Addressing Stigma and Advancing Care in Alcohol-Associated Liver Disease, With Frances Lee, MD

Alcohol-associated liver disease (ALD) remains a major and growing cause of liver-related morbidity and mortality, yet it is often approached through an oversimplified and stigmatized lens.

Misconceptions about who develops the disease, why it occurs, and how it should be treated continue to influence both patient engagement and clinical decision-making. As understanding of ALD evolves, there is increasing recognition that effective care extends beyond managing liver injury alone and requires a more nuanced, multidisciplinary approach.

“[It] is a really interesting topic because there are a lot of misconceptions both on the patient side and on the clinician side,” Frances Lee, MD, an assistant professor of medicine in the division of liver diseases at Mount Sinai, told HCPLive, describing misinformed beliefs about comorbid alcohol use disorder and the subsequent stigmatization this thought process introduces.

For patients, she says this stigma may discourage engagement with care or delay presentation altogether, while for clinicians, it can unconsciously narrow how the disease is approached and managed.

Lee goes on to emphasize that ALD care involves more than just treating the liver disease–it also requires addressing factors impacting the patient’s drinking patterns. Because of this, she says multidisciplinary care is essential, like that provided by Mount Sinai’s Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program.

Co-located within Mount Sinai Hospital’s Internal Medicine Associates, REACH provides a patient-centered, harm reduction approach to primary care for persons who use alcohol and other drugs, and for individuals living with hepatitis C virus infection. Similar programs exist at other institutions, like Massachusetts General Hospital’s Long-term Individualized Follow-up after Transplant (LIFT) Clinic for the the prevention and management of alcohol relapse in high-risk liver transplant recipients.

Beyond multidisciplinary care, Lee also looks ahead to the future of pharmacotherapy for ALD, describing her excitement about trials exploring GLP-1s and siRNA molecules for this indication.

“Right now, the current medications that we use for alcohol-associated liver disease are really medications for alcohol use disorder and alcohol use cravings, so to be able to offer patients a liver-specific therapy for their disease courses in the future is very exciting,” she said.

Editors’ Note: Lee does not report any relevant disclosures.

References

1. Mount Sinai. Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program. Accessed January 15, 2026. https://www.mountsinai.org/care/primary-care/upper-east-side/ima/reach

2. Zhang W. Preventing Alcohol Relapse After Liver Transplant, with Wei Zhang, MD, PhD. HCPLive. May 5, 2025. Accessed January 15, 2026. https://www.hcplive.com/view/preventing-alcohol-relapse-after-liver-transplant-with-wei-zhang-md-phd