Alcohol-related liver diseases represent one of the most affected medical issues worldwide, requiring a multidisciplinary approach to treatment. Despite significant advances in understanding and treating liver diseases, many patients still have limited access to effective therapies. Among them, a new clinic in San Francisco stands out, aiming to change the way alcohol-related liver diseases are treated. This clinic not only deals with the symptoms of the disease, but also focuses on the underlying cause – alcohol addiction.

Alcohol is known as one of the most dangerous toxins for the human liver, but the remarkable ability of this organ to regenerate when harmful factors, such as alcohol, are removed, opens the door for significant recovery. In situations where the liver is severely damaged due to chronic alcohol consumption, such as alcoholic hepatitis and cirrhosis, there is a possibility of improving the condition with appropriate treatment. Treatment that includes medications, abstinence, and emotional support can significantly aid in recovery, even in the most severe cases.

However, such an integrated approach to treating alcohol-related liver diseases was not widely available until recently. Many doctors, according to dr. Courtney Sherman, hepatologist and professor at UC San Francisco, were not trained to address the underlying causes of the disease, such as addiction. "In medical schools we mostly learned how to manage the symptoms of liver disease, such as elevated liver tests or complications of cirrhosis, but we rarely dealt with the fundamental problem – addiction," explains Sherman.

For patients, this meant that they continued to drink alcohol, further damaging their liver, while doctors limited themselves to managing increasingly severe symptoms. This cycle, without a proper solution, led to a continuous deterioration of the condition, creating an unsustainable situation.

Inspired by the success of similar initiatives at the University of Michigan, dr. Sherman and Davina Martinez, LCSW, MPH, founded in 2023 the first multidisciplinary clinic for the treatment of alcohol-related liver diseases and alcoholism, named HALT – Healing Alcohol-Associated Liver Disease Together. This clinic is currently the only one of its kind in Northern California, and its purpose is to offer patients a holistic approach to treatment that encompasses both the physical and psychological aspects of their disease.

Alcoholism is a serious health problem, and according to data, more than 10% of people over 12 years old in the United States suffer from alcohol-related disorders. Interestingly, alcohol addiction has different prevalence rates among various ethnic groups. For example, among American Indians and Alaska Natives, the addiction rate is 11.6%, while among White Americans it is 11%, among Latinos 10.8%, and among African Americans 9.6%.

For many patients, the HALT clinic represents an opportunity for recovery and life change. "My motivation is to ensure that communities are aware of this important resource," says Martinez, an addiction specialist and member of the Chemehuevi tribe. At the HALT clinic, patients have the opportunity to collaborate with experts such as Sherman and Martinez to create personalized treatment plans that not only treat the liver, but also help patients break free from addiction.

A holistic approach to treatment

At the HALT clinic, patients first consult a hepatologist, dr. Sherman, who focuses on the condition of the liver and how best to manage complications associated with alcohol. All treatment options are considered, including the possibility of a liver transplant if necessary. After that, patients meet with Martinez, who helps assess their readiness for abstinence. Here, triggers for alcohol consumption are analyzed, strategies for impulse control are considered, and a plan for preventing relapse is developed.

For all patients, there is also the option of consulting dr. Triveni Defries, an addiction medicine specialist, who can prescribe medications to control withdrawal symptoms and cravings. This comprehensive approach enables patients to address all aspects of their disease, including physical and emotional well-being, thereby significantly increasing the chance of successful recovery.

Proven successes of the HALT program

The results of initial studies, including a study from February 2025 conducted by the Cleveland Clinic, showed significant effectiveness of integrated programs for treating alcohol-related liver diseases. The study demonstrated that 45% of patients who participated in a program like HALT were in remission at the first follow-up, and they also improved their MELD (Model for End-Stage Liver Disease) scores, indicating improvement in liver condition.

According to researchers from Cleveland, patients who participated in the multidisciplinary approach experienced significant improvements in indicators of liver damage, severity of liver disease, and reduction in alcohol consumption. Sherman and Martinez, who are already collecting data on the effectiveness of HALT, have together treated more than 300 patients since the clinic opened two years ago.

The HALT program shows that the integration of pharmacological therapy and mental health can be the most effective for treating alcohol-related liver disease. "The goal of HALT is to provide comprehensive care – care not only for the liver, but for the whole person," emphasizes dr. Sherman.

Breaking the vicious cycle

Patients who come to the HALT clinic face various stages of liver disease. Some of them have livers so damaged that a transplant is necessary for survival, while others seek alternative ways for recovery without the need for surgery. Many patients are overwhelmed by the challenges of maintaining abstinence. However, dr. Sherman and Martinez constantly remind them that they are not alone in their recovery journey and that there is scientific evidence supporting the possibility of healing.

"I have seen countless patients with advanced liver failure who need a liver transplant, but who do not meet the criteria due to continued alcohol consumption or other psychosocial challenges. With alcohol abstinence, many patients improve to the point where they no longer require a transplant and address many symptoms associated with liver disease," says Sherman.

Alcohol is toxic to the liver, but if this toxin is removed, the liver has the capacity to regenerate. This simple yet powerful principle is the basis for the successful recovery of patients and shows that with the right approach and support, even the most severely damaged liver can begin to heal.

Source: University of California