Three-Year Changes in Adult Risk Drinking Behavior in Relation to the Course of Alcohol-Use Disorders

Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Bethesda, Maryland 20892-9304, USA.
Journal of studies on alcohol and drugs (Impact Factor: 2.76). 11/2008; 69(6):866-77. DOI: 10.15288/jsad.2008.69.866
Source: PubMed


This study examines the associations between the course of alcohol-use disorder (AUD) and changes in average daily volume of ethanol intake, frequency of risk drinking, and maximum quantity of drinks consumed per day over a 3-year follow-up interval in a sample of U.S. adults.
Data were taken from a longitudinal study of a nationally representative sample of U.S. adults, who were 18 years of age and older (mean age = 46.4) when initially interviewed in 2001-2002 and successfully reinterviewed approximately 3 years later (n = 22,245 baseline drinkers). The time reference period for the drinking measures was the 12 months preceding the interview. Changes in consumption reflect differences between Wave 1 and Wave 2 measures for individuals with nonmissing values at both Waves (n = 22,003 for volume of intake, 22,132 for frequency of risk drinking and 21,942 for maximum quantity of drinks).
There were positive changes in all consumption measures associated with developing an AUD and negative changes associated with remission of an AUD, even among individuals who continued to drink. Increases and decreases associated with onset and offset of dependence exceeded those associated with onset/ offset of abuse only, and the decreases associated with full remission from dependence exceeded those associated with partial remission. There were few changes in consumption among individuals whose AUD status did not change. Interactions of AUD transitions with other factors indicate that development of an AUD is associated with a greater increase in consumption among men, possibly reflecting their greater total body water and lower blood alcohol concentration in response to a given dose of ethanol, and among individuals with high baseline levels of consumption.
Changes in consumption associated with onset and offset of AUD are substantial enough to have important implications for the risk of associated physical and psychological harm.

Full-text preview

Available from:
  • Source
    • "Our results should be interpreted in the context of the study's limitations. As it is not uncommon in longitudinal studies (Dawson et al., 2008; Karlamangla et al., 2006; U.S. National Institutes of Health, 2010), our follow-up was under five years which precludes a full assessment of the magnitude of time changes in drinking patterns. Also, the methodology of collecting data on alcohol consumption varied between the two surveys, due to a slight variation in the questions on average alcohol intake and interview methodology (face-to-face at baseline versus telephone interview at followup ). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined changes in alcohol drinking patterns (DP) and associated variables in a Mediterranean country. Changes in DP between baseline (2008-2010) and follow-up (2012-2013) were examined on a Spanish population-based cohort of 2254 adults (18-59 years) using multinomial logistic regression. Heavy consumption was defined as ≥40g/day of alcohol in men (≥24g/day in women) and binge drinking (BD) as the intake of ≥80g of alcohol in men (≥60g in women) on one occasion in the previous month. Six patterns were defined: (1) non-drinkers; (2) ex-drinkers; (3) moderate drinkers without BD (MNB); (4) moderate drinkers with BD (MB); (5) heavy drinkers without BD (HNB); and (6) heavy drinkers with BD (HB). Overall, 45.2% of participants changed DP during follow-up. Over 24% of non-drinkers and 19.4% of ex-drinkers at baseline qualified as MNB at follow-up. The largest flow was from HNB to MNB (57.1%). Light-drinking patterns experienced the largest gains (ex-drinkers: 37.5% and MNB: 66.7%) by absorbing individuals lost by heavy-drinking patterns (MB: 50.8% and HNB: 48.4%). Men, younger individuals, and current smokers were more likely to report heavy-drinking patterns at one or both assessments. Being married or employed increased the likelihood of reporting light-drinking patterns at both surveys (p<0.05). Improving physical quality of life and exercise were associated with a shift from light- to heavy-drinking pattern during follow-up (p<0.05). DP in Spain changed over 3 years with a tendency to "regress" toward moderate patterns. Repeated measures of alcohol intake may reduce classification errors and biased results when examining the impact of alcohol on health.
    Full-text · Article · Apr 2014 · Drug and alcohol dependence
  • Source
    • "Prior to these adjustments, the decrease in QOL found in this study was greater, although still only about half as large as the difference reported by Volk et al. More importantly , individuals who developed alcohol dependence during the 3-year follow-up interval between Waves 1 and 2 of the NESARC represent individuals in the early stages of dependence , among whom consumption levels were still relatively low (Dawson et al., 2008). With a longer follow-up interval, dependence likely would have increased in severity and thus have been associated with a greater decline in mental and psychological functioning. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to investigate longitudinal changes in quality of life (QOL) as a function of transitions in alcohol use disorders (AUD) over a 3-year follow-up of a general US population sample. The analysis is based on individuals who drank alcohol in the year preceding the Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions and were reinterviewed at Wave 2 (n = 22,245). Using multiple linear regression models, changes in SF-12 QOL were estimated as a function of DSM-IV AUD transitions, controlling for baseline QOL and multiple potential confounders. Onset and offset of AUD were strongly associated with changes in mental/psychological functioning, with significant decreases in mental component summary (NBMCS) scores among individuals who developed dependence and significant increases among those who achieved full and partial remission from dependence. The increases in overall NBMCS and its social functioning, role emotional and mental health components were equally great for abstinent and nonabstinent remission from dependence, but improvements in bodily pain and general health were associated with nonabstinent remission only. Onset of abuse was unrelated to changes in QOL, and the increase in NBMCS associated with nonabstinent remission from abuse only was slight. Individuals with abuse only or no AUD who stopped drinking had significant declines in QOL. These results suggest the possible importance of preventing and treating AUD for maintaining and/or improving QOL. They are also consistent with the sick quitter hypothesis and suggest that abuse is less a mental disorder than a maladaptive pattern of behavior.
    Preview · Article · Dec 2008 · Alcohol and Alcoholism
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has been the lead Federal agency responsible for scientific research on alcohol and its effects for 40 years. During that time, NIAAA has conducted and funded groundbreaking research, distilled and disseminated those research findings to a broad audience, and ultimately improved public health. Among NIAAA's many significant contributions are the National Epidemiologic Survey on Alcohol and Related Conditions, the largest survey ever conducted on alcohol and associated psychiatric and medical conditions; investment in research to identify the genes underlying vulnerability to alcoholism; creation of the Collaborative Studies on Genetics of Alcoholism, a study of the genetics of alcoholism in a human population; leadership in exploring the effects of alcohol on fetal development and on a variety of diseases and organ systems; fostering alcoholism treatment, including supporting a medications development program that has funded more than 30 Phase 2 trials and 15 human laboratory studies; international collaborations and work across the National Institutes of Health; influential research on preventing alcohol problems through community programs as well as policy changes; and the translation of research findings to everyday practice, including the production of award-winning clinician training materials.
    Preview · Article · Jan 2010 · Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism
Show more