Telescoping and Gender Differences in Alcohol Dependence: New Evidence From Two National Surveys

Abstract

Objective The course of alcohol disorders in women is often described as “telescoped” compared to that in men, with a later age at initiation of alcohol use but shorter times from use to dependence and treatment. This study examined evidence for such a telescoping effect in the general population and tested birth cohort effects for gender differences. Method Data from two U.S. national surveys conducted 10 years apart (1991–1992 and 2001–2002) using the same diagnostic instrument (the Alcohol Use Disorder and Associated Disabilities Interview Schedule–IV) were used to analyze five birth cohorts. Age at initiation of alcohol use, time from first use to dependence, and time from dependence to first treatment were analyzed. Interaction terms (cohort by gender; cohort by gender by time) were tested in Cox proportional hazards models. Results Little evidence was found for a telescoping effect in women. For alcohol use and dependence, cohort and gender interacted, which suggests that gender differences are diminished in more recent cohorts. A three-way interaction of cohort, gender, and time was significant for time from first use to dependence, suggesting that men have a shorter time to dependence, especially in younger cohorts. Conclusions A telescoping effect is not evident in the general population. Gender differences in the overall hazard of alcohol use and dependence are decreasing in more recent cohorts, while gender differences in time from first use to dependence are increasing. These findings challenge the commonly held notion of a gender-specific course of alcohol disorders and suggest the need for a greater clinical focus on problem drinking in women and further research on accelerated time to dependence in men.

Family History Density of Alcoholism Relates to Left Nucleus Accumbens Volume in Adolescent Girls

“…It is possible that multiple neurobiological risk factors for alcoholism differ by sex in those with familial AUDs since there are also differences by sex in WM volume relationships with neuropsychological functioning in youth with and without a family history of substance abuse/dependence (Silveri et al, 2008). Differences in the neurobiology between males and females with a family history of AUDs can also help explain why the development and progression of alcoholism has been shown to differ between the sexes (Keyes et al, 2010;Schuckit et al, 1998), which is likely related to sex differences in response to alcohol, variations in neurotransmitter systems between men and women, and different effects of alcohol-related neurotoxicity between the sexes (Ceylan-Isik et al, 2010).…”

Sex Differences in Animal Models: Focus on Addiction

“…We note that whether women exhibit greater telescoping for alcoholism than men remains controversial (Keyes et al, 2010;Sharrett-Field et al, 2013), but this highlights the need for a better understanding of what it means for there to be sex differences in "telescoping." The initial report of telescoping considered the onset and time course of alcohol dependence in men and women in a treatment program.…”

“…Among respondents aged 12 and older, there were increases in the percentages of females but not males who were current drinkers and binge drinkers. Drinking days per month increased for females and decreased for males (Keyes et al, 2010). Sex differences in the patterns of alcohol drinking behavior in humans emerge by the end of adolescence (around 17 years of age) and persist across adulthood (Substance Abuse and Mental Health Services Administration, 2007).…”

“…Indeed, a recent analysis of evidence of telescoping using data from two United States national surveys found no evidence that women exhibit a shorter period of time from first use to dependence in the general population, but at the same time they reported a convergence in the overall hazard of alcohol dependence for men and women (Keyes et al, 2010). The Sex Differences in Addiction discrepancy between an analysis of the general population and a treatment-seeking population can be explained by considering the mechanisms that influence the expression of this sex difference.…”

Transtornos relacionados ao uso de álcool e as mulheres: impacto nos circuitos integrativos e de neurorregulação do estresse

“…Essa aparente sensibilidade aumentada aos efeitos nocivos do álcool e um caminho mais curto entre o uso abusivo do álcool e a dependência deram origem ao termo telescoping eff ect 13 . Em populações mais jovens, há dados bastante heterogêneos em relação a esse efeito, principalmente com relação à idade de início de uso 14 . A progesterona está associada, de forma bem documentada na literatura, em estudos pré-clínicos, a um menor efeito positi vo no sistema de recompensa cerebral, sugerindo a infl uência dos hormônios gonadais tanto na neurobiologia quanto na sensibilidade ao álcool.…”