A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis?

A. Inhalants: While inhalants can cause significant harm to the body, including brain damage and respiratory issues, they are not the primary cause of liver cirrhosis. B. Cocaine: Cocaine can cause various cardiovascular, neurological, and respiratory complications, but it is not the primary cause of liver cirrhosis. C. Caffeine: Although excessive caffeine consumption can have various health effects like anxiety, insomnia, and palpitations, it is not directly associated with causing liver cirrhosis. D. Alcohol: Chronic alcohol consumption is the leading cause of liver cirrhosis. Alcohol can damage liver cells, leading to inflammation, fatty liver, fibrosis, and ultimately cirrhosis. It is the most common substance use-related cause of cirrhosis.