Lots of prescribed medications are harsh on the liver. Accutane for example is really rough on the liver, and doctors will test your liver regularly when you are on accutane. They will adjust your dosage and prescribe liver support for liver issues.
We don’t have the luxury of having access to a huge range of liver support drugs, so we often go with the bare minimum OTC supplements to get the job done. There are also a ton of people who use AAS who don’t know or care about long term health.