Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011

Abstract

IntroductionExcessive alcohol consumption is responsible for 88,000 deaths annually and cost the United States $223.5 billion in 2006. It is often assumed that most excessive drinkers are alcohol dependent. However, few studies have examined the prevalence of alcohol dependence among excessive drinkers. The objective of this study was to update prior estimates of the prevalence of alcohol dependence among US adult drinkers. MethodsData were analyzed from the 138,100 adults who responded to the National Survey on Drug Use and Health in 2009, 2010, or 2011. Drinking patterns (ie, past-year drinking, excessive drinking, and binge drinking) were assessed by sociodemographic characteristics and alcohol dependence (assessed through self-reported survey responses and defined as meeting ≥3 of 7 criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).ResultsExcessive drinking, binge drinking, and alcohol dependence were most common among men and those aged 18 to 24. Binge drinking was most common among those with annual family incomes of $75,000 or more, whereas alcohol dependence was most common among those with annual family incomes of less than $25,000. The prevalence of alcohol dependence was 10.2% among excessive drinkers, 10.5% among binge drinkers, and 1.3% among non-binge drinkers. A positive relationship was found between alcohol dependence and binge drinking frequency.ConclusionMost excessive drinkers (90%) did not meet the criteria for alcohol dependence. A comprehensive approach to reducing excessive drinking that emphasizes evidence-based policy strategies and clinical preventive services could have an impact on reducing excessive drinking in addition to focusing on the implementation of addiction treatment services.

Transitioning from First Drug Use to Dependence Onset: Illustration of a Multiparametric Approach for Comparative Epidemiology

“…Within the field of epidemiological research on drug dependence in cross-sectionally observed community samples, there is a tradition of plotting the number of days of drug use on the xaxis and the estimated probability of being drug dependent on the y-axis (Apelberg et al, 2014;Chen et al, 1997;Chen and Kandel, 2002;Esser et al, 2014). The result is a figure that resembles a dose-response or dose-effect curve from laboratory experiments designed so that dosage level or number of dosage days are "fixed effect" exogenous explanatory variables that are under the control of the experimenter.…”

The temporal “pulse” of drinking: Tracking 5 years of binge drinking in emerging adults.

“…Relative to all alcohol-related problems, binge drinking is “responsible” for half of the 80,000 estimated deaths, two-thirds of the 2.3 million life years lost, and three-fourths of the $200+ billion economic costs annually. In addition to these hazards, binge drinking is concurrently related to prevalence of alcohol dependence at the population level (Esser et al, 2014), and, when measured in adolescence, has been predictive of later alcohol use disorders (AUDs; Jennison, 2004), and more generalized substance abuse diagnoses (Chassin, Pitts, & Prost, 2002). …”

“…In fact, as few as 10% of binge drinkers meet criteria for alcohol dependence (Esser et al, 2014). In recognition of this disparity, the CDC has recommended physician screening and brief counseling for binge drinking (2014), and the United States Department of Health and Human Services (DHHS) has made reduction of binge drinking rates in young adults an objective in the Healthy People 2020 initiative (DHHS, 2011).…”

The business case for hospital-based Behavioral Screening and Intervention

“…[33] For binge drinking, BSI is most effective for non-alcohol dependent individuals, who comprise 90% of individuals who drink above recommended healthy limits. [58,59] For such individuals, brief interventions -ideally consisting of an initial 5-to 20-minute session plus one to three follow-up sessions -elicit reductions of 20% in days of binge drinking, 33% in injuries, 37% in hospitalizations 20% in emergency department visits and a $523 one-year reduction in net healthcare costs. [60] A study of disabled Medicaid emergency department patients found a $4,392 one-year net reduction in healthcare costs within one year.…”