Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-9304, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 11/2005; 80(1):105-16. DOI: 10.1016/j.drugalcdep.2005.03.009
Source: PubMed

ABSTRACT To date, there have been no published data on 12-month comorbidity of DSM-IV alcohol and drug use disorders in the general U.S. population. The purposes of the present study were to examine the prevalence and comorbidity of alcohol and specific drug use disorders, and to identify sociodemographic and psychopathologic correlates and treatment seeking among three groups of respondents: (1) those with alcohol use disorders only; (2) those with drug use disorders only; (3) those with comorbid alcohol and drug use disorders.
Information on 12-month alcohol and specific drug use disorders in the United States was derived from face-to-face interviews in the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC: n = 43,093).
Prevalences were 7.35% for alcohol use disorders only, 0.90% for drug use disorder only and 1.10% for comorbid alcohol and drug use disorders. Sociodemographic and psychopathologic correlates of these three groups were quite different, with the drug use disorder and comorbid groups significantly more likely to be young, male, never married and of lower socioeconomic status than the alcohol use disorder only group. Associations between current alcohol use disorders and 25 specific drug use disorders were generally positive and statistically significant. The 12-month prevalence of treatment seeking significantly increased from 6.06% for those with an alcohol use disorder only to 15.63% for those with a drug use disorder only, and to 21.76% for those with comorbid alcohol and drug use disorders.
This study provides detailed data on the homotypic comorbidity of alcohol use disorders and 25 different drug use disorders and confirms the high levels of association seen in previous studies based on lifetime measures. Implications of this study are discussed in terms of integrating alcohol and drug treatment services and refining prevention and intervention efforts.

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    • "Briefly, exclusions were neurological and psychiatric disorders which affect neurobiology or neurocognition, but not hepatitis C, type-2 diabetes, hypertension, and unipolar mood disorder, highly prevalent in addiction (Hasin et al., 2007; Stinson et al., 2005). Thirty-one LD (25 nonsmokers, 6 smokers) recruited from the community served as controls. "
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    ABSTRACT: Background Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity or decision making are not well known. Methods Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol dependent individuals with comorbid stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers. Results ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity. Conclusion Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.
    Drug and alcohol dependence 02/2015; 150. DOI:10.1016/j.drugalcdep.2015.02.022 · 3.42 Impact Factor
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    • "While past research indicates cooccurrence between alcohol and cannabis use in adolescence and young adulthood (Flory et al., 2004; Jackson et al., 2008; Mason et al., 2013), there have been comparatively few prospective studies using diagnostic data of either AUDs or CUDs (e.g., Hayatbakhsh et al., 2009; Stinson et al., 2005). Hayatbakhsh et al. (2009) investigated early risk factors of CUDs in young adulthood but did not include relations with AUDs, and Stinson et al. (2005) documented the 12-month prevalence of AUDs, other substance use disorders (SUDs), and comorbidity of different SUDs in the U.S. population. Research is extremely limited on the comorbid relations between AUDs and CUDs during different developmental periods, specifically from youth through early adulthood. "
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    ABSTRACT: Background: Alcohol and cannabis are among the most widely used and abused drugs in industrialized societies. Investigations of patterns in comorbidity and temporal sequencing between alcohol use disorders (AUDs) and cannabis use disorders (CUDs) from childhood to adulthood are important for understanding the etiologies of these disorders. Methods: The sample comprised 816 individuals (59% male, 89% white). Dichotomous measures indicated whether or not a participant was in an AUD or CUD episode during three developmental periods-youth (childhood through adolescence), early adulthood, and adulthood. Structural equation modeling was used to determine relations between AUDs and CUDs across the three developmental periods, and to test for gender differences. Results: Concurrent associations between AUD and CUD were significant. Both AUD and CUD in previous developmental periods significantly predicted the same substance disorders in subsequent periods. Cross-lagged paths from youth AUD to young adult CUD and youth CUD to young adult AUD were both significant. However, only the cross-lagged path from youth CUD to adult AUD was significant. The cross-lagged paths from young adult AUD to adult CUD and young adult CUD to adult AUD were both nonsignificant. Males and females were mostly similar with only three differences found between genders. Conclusions: Comorbidity of AUDs and CUDs was evident from youth through adulthood but the strength of the relationship lessened in adulthood. Temporal sequencing influences of AUDs and CUDs on each other were similar in youth and adulthood but not young adulthood. Same substance stability was greatest in adulthood.
    Drug and Alcohol Dependence 01/2015; 149. DOI:10.1016/j.drugalcdep.2015.01.025 · 3.42 Impact Factor
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    • "Potentially influential predictors of progression to alcohol-related harm besides alcohol consumption include socioeconomic position (SEP) [24, 25], early age of alcohol initiation [26], being male (although females appear to suffer serious negative consequences of alcohol consumption earlier and to a greater degree than men) [27, 28], family history [29], comorbid substance use, with alcohol use increasing the risk for other drug use disorders [30, 31], poor physical and mental health [32], sex differences [33, 34], and ethnicity [35]. The adverse effects of alcohol drinking behavior affect not only the index drinker but also family members of the drinker [36] and the society as well. "
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    ABSTRACT: Alcohol use and associated alcohol-related harm (ARH) are a prevalent and important public health problem, with alcohol representing about 4% of the global burden of disease. A discussion of ARH secondary to alcohol consumption necessitates a consideration of the amount of alcohol consumed and the drinking pattern. This study examined the association between alcohol drinking patterns and self-reported ARH. Pearson chi-square test (χ (2)) and logistic regression analyses were used on data from the National Comorbidity Survey Replication (NCS-R). The NCS-R is a cross-sectional nationally representative sample. Data was obtained by face-to-face interviews from 9282 adults aged ≥18 years in the full sample, and 5,692 respondents in a subsample of the full sample. Results presented as odds ratio (OR) and 95% confidence intervals (95% CI). Alcohol drinking patterns (frequency of drinking, and drinks per occasion) were associated with increased risks of self-reported ARH; binge or "risky" drinking was strongly predictive of ARH than other categories of drinks per occasion or frequency of drinking; and men had significantly higher likelihood of ARH in relation to frequency of drinking and drinks per occasion. Findings provide evidence for public health practitioners to target alcohol prevention strategies at the entire population of drinkers.
    BioMed Research International 06/2014; 2014:853410. DOI:10.1155/2014/853410 · 3.17 Impact Factor
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