Thursday, August 10, 2017

High-Risk Drinking, Alcohol Use Disorder Rises Significantly Over Past Decade

Between 2001-2002 and 2012-2013, the percentage of U.S. adults who engaged in regular high-risk drinking increased by almost 30%, and the percentage of people meeting criteria for alcohol use disorder (AUD) grew by 49.4%, according to a report published today in JAMA Psychiatry.

“Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income,” Bridget F. Grant, Ph.D., of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and colleagues wrote.

Grant and colleagues compared information collected during face-to-face interviews from two nationally representative surveys of U.S. adults: NIAAA’s 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012-2013 NESARC-III. Survey participants were asked identical questions regarding 12-month alcohol consumption and how often they engaged in high-risk drinking (four or more standard drinks containing alcohol [for example 12 oz. beer or 5 oz. wine] on any given day for women; five or more standard drinks for men); for this study, high-risk drinking was defined as exceeding the daily drinking limits at least weekly. Participants were considered to have a DSM-IV AUD diagnosis if they met criteria for alcohol dependence or abuse in the past 12 months.

The study sample included 43,093 participants in the NESARC and 36,309 participants in the NESARC III. Between 2001-2002 and 2012-2013, alcohol use in the United States increased from 65.4% to 72.7% (11.2% increase), high-risk drinking increased from 9.7% to 12.6% (29.2% increase), and the prevalence of DSM-IV AUD increased from 8.5% to 12.7% (49.4% increase). 

“While the prevalence of AUD among both 12-month alcohol users and 12-month high-risk drinkers increased, the prevalence of AUD among high-risk drinkers (46.5% in 2001-2002 and 54.5% in 2012-2013) was much greater than the prevalence of AUD among 12-month users (12.9% in 2001-2002 and 17.5% in 2012- 2013), highlighting the critical role of high-risk drinking in the increase in AUD between 2001-2002 and 2012-2013,” the authors wrote. 

In a related editorial, Marc A. Schuckit, M.D., a professor of psychiatry at the University of California, San Diego, described the costs associated with alcohol-related problems and noted that the populations that appear to be at greatest risk may also be least likely to have access to care.

The article “makes a compelling case that the United States is facing a crisis with alcohol use, one that is currently costly and about to get worse,” he wrote. It is also a reminder that “the chilling increases in opioid-related deaths reflect a broader issue regarding additional substance-related problems.”

The findings “highlight the urgency of educating the public, policymakers, and health care professionals about high-risk drinking and AUD, destigmatizing these conditions, and encouraging those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment,” Grant and colleagues wrote.

For related information, see the Psychiatric News article “Why Treat Alcohol Use Disorders in Primary Care?” and the AJP article “Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption.”

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