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. Cocaine: Cocaine use is primarily associated with cardiovascular complications such as arrhythmias, myocardial infarction, and stroke. Although it can cause hepatic ischemia in rare cases, it is not a leading cause of cirrhosis. B. Inhalants: Inhalants can cause significant damage to the lungs, brain, and kidneys, and can lead to sudden cardiac death, but they are not known to directly cause liver cirrhosis. While some liver stress can occur, inhalants are not a primary hepatotoxic substance linked to chronic liver disease. C. Caffeine: Caffeine is a central nervous system stimulant with minimal hepatic toxicity when used in moderation. There is no established link between caffeine use and the development of liver cirrhosis. In fact, caffeine may even have protective effects against certain liver conditions. D. Alcohol: Chronic alcohol use is the most common and well-documented cause of liver cirrhosis. It leads to progressive liver damage through inflammation, fatty liver development, and eventual scarring (fibrosis), which impairs liver function and results in cirrhosis over time.