Sertraline in the treatment of co-occurring alcohol dependence and posttraumatic stress disorder

BACKGROUND: Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD. METHODS: A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants. RESULTS: There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05). CONCLUSIONS: There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.     

Disparities in patterns of alcohol use among reservation-based and geographically dispersed American Indian populations

BACKGROUND: High rates of alcohol use and alcohol-related morbidity and mortality among American Indians (AI) are major public health concerns. The purpose of this paper is to describe patterns of alcohol consumption among three distinct samples of American Indians (AIs) compared to a U.S reference population. METHODS: Data were drawn from two epidemiologic studies: 1) a study of 2,927 AIs living on or near reservations from two culturally distinct tribes in the Southwest (SW-AI) and Northern Plains (NP-AI); and 2) the National Longitudinal Alcohol Epidemiologic Study (NLAES), which included data from a geographically dispersed sample of AIs (n = 780) as well as the US reference population (all-race excluding AIs, n = 30,063). Multivariate analyses were used to assess drinking patterns. RESULTS: After controlling for demographic characteristics, the prevalence of drinking during the past year was similar among males in the NP-AI, NLAES-AI, and the US populations. SW-AI males and females were significantly less likely to drink during the past year (Odds Ratios of 0.74 and 0.41, respectively), while the odds of NP-AI females being current drinkers were twice that of US females. Among those who drank during the past year, the AIs consumed a larger quantity of alcohol per drinking day than the US reference population. However, the reservation-based AIs consumed alcohol less frequently (Odds Ratios between 0.18-0.40, p < 0.01) than the NLAES-AI and US populations. CONCLUSIONS: Patterns of alcohol consumption varied substantially between the two reservation-based AI populations, the geographically dispersed sample of AIs, and the US reference population. Careful consideration of these variations may improve the effectiveness of alcohol prevention and treatment programs as they may reflect important underlying differences in the cultures of alcohol consumption across these populations.     

Pattern of drinking and fatal injury: a population-based follow-up study of Finnish men

AIM: To find out how the frequency of drinking one to two drinks, three to four drinks and five or more drinks of alcohol per drinking occasion predicts injury mortality in 16 years of follow-up among the Finnish 15-69-year-old male population. DESIGN: Three alcohol surveys conducted in 1969, 1976 and 1984 were pooled and linked with mortality information from the national cause of death register. METHOD: Cox proportional hazard models were used for analysing the survival time data. FINDINGS: Drinking at the level of one to two drinks, regardless of frequency, did not elevate the risk of fatal injury, nor did drinking at the level of three to four drinks. Drinking five or more drinks at a time significantly increased the risk of fatal injury in graded relation, compared with those who never drank at that level. The risk was highest for those who drank five or more drinks at a time at least weekly (RR = 5.78, 95% CI = 2.80-11.94), when adjusted for possible confounders. CONCLUSIONS: We found that besides the total volume of consumption, a drinking pattern that involves drinking occasions when consumption exceeds four drinks of alcohol at a time leads to a significant increase in the risk of fatal injury among Finnish men. The risk is highest among those who have the highest annual number of heavy drinking occasions. The finding does not support the hypothesis that alcohol tolerance would lower the risk of fatal injuries among frequent heavy drinkers.     

The identification of alcohol dependence criteria in the general population

Aims. To assess the criteria used to identify alcohol dependence in the general population. Design and setting. Two independent probability surveys of the US household population 18 years of age and older were analyzed: the 1994 National Telephone Survey (NTS-94), which interviewed 637 respondents, and the 1988 National Household Interview Survey (NHIS-88) which interviewed 43 809 respondents in their homes. Participants. The analyses of the NHIS-88 dataset focused on drinkers who consumed at least 12 drinks of alcohol in the 12 months prior to the survey interview ( N = 22, 102). The analyses of the NTS-94 dataset focused on drinkers who consumed at least one drink in the 12 months prior to the survey interview ( N = 637). Measurements. Criteria for DSM-IV alcohol dependence were operationalized using 15 items from a standardized questionnaire. Findings. Analyses suggested that normal drinking behavior can be misidentified as dependence criteria. Results for men who drank up to two drinks per day suggest that if the dependence criteria were invalid, reductions in the prevalence of specific indicators of alcohol dependence would range from 0.3% to 5.2%. Correcting for the misidentification of alcohol dependence diagnosis would reduce the overall prevalence of alcohol dependence by 0.5%. Up to 7% of the men could have been diagnosed as alcohol-dependent and could have provided invalid reports. Conclusions. The identification of alcohol dependence in general population samples must include careful probing of the nature of drinking-related behavior reported by respondents. This will decrease misidentification of dependence criteria, increasing the validity of dependence diagnosis in survey research.     

A taxometric study of alcohol abuse and dependence in a general population sample: evidence of dimensional latent structure and implications for DSM-V

Aims   To explore, with the aid of taxometric analysis, whether alcohol abuse and alcohol dependence are each conceptualized most effectively as single latent dimensions or distinct latent categories.
Design   Data were taken from a nationally representative cross-sectional epidemiological survey of psychiatric and substance use disorders.
Setting   General population of Australia.
Participants   A subsample of all respondents who had consumed at least 12 drinks in the year prior to the survey and who had consumed at least three drinks on at least one single day ( n  = 4920 of a possible 10 641).
Measurements   DSM-IV criteria for alcohol abuse and dependence were assessed with the Composite International Diagnostic Interview, version 2.1. Two independent taxometric procedures, MAXimum EIGenvalue (MAXEIG) and mean above minus below a cut (MAMBAC), together with analysis of simulated dimensional and categorical data sets, were carried out.
Findings   Consistent evidence was found for a single latent dimension underlying the symptoms of alcohol dependence. Less consistent evidence of dimensionality was found for the symptoms of alcohol abuse.
Conclusions   These findings support the growing consensus regarding the need for continuous measures of alcohol use disorders to complement the traditional categorical representations in upcoming versions of the major psychiatric classification systems.     

Cigarette smoking and the risk for alcohol use disorders among adolescent drinkers

BACKGROUND: Cigarette smoking and alcohol use disorders (AUDs) are closely linked, but it is not clear whether higher rates of AUD among smokers are solely attributable to heavier drinking or, alternatively, whether smokers are more vulnerable to alcohol abuse and dependence than nonsmokers who drink comparable quantities. We sought to address this issue using data from a nationally representative U.S. sample of adolescents and young adults. Specifically, we analyzed the relationship between cigarette smoking, drinking, and AUDs. METHODS: Data were from the aggregated 2002 through 2004 U.S. National Survey on Drug Use and Health. Participants were randomly selected, household-dwelling adolescents and young adults (ages 12-20) from the noninstitutionalized, civilian population of the United States (N=74,836). Measurements included current DSM-IV alcohol abuse or dependence, number of drinks in the past 30 days, and past-year cigarette smoking, defined as having smoked more than 100 cigarettes across the lifetime and having smoked during the past year. RESULTS: Past-year smokers (prevalence=16.0%) drank in higher quantities than never-smokers, but were also at elevated risk for AUD when compared with never-smokers who drank equivalent quantities. The effect was observed across age groups, but was more prominent among younger adolescents. After adjusting for drinking quantity and sociodemographic variables, smokers had 4.5-fold higher odds of AUD than never-smokers [95% confidence interval (95% CI), 3.1-6.6]. Youths who reported smoking but did not cross the 100-cigarette threshold were at intermediate risk [odds ratio (OR), 2.3; 95% CI, 1.7-3.3]. Differences in AUD between smokers and never-smokers were most pronounced at lower levels of drinking. CONCLUSIONS: The results are consistent with a higher vulnerability to AUDs among smokers, compared with nonsmokers who drink equivalent quantities.     

A measure of the intensity of response to alcohol in a military population.

Heavy drinking and associated problems are relatively common in young men, including those in a military setting. This article explores characteristics of alcohol intake and associated difficulties and their relationship to a self-report of the usual intensity of response to alcohol in a sample of U.S. Marines. Two questionnaires related to demography and alcohol use histories, along with a simple, 12-item self-report measure of the usual number of drinks to experience an effect (the Self-Rating of the Effects of Alcohol, SRE) were administered to 1320 U.S. Marines. The sample had an average age of 22 years, 78% were Caucasian, and 92% were enlisted personnel. The relationships and correlations among drinking characteristics and problems and the usual number of drinks for an effect were determined. These subjects drank an average of 6 days per month, consuming an average of almost six drinks per drinking day, and reported more than three times per month in which they consumed six or more drinks per occasion. Consistent with studies of other populations, the SRE measures of intensity of response to alcohol showed a positive correlation with both drinking practices and problems, with the latter remaining significant even after controlling for recent drinking practices. The prodigious level of alcohol intake and associated problems, along with the SRE scores, indicate that the Marine Corps personnel are at especially high risk for alcohol-related life problems. These data also support the potential usefulness of the SRE both in identifying individuals likely to have more severe alcohol profiles and in educating individuals regarding their levels of risk for alcohol abuse and dependence.     

Associations of cohort and socio-demographic correlates with transitions from alcohol use to disorders and remission in metropolitan China

Aims   To examine socio-demographic associations of transitions from alcohol use to disorders and of remission from disorders in metropolitan China.
Design and setting   Face-to-face interviewing by trained lay-interviewers on a multi-staged, clustered sample from the general population of Beijing and Shanghai, China.
Participants   A total of 5201 adults aged 18–70 years and with household registration.
Measurements   World Mental Health version of Composite International Diagnostic Interview.
Findings   Lifetime prevalence estimates for alcohol use, regular use (at least 12 drinks in a year), DSM-IV abuse and dependence with abuse were 65.4%, 39.5% (60.4% of ever-drinkers), 4.6% (11.6% of regular users) and 0.9% (20.4% of lifetime alcohol abusers), respectively. These estimates were higher among respondents from the recent cohort; 64.3% and 36.9% respondents with a history of lifetime abuse and dependence respectively had remitted. The number of socio-demographic associations for the onset of each transitional stage decreased from alcohol use to alcohol dependence. Onset of ever-use was more common in respondents who were male, 18–50 years of age, with middle education level and never married, but less common among the previously married and students. First onset of regular use among those with ever-use was more common in respondents who were male, less than 50 years of age and never married, but less common in students. Being male and less than 50 years of age was associated with more alcohol abusers among regular users.
Conclusion   This study was the first to reveal in a Chinese population that qualitatively different risk factors might operate during the different stages of progression from alcohol use to disorders. Further research is needed to clarify the mechanisms underlying these differences in order to guide prevention programmes.     

Energy drink consumption and increased risk for alcohol dependence

Background: Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol‐related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Methods: Data were collected via personal interview from 1,097 fourth‐year college students sampled from 1 large public university as part of an ongoing longitudinal study. Alcohol dependence was assessed according to DSM‐IV criteria. Results: After adjustment for the sampling design, 51.3%_wt of students were classified as “low‐frequency” energy drink users (1 to 51 days in the past year) and 10.1%_wt as “high‐frequency” users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low‐frequency group, high‐frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High‐frequency users were at significantly greater risk for alcohol dependence relative to both nonusers (AOR = 2.40, 95% CI = 1.27 to 4.56, p = 0.007) and low‐frequency users (AOR = 1.86, 95% CI = 1.10, 3.14, p = 0.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low‐frequency energy drink users did not differ from nonusers on their risk for alcohol dependence. Conclusions: Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention.     

Measuring average alcohol consumption: the impact of including binge drinks in quantity-frequency calculations

AIMS: Average daily alcohol consumption is usually calculated based on self-reports of the quantity (number of drinks consumed per drinking-day) and frequency (number of drinking-days) of alcohol consumption within a given time period. However, this method may underestimate average daily alcohol consumption (and in turn, the prevalence of heavy drinking), because studies demonstrate that respondents do not typically include binge drinking occasions in estimates of their 'usual' or 'average' daily alcohol consumption. DESIGN: We used the Behavioral Risk Factor Surveillance System (BRFSS), an annual random-digit telephone survey of US adults aged 18 years or older, to estimate average daily alcohol consumption using standard quantity-frequency questions, and then recalculated this measure by including self-reports of binge drinking. The proportion of respondents who met a standard, sex-specific definition of heavy drinking based on average daily alcohol consumption was then assessed nationally and for each state. FINDINGS: Compared to standard quantity-frequency methods, including binge drinks in calculations of average daily alcohol consumption increased the relative prevalence of heavy drinking among all adults by 19% to 42% (depending on the method used to estimate the number of drinks per binge). Among binge drinkers, the overall prevalence of heavy drinking increased 53% relative to standard quantity-frequency methods. As a result, half of women binge drinkers and half of binge drinkers aged 55 or older met criteria for heavy drinking. CONCLUSIONS: Including binge drinks (especially the application of age- and sex-specific estimates of binge drinks) in the calculation of average daily alcohol consumption can improve the accuracy of prevalence estimates for heavy drinking among US adults, and should be considered to increase the usefulness of this measure for alcohol surveillance.     

The drinking habits of Sikh, Hindu, Muslim and white men in the West Midlands: a community survey

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol-related disorders. A community survey of random samples of 200 each of Sikh, Muslim and Hindu men and 200 white English-born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/Temple attenders drank regularly.     

Motivational interviewing versus feedback only in emergency care for young adult problem drinking

AIM: To establish the efficacy of a brief motivational intervention compared to feedback only when delivered in an emergency department for reducing alcohol use and problems among young adults. DESIGN: Two-group randomized controlled trial with follow-up assessments at 6 and 12 months. SETTING: Level I Trauma Center. PARTICIPANTS: A total of 198 18-24-year-old patients who were either alcohol positive upon hospital admission or met screening criteria for alcohol problems. INTERVENTION: Participants were assigned randomly to receive a one-session motivational intervention (MI) that included personalized feedback, or the personalized feedback report only (FO). All participants received additional telephone contact 1 month and 3 months after baseline. MEASUREMENTS: Demographic information, alcohol use, alcohol problems and treatment seeking. FINDINGS: Six months after the intervention MI participants drank on fewer days, had fewer heavy drinking days and drank fewer drinks per week in the past month than did FO patients. These effects were maintained at 12 months. Clinical significance evaluation indicated that twice as many MI participants as FO participants reliably reduced their volume of alcohol consumption from baseline to 12 months. Reductions in alcohol-related injuries and moving violations, and increases in alcohol treatment-seeking were observed across both conditions at both follow-ups with no differences between conditions. CONCLUSIONS: This study provides new data supporting the potential of the motivational intervention tested to reduce alcohol consumption among high-risk youth.     

The dimensionality of alcohol use disorders and alcohol consumption in a cross‐national perspective

Aims To replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether the usual 5+ drinks for men and 4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from emergency departments (EDs) in four countries. Design Cross‐sectional surveys of patients aged 18 years and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM‐IV alcohol dependence and alcohol abuse; quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year. Setting Participants were 5195 injured and non‐injured patients attending seven EDs in four countries: Argentina, Mexico, Poland and the United States (between 1995–2001). Findings Using exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear‐cut distinction between the criteria for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM‐IV criteria tap people in the middle–upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM‐IV diagnostic criteria to help tap the middle–lower part of this continuum. Even though some specific diagnostic criteria and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system. Conclusions DSM‐IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. The DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples.     

Drinking habits and health in Northern Italian and American men

Background and aimThe aim of this study was to investigate alcohol drinking habits in two male cohorts, one Italian and one American, and to investigate whether cardiovascular disease risk factors are related to different drinking patterns. Furthermore, socio-demographic characteristics were taken into account.MethodsThe Italian sample was drawn from the National Alpines Association. A dietary questionnaire was sent to the members of this association as an additional supplement to their monthly magazine. Eleven thousand one hundred and thirty-four men, 18–94 years, from Northern Italy were included in this analysis. The American sample is part of the Western New York Health Study (WNYHS) including 1927 male participants.ResultsIn both populations, those who drank more than 4 drinks/day were the least educated and showed the highest percentage of current smokers; the highest prevalence of hypertension occurred in heavier drinkers and those who mostly drank without food. By contrast, lifetime abstainers exhibited the lowest percentage of hypertension and the highest level of serum cholesterol; in both populations the highest prevalence of diabetes was present in lighter drinkers.ConclusionsThe current study shows that drinking habits are quite different in the two countries and are basically linked with socio-demographic and behavioral variables and support the notion that excess volume of alcohol consumed, and drinking without food, are associated with a higher risk of hypertension and hyperlipidaemia, particularly for Italians.     

Alcohol use disorders, nicotine dependence, and co-occurring mood and anxiety disorders in the United States and South Korea-a cross-national comparison

Background: The strong comorbidity between substance use disorders (SUDs) and mood and anxiety disorders has been well documented. In view of lack of research findings addressing the co‐occurrence of SUDs and mood and anxiety disorders, this study examined the pattern of comorbidity of alcohol use disorders (AUDs) and nicotine dependence (ND) between 2 culturally diverse countries, the United States and South Korea. Methods: Using the nationally representative samples of the U.S. and Korean general populations, we directly compared rates and comorbidity patterns of AUDs, ND, and mood and anxiety disorders between the 2 countries. We further examined the rates and the comorbidity pattern among individuals with AUDs who sought treatment in the last 12 months. Twelve‐month prevalence rates were derived to estimate country differentials, and odds ratios (ORs) and 95% confidence intervals were estimated to measure the strength of comorbid associations while adjusting for all sociodemographic characteristics in multivariate logistic models specific to each country. Results: The 12‐month prevalence rates of AUDs, ND, and any mood disorder and any anxiety disorder were 9.7, 14.4, 9.5, and 11.9% among Americans, whereas the corresponding rates were 7.1, 6.6, 2.0, and 5.2% among Koreans. These rates were significantly greater (except for any AUD) among Americans than among their Korean counterparts. With respect to comorbidity, both countries showed comparable patterns that the prevalence rates of mood and anxiety disorders were consistently the highest among persons with alcohol dependence (AD). Also, a disparate pattern was observed in Korea that the prevalence rates of mood and anxiety disorders were generally lower among individuals with ND than among those with alcohol abuse and AD. Furthermore, despite significantly greater prevalence of AD in Korea (5.1%) than in the United States (4.4%), alcohol‐dependent Americans were 4 times (OR = 3.93) more likely to seek treatment compared to their Korean counterparts. Conclusions: Our results indicated that the prevalence of AD in Korea was substantially greater than that in both Western and other Asian countries, suggesting a maladaptive pattern of alcohol use in Korea, which is different from the general use pattern of other East Asian countries. The low rate of treatment utilization among Koreans might be attributable to perceived social stigma toward SUDs or mental health problems despite the fact that the Korean government offers national health insurance.     

Alcohol Use and Periodic Limb Movements of Sleep

Alcohol causes significant sleep disturbance but the causes are not well understood. We investigated the relationship between alcohol use and periodic limb movements in a large population of patients at a sleep disorders center. The likelihood of having a clinically significant number of periodic leg movements (more than 20 per hour of sleep) was increased 3-fold in women who consumed two or more alcoholic drinks per day compared with those who did not (25% versus 8%). A similar relation was found among men (22% versus 13%). In addition, women who consumed two or more drinks per day were more likely to report symptoms of restless legs and to be diagnosed with restless legs syndrome. These findings suggest that periodic leg movements contribute to sleep disturbance in a significant proportion of alcohol users. Alcohol use may increase the frequency of periodic leg movements in susceptible individuals. On the other hand, subjects with symptoms related to periodic leg movements may be using alcohol to relieve symptoms, or the movements may be secondary to alcohol-induced sleep disturbance.     

Patterns of DSM-IV alcohol abuse and dependence criteria among adolescents and adults: results from the 2001 National Household Survey on Drug Abuse

BACKGROUND: Studies of the prevalence of DSM-IV alcohol use disorders (AUDs) in general population samples of adolescents and adults are rare. Comparisons of the prevalence of alcohol abuse and dependence in adolescent surveys with the prevalence in adult general population surveys are confounded by differences in survey design and measurement, thereby reducing their validity. The purpose of the present study was to examine the effects of age, sex, race/ethnicity, and drinking status on the prevalence of DSM-IV alcohol abuse and dependence (including diagnostic orphans) and associated diagnostic criteria among adolescents and adults aged 12-65 years in a single representative sample of the US population. METHODS: This study was based on data from the 2001 National Household Survey on Drug Abuse public use file. Of the 55,561 subjects in the survey, 33,576 (60.5%) reported alcohol use in the past year and provided information on DSM-IV AUD criteria. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months. RESULTS: Overall, the most prevalent criteria of DSM-IV alcohol dependence were "tolerance" and "time spent obtaining alcohol, drinking, or getting over its effects." The most prevalent criterion of DSM-IV alcohol abuse was "hazardous use." The prevalence of alcohol abuse only and of dependence with and without abuse was highest among respondents aged 18-23 years, followed by respondents aged 12-17 years, and lowest among respondents aged 50 years and older. Among subgroups of current and heavier drinkers, differences between adolescents and young adults were less pronounced, especially among females. For each age group, the prevalence of alcohol abuse only was greater than the prevalence of dependence (with or without abuse). The abuse-to-dependence ratios also were generally consistent across age groups and slightly higher among males (2.1:1.0) than females (1.6:1.0). CONCLUSIONS: The higher prevalence for some dependence criteria among adolescents and young adults as measured in the present study may blur the distinction between symptom reports associated with the normative development of drinking patterns and clinically relevant aspects of DSM-IV alcohol dependence.     

Prevalence of alcohol dependence among excessive drinkers in New Mexico

BACKGROUND: Excessive alcohol consumption claims more than 75,000 lives in the United States each year. The prevalence of alcohol dependence among excessive drinkers is not well known. METHODS: Data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS) in New Mexico were used to assess the prevalence of excessive drinking, including binge drinking, heavy drinking, alcohol-impaired driving, and alcohol dependence. RESULTS: Of 4,761 respondents, 16.5% were excessive drinkers; 14.4% binge drank and 1.8% were alcohol dependent. While the rates of alcohol dependence were higher among the youngest age group, males, those with some college education, and those of race/ethnicity other than White, non-Hispanic, only differences by age were statistically significant. The prevalence of alcohol dependence was the highest among those who reported alcohol-impaired driving in the past 30 days (15.9%), and was lower among those who reported heavy drinking (13.4%) and binge drinking (8.1%). CONCLUSIONS: Although 16.5% of New Mexico adults had at least 1 type of excessive drinking, only 1.8% of all adults met the criteria for alcohol dependence. Furthermore, only a minority of those who reported binge drinking, heavy drinking, or alcohol-impaired driving met the criteria for alcohol dependence. This suggests that most alcohol problems in New Mexico are likely due to excessive drinking among persons who are not alcohol dependent. The adverse health and social consequences associated with excessive drinking are not limited to those who are alcohol dependent, but extend to a broader range of problem drinkers across the population.