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Background: Surveys of changes in drinking during the COVID‐19 pandemic have primarily relied on retrospective self‐report. Further, most such surveys have not included detailed measures of alcohol use patterns, such as beverage‐specific consumption, nor measures of alcohol use disorder (AUD) symptoms that would allow a comprehensive understanding of changes in alcohol use. Methods: Data from 1819 completed interviews from the N14C follow‐up survey to the 2019 to 2020 National Alcohol Survey (N14) were conducted between January 30 and March 28, 2021. Questions on alcohol use from the Graduated Frequency series, beverage‐specific quantity and frequency, and DSM‐5 AUD items were asked in both surveys and used to estimate changes from pre‐pandemic drinking to drinking during the pandemic. Analyses focus on changes in these measures over time and comparisons between key subgroups defined by gender, race/ethnicity, and age. Results: Key findings include particularly large increases in drinking and AUD for African Americans and women, reduced drinking and heavy drinking prevalence among men and White respondents, and a concentration of increased drinking and AUD among respondents aged 35 to 49. Increases in alcohol use were found to be driven particularly by increases in drinking frequency and the consumption of spirits. Conclusions: Results confirm prior findings of overall increases and subgroup‐specific changes, and importantly, provide detailed information on the patterns of change across major socio‐demographic subgroups. Substantial increases in the prevalence of DSM‐5 moderate to severe AUDs are a novel finding that is of particular concern. [ABSTRACT FROM AUTHOR]

Background: Despite its potential to produce serious adverse outcomes, DSM‐5 alcohol withdrawal syndrome (AWS) has not been widely studied in the general population. Methods: We used cross‐sectional data from 36,309 U.S. adults from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions‐III to examine the past‐year prevalence of AWS and its correlates. We focused on an important clinical population–past‐year drinkers with unhealthy alcohol use–i.e., those with a positive score on the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire. We also examined the association of AWS with sociodemographic measures, psychiatric disorders, alcohol‐related measures, and healthcare utilization. Results: Approximately one‐third (n = 12,634) of respondents reported unhealthy alcohol use (AUDIT‐C+). Of these, 14.3% met criteria for a DSM‐5 AWS diagnosis. The mean (SE) number of withdrawal symptoms among individuals with AWS was 2.83 (1.88), with the most common being nausea/vomiting and insomnia (19.8% and 11.6%, respectively). Among AUDIT‐C+ respondents, the odds of AWS were significantly higher among males (adjusted odds ratio [aOR] = 1.17 [95% CI, 1.02–1.33]), unmarried participants (aOR = 1.55 [95% CI, 1.25–1.92]), and those at the lowest (vs. highest) income levels (aOR = 1.62 [95% CI, 1.37–1.92]). Among AUDIT‐C+ respondents, AWS was also associated with psychiatric disorders (with aORs that ranged from 2.08 [95% CI, 1.79–2.41]) for major depressive disorder to 3.14 (95% CI, 1.79–2.41) for borderline personality disorder. AUDIT‐C+ respondents with AWS also had higher odds of past‐year alcohol use disorder (aOR = 11.2 [95% CI, 9.66–13.07]), other alcohol‐related features (e.g., binge drinking), and healthcare utilization. Conclusions: Among individuals with unhealthy alcohol use, AWS is prevalent, highly comorbid, and disabling. Given the risk of AWS among unhealthy drinkers, a comparatively large segment of the general population, clinicians should seek to identify individuals with AWS and intervene with them to prevent serious adverse outcomes. [ABSTRACT FROM AUTHOR]

Background: Binge drinking among adolescents and young adults has changed over time, but patterns differ by age and gender. Identifying high‐risk groups to target future efforts at reducing drinking in this population remains a public health priority. Forecasting methods can provide a better understanding of variation and determinants of future binge drinking prevalence. Methods: We implemented regression‐based forecasting models to estimate the prevalence and gender differences in binge drinking among cohort groups of U.S. young adults, ages 18, 23–24, and 29–30 through 2040. Forecasting models were adjusted for covariates accounting for changes in demographic, Big‐5 social roles (e.g., residential independence), and drinking norms and related substance use, to understand the drivers of forecasted binge drinking estimates. Results: From the last observed cohort group (years varied by age) through 2040, unadjusted binge drinking prevalence was forecasted to decrease from 26% (95% CI: 20, 33%) (2011–15) to 11% (95% CI: 4, 27%) at age 18, decrease from 38% (95% CI: 30, 45%) (2006–2010) to 34% (95% CI: 18, 55%) at ages 23/24, and increase from 32% (95% CI: 25, 40%) (2001–2005) to 35% (95% CI: 16, 59%) at ages 29/30. Gender‐stratified forecasts show a continuation in the narrowing of binge drinking prevalence between young men and women, though the magnitude of narrowing differs by age. Estimated trends were partially explained by changing norms regarding drinking and other substance use, though these indirect effects explained less of the total trend as age increased. Conclusions: Understanding how covariates influence binge drinking trends can guide public health policies to leverage the most important determinants of future binge drinking to reduce the harm caused by binge drinking from adolescence to adulthood. [ABSTRACT FROM AUTHOR]