A new US study estimates that about 30 per cent of Americans report having an alcohol disorder at some time in their lives. Over half (17.8 per cent) are due to alcohol abuse and the rest to alcohol dependence (12.5 per cent).

The study is published in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Alcohol abuse and dependence often have serious consequences like car crashes, domestic violence and birth defects. They also have a negative impact on the economy and cause enormous distress and impairment said the researchers who are from Columbia University in New York, New York State Psychiatric Institute, and the National Institute on Alcohol Abuse and Alcoholism.

Dr Deborah Hasin, from the Columbia University Medical Center and her colleagues analyzed data from face to face interviews with a representative cross section of the American population that took place with over 43,000 adults in 2001 and 2002.

The interviewers sought symptoms of alcohol abuse and dependence as defined in the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a “gold standard” used by psychiatrists and psychologists.

A diagnosis of alcohol abuse required one or more of the alcohol abuse criteria to be present and alcohol dependence required three or more of the seven criteria for dependence given in the manual.

Diagnoses of other mental and psychiatric disorders were also conducted, such as for depression, bipolar disorder, anxiety, abuse and dependence on other substances.

The results showed that:

  • 8.5 per cent of adults had an alcohol use disorder in the 12 months up to the survey.
  • This included 4.7 per cent with alcohol abuse and 3.8 per cent with alcohol dependence.
  • Alcohol dependence was more common among men, whites, Native Americans, younger unmarried adults and those on lower incomes.
  • Current alcohol abuse was more common among men, whites, and younger unmarried adults.
  • But lifetime rates of abuse were highest among middle aged Americans.
  • Alcohol abuse developed at an average age of 22.5, while alcohol dependence developed at an average age of 21.9.
  • Alcohol dependence was linked with disability and the levels of disability progressed steadily higher with increasing severity of dependence.
  • Of those who had alcohol dependence at some point in their lives, ony 24.1 per cent had ever been treated.
  • Of those who had alcohol dependence during the previous 12 months, only 12.1 per cent had been treated during the same period.
  • On average, patients received treatment 8 years after the age at which they developed the condition.
  • Treatment rates were slightly lower than those found 10 years earlier.

The researchers said that:

“On average, respondents with alcohol dependence manifested less disability than those with drug dependence and anxiety disorders, but their disability was comparable with that among respondents who had drug abuse, mood and personality disorders.”

They also found that alcohol abuse and dependence were linked quite significantly to use of other substances and their associated disorders but the link became weaker when they controlled for other conditions:

“Significant associations between mood, anxiety and personality disorders and alcohol dependence were reduced in number and magnitude when controlling for other comorbidity,” the researchers said.

This suggests that there is a unique underlying factor that links alcohol and other substance abuse disorders but the link between alcohol abuse or dependence and disorders such as personality, anxiety and mood disorders might be due to factors in common between the alcohol problems and these psychiatric disorders.

The authors concluded that:

“Alcohol abuse and dependence remain highly prevalent and disabling.”

“Persistent low treatment rates given the availability of effective treatments indicate the need for vigorous education efforts for the public and professionals,” they added.

A”Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions.”
Deborah S. Hasin, Frederick S. Stinson, Elizabeth Ogburn, and Bridget F. Grant.
Arch Gen Psychiatry. 2007;64:830-842.
Vol. 64 No. 7, July 2007

Click here for Abstract.

Click here for National Institute on Alcohol Abuse and Alcoholism.

Written by: Catharine Paddock
Writer: Medical News Today