deaths are at their highest since records began. in 2001, there were more than 5,500 deaths but, by 2022, it had topped 10,000. the mortality rates

are still highest among men, especially older men, but i'm really shocked to see the figures for younger women. this graph focuses on deaths in women aged 35 to 1m. it tracks the relative change for the main six diseases in england, going back more than 50 years. the number of people dying of major diseases like diabetes, cancers and heart disease are all falling, except for liver disease, which is skyrocketing. in 1968, 36 women in this cohort died of liver disease and, by 2022, there were 356 deaths. adjusting for the rising population, that is still an eight—fold increase. i find that really shocking.

ijust really do. the thing is, we know that there has been so many public health campaigns and, you know, adverts about how we need to get mammograms and checking yourself. but, actually, the same can be said for liver disease getting checked, yet we never hear about that. why is no—one talking about it? the statistics show a changing profile of who is affected by alcohol—related liver disease. why are women under 45 dying in increasing numbers? i want to know what this situation looks like on the ground in our hospitals. i've come to king's college hospital in london to talk to consultant hepatologist debbie shawcross at one of the biggest liver units in the uk. we're absolutely busy. so, on monday, we had probably one of our busiest days that i've known in a couple of years in terms of the number of patients that had come in over the weekend or had been transferred for expert care. knock, knock!

who is on this ward and what kind of people are you... ..are you seeing? what we're seeing is a huge proportion of younger individuals who present with liver disease and liver failure, sometimes as young as 20. one of the groups we see are actually highly successful women, women in their forties and fifties. they have great careers, but they're also juggling things. they're spinning plates in the air, and they've maybe got young families. they've got other things going on. they're not alcoholics, you know, they've never probably even been drunk, but they are just drinking too much as a habit, really. what you have described in that answer, you're talking about me. you know, i didn't have a physical dependency, but it's been a life—changing diagnosis for me. actually, it's ok to talk about this. you know, it's a national problem. it's not a personal problem. it's something we need to deal with as a nation to actually make everybody healthier.

i want to find out what could have happened to me if my condition hadn't been discovered in time. i've come to meet emma jones. at 39, she's seven years older than me and grew up in north wales. i was always a super, super sociable person, had loads of different groups of friends, was, like, always going out. i went to university, studied law. as my career started to progress, there always tends to be, like, a drink there or, after meetings, we would all go to the pub. i didn't touch spirits so, when i was out with friends, we were all going round, buy a bottle of wine, share it between three, four of us. i was just drinking the same amount as everybody else around the table at the time. i didn't see myself with a problem at all until covid hit.

i was living alone in london. the way the world was, it was a really scary place to be, and ifound that i was relying more on alcohol, and i think it spiralled from there. at most, i was drinking about three bottles of wine a day. i knew it was affecting me as a person, but at no one point did i think internal organs were failing. and then, in october 2022, i went to stay with a friend. basically, all the symptoms had kicked in by this point. i was jaundice. i'd lost a dramatic amount of weight, and that night she took me into hospital. i was told that i had less than 36 hours left to live. but you must have been terrified? i was petrified.

it was the wake—up call i needed. but in my head, it was too late. i'd done the worst thing i could have done, which is kill myself. emma was in end—stage liverfailure. her only hope lay in a liver transplant. in the uk, you need to prove sobriety for six months before you're eligible to go on the transplant list. i was told the likelihood of me surviving the six months was very minimal, but i gave it a go. i got my transplant on the 7th ofjuly, 2023, 15 months ago. yeah. how has things been? how do you feel? yeah, i feel incredible. um...

but there's. .. it's a different life. so obviously you've got your scar. luckily for me, i relish my scar. i love it, but you've got a lifetime of hospital visits, and i will be on anti—rejection tablets for the rest of my life. the guilt is unreal. but i've been given a second chance at life, so i'm definitely making the most of it. so, when you hear about people having end—stage liver disease, you think that they've been heavy, heavy drinking for a number of years. i know that my own drinking was exacerbated during lockdown, so to have things turn so bad so quickly puts that into perspective, and that's terrifying. meeting emma and talking with professor debbie shawcross

has given me a lot to process. i find myself thinking differently about our relationship with alcohol as a nation and also about my own history. you know, when i was in my 20s, i drank a lot, you know? don't think i ever had a sober birthday. i was in a band, for example, with six other guys, and we would play around pubs and clubs and, you know, a lot of the time we'd get paid in drink. i'm five foot four and 8.5 stone and forgetting that i can't drink like a guy, but i would. i would, just because it was normal around me. but i never thought of myself as drinking in a way that would give me liver damage. we weren't drinking every day. i guess we were binge drinking. could that have been

enough to cause this harm? i want to know more about the possible impact of this pattern of drinking. i've come to the royal free in north london to meet dr gautam mehta. he is one of the authors of a recent study looking at the connections between binge drinking and liver disease. when you think about binge drinking, people have a vision of people sprawling out of bars and clubs and, you know, falling around by bus stops. that's not what we mean biologically. what is a binge? so we can define a binge. it's defined by the world health organization and it's also in uk guidance. so, for a woman, its six units of alcohol at one sitting. and, fora man, it's eight units. i'm trying to make sense of... trying to make sense of that. six units could be two large glasses of wine. so, if you have 2.5 regular—sized glasses of wine

or two large glasses of wine, and you're a female, you're at your limit for being below a binge level. do people have a hard time believing that that is real and that will cause you harm if you exceed that? yeah. i think they do. what we recently showed was that binge drinking on its own, even with a weekly consumption of less than 1a units, will increase your risk of liver disease. wow! if you had a binge pattern of drinking, at sort of a six—unit level at least once a week, then your risk of liver cirrhosis was incremented between two and threefold. but the risk goes up if you binge more — nine units, let's say. so that's three glasses of wine now, large glasses of wine, then that increments your risk further to around four times. dr mehta's new research is telling us that, for a woman, drinking two large glasses of wine in one session is a binge. drinking at this level at least weekly can double or treble your risk of liver damage in the long term, and three large glasses of wine in one night could put

you at up to four times the risk. as we come up to christmas, and i look at all of these people, ithink, does everyone else know this? it makes me want to have a really frank chat with my friends and family. we've been going out and drinking together for years. but tonight i'm on the alcohol—free beer. the first time i ever got drunk was with you. i maybe was the bad influence. i think we were 15. yeah, 1a, 15. and i remember we had a half bottle of vodka. i remember we both got drunk and then we were both sick! what do you think the medical definition of a binge is? i'd say seven units. seven units in a binge? i was going to say more, like ten. i ten? i'm going to guess, like, six or something. shut up! it's six! hey! it's six. so, lindsey and laura, six units in a binge.

but robbie and brian, eight. so, like, a bottle of wine is nine units. people say binge drinking is going out to a club or a pub and, wahey! not binge drinking as in drinking a bottle of wine in your house, watching tv. it was like a normal thing that we did. it's the culture. in other cultures, there's initiation and transitioning to an adult. but in the uk, our initiation is, when can we drink? yeah. isn't this just a rite of passage that everyone has gone through over the decades? was my generation any different? i've come to meet professor fiona measham, a leading expert on drink and drugs culture in the uk over the last a0 years. i was born in 1992. can you put that into context for me, into where my generation kind of fits in? yeah, absolutely. so it used to be that pubs were quite male spaces, male—dominated spaces.

women might come along at weekends, but they would come along usually sort of at the invitation of men. there was a real change in the early 1990s that i saw. and i was doing research on raves, and what we could see was that the raves were really attractive for young women. there was a sense of equality and also, people weren't drinking. and so, i think, for the alcohol industry, this was a bit of a wake—up call. you know, there was a concerted effort to woo female customers. so we see the advent of alcopops. we see the start of the bottled spirit mixers and also shots, or shooters, for the first time that were marketed to young women and they were appealing to young women. i can remember alcopops coming out.

i can remember being in uni and someone walking around with, you know, shots and, you know... in the holsters. in the holsters, yeah, yeah. i can remember all that. looking back at that, at what point did you think that there was something wrong here? i wouldn't say that at the time it felt wrong. what it did feel like was unbridled, shall we say? women's drinking pretty much doubled in a really short period of time. and i think it was about ten years. people who started drinking really, in any time, from when you were born in �*92, right through to 2010, and that was really the time where we saw the least responsible drinking practices when the alcohol industry was most targeting women. what was everyone thinking? like, of course this was going to be a public health nightmare. you actively had companies throwing all this marketing towards young women. my generation was growing up right through that. pieces of the puzzle are starting to...slot into place. i understand more now about why we were drinking like that when we were young but, as we've got older and our priorities have changed, has the alcohol industry continued to target the same group of women now in their thirties and forties?

professor carol emslie has studied the way that alcohol has been marketed to women and has founded an online campaign highlighting its presence in our everyday lives. nobody thinks that marketing works on them and yet the alcohol industry is spending huge sums of money doing it. if you go into any supermarket, there's a whole array of pink drinks with shaped elegant bottles or slimline cans that are echoing the idea that some products are associated with slimness and beauty and wellness. a few years ago, we started a social media campaign called don't pink my drink, which was really to try and show the variety of cynical ways that women are marketed to with alcohol. i think quite often alcohol companies are very good at identifying trends or identifying what's being talked about, but then

they really magnify it. so it's very cleverly interwoven into women's lives, using things that they're talking about already. so this idea of kind of time for self, self—care and empowerment is very much harnessed by the alcohol industry to sell to women. and the market has grown and grown for women in their 305, 405 and 505 now. it'5 the5e cohorts of women that are continuing to drink at quite heavy levels. talk to me, if you can, about whether there's a correlation between all of this marketing and actually the impact that it has on women's health. there's been a huge increase in deaths attributed to alcohol among women. so i think it's really important that we balance the5e things out, you know, the need for companies to make profit with the harm that is done by that profit. make no mistake, this is... they see it as theirjob to market to women and they will resist, to the best of their ability, any attempts

to reduce the power that they have. the portman group, which represents the alcohol industry, says, while... it says its code of practice... ..but sets... and it's... the department of health and social care says... ..and the... any policy change will take time, but this is a problem 110w. today, i've come to nottingham, where one charity, the british liver trust, has taken matters into its own hands at their love your liver roadshow. cirrhotic liver. it doesn't look healthy at all, does it? you're in big trouble if your liver is like this. i'm one of the nurses at the british liver trust. hello.

any policy change will take time, but this is a problem 110w. today, i've come to nottingham, where one charity, the british liver trust, has taken matters into its own hands at their love your liver roadshow. cirrhotic liver. it doesn't look healthy at all, does it? you're in big trouble if your liver is like this. i'm one of the nurses at the british liver trust. hello. so this machine here gives us a wee bit of indication of the health of your liver. 0k? this vehicle is kitted out with a fibroscan, the same instrument that detected the damage to my liver. folk are invited to come on board and take this free five—minute test to find out the health of their liver. if anything is starting to cause damage to their liver, that obviously makes the tissue 5tiffer, and the machine simply measures that level of liver 5tiffne55 on a gradient. so it's telling us whether the liver is in a healthy 5tate

or not and, if not, how advanced that damage is. hello. hiya. do you want to just hop up on there for me? saw you guys setting up this morning over| here and i was like, - "i have been drinking a fair amount "and i did go - to university, "so i probably did a bit of damage there. "probably best to go - and get it checked out." yes, that's a really good score, my love. 0k? all right. perfect. thank you so much. i've quit drinking for 32 days today. ijust want to make sure everything's still ok now that i've stopped. but before that, i've been kind of under pressure with courses and stuff like that, so i've been pretty much drinking all year. what's my bad boy saying? it says that your liver is nice and healthy. good. nothing to worry about. wicked. thank you very much. no problem. everybody that we have spoken to, thankfully, have all had very low readings. like, when i was fibroscanned last, my reading was 10.2. you know, i was thinking, i can't be the only person this has happened to and ijust wondered what you thought

about that. no, you're not alone. so, if i go back 20 years, . people with alcohol—related liver disease look much more like me, middle—aged men,| whereas that has changed. so, although it's still— a predominantly male problem, women are catching up, i'm afraid. - the british liver trust has only one of these vehicles. working at full capacity, they can scan around 100 people a day. we've scanned nearly 90 people so far and we've already found eight people out of those 90 who need to visit their gp and get some follow—up checks to find out exactly what's happening with their liver. we asked the british liver trust to analyse their figures. of the people under a0 who have used their road show, 1 in 15 showed signs of possible liver damage. for me, you know, it started with a blood test and then it was more blood tests, then it was a blood test six months later and then it was an ultrasound, and then eventually it was a fibroscan. so, to be able to just pull in off the street, get your liver scanned and be done with it is, like, is really cool.

it's been nearly ten months since my original diagnosis and i've managed to stay off alcohol completely. today, i've been invited back to the hospital for a follow—up scan. this scan will reveal whether my liver has been able to heal or whether i'm facing permanent damage. my original fibroscan reading was 10.2, just under the threshold for liver cirrhosis. a healthy reading would be seven or under. hazel? hi. through you come. thank you. with all the changes i've made in my life the past year, has it been enough? 0k.

that's you. all done. much better. really? a.7. you're joking! no. that's a big difference. mm—hm. that's a really big difference. mm—hm. hello. a.7. ipr a% and cap 182. fantastic. it's a fantastic result. the improvement has been quite staggering, really, in a relatively short space of time. you could drink again, but i think you've got to be wary of the habits, or the bad habits, you developed in the past. and do they creep back in again, and then you're back in a similar situation or potentially worse in the future? so, um, ithink the idealway would be to try and avoid alcohol in the future. thank you so much for that, dr datta. you're welcome.

i feel lucky to have such a drastic improvement in such a short space of time. you can't get away from the fact that it could have gone the other way and i could be sitting here coming to terms with the fact that i have damaged part of me irreparably, which is exactly what could have happened, and i think that's what happens to so many people. in my case, it took a shocking medical diagnosis to force me to break patterns of damaging behaviour. is it time the alcohol industry and government took our binge drinking culture more seriously too? i can't ignore the relationship that alcohol has played in my life. this is never going to happen again because i am well and healthy. my liver is, anyway. and, you know, i don't think you can underestimate that and how good that feels.

live from singapore, this is bbc news. officials warn of a very high wildfire threat across los angeles as the death toll rises to 2a.

plus — donald trump wants greenland. we hearfrom a danish lawmaker who says they don't want to be american. and from some greenlanders, who say they don't want to be danish either. and a week from donald trump's return to office — we look at what's in store for us—china relations. welcome to newsday, i'm steve lai. firefighters in los angeles are tackling new fires that have flared up in angeles national forest, located just above nasa's jet propulsion lab. the area is popularfor hiking near millard waterfall. a crew at the scene reports the area is now "dry as a bone". some progress has been made as firefighters continue to battle multiple fires across the city,

but the la county fire chief says that the threat of more