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Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR = 3.5; 95% CI 2.6 to 4.8) and dependence (OR = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting. [ABSTRACT FROM AUTHOR]

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: Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care for persons with AUD. Methods: Using 2015–2019 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: (1) adult prevalence of AUD; (2) proportion of adults with AUD who utilized health care in the past 12 months; (3) proportion with AUD screened about their alcohol use; (4) proportion with AUD who received a brief intervention about their alcohol misuse; (5) proportion with AUD who received information about treatment for alcohol misuse; and (6) proportion with AUD who received treatment. Analyses were stratified by AUD severity. Results: Of the 214,505 persons included in the sample, the weighted prevalence of AUD was 7.8% (95% CI 7.6–8.0%). Cascades of care showed the majority of individuals with AUD utilized health care in the past 12 months [81.4% (95% CI 80.7–82.1%)] and were screened about alcohol use [69.9% (95% CI 68.9–70.8%)]. However, only a minority of individuals received subsequent steps of care, including 11.6% (95% CI 11.0–12.2%) who reported receiving a brief intervention, 5.1% (95% CI 4.6–5.6%) who were referred to treatment, and 5.8% (95% CI 5.4–6.3%) who received treatment. Similar patterns were observed when cascades of care were stratified by AUD severity. Conclusions: Persons with AUD commonly utilize health care and are often screened about alcohol use, but few receive treatment. Healthcare settings—particularly primary care settings—represent a prime opportunity to implement AUD treatment to improve outcomes in this high‐risk population. [ABSTRACT FROM AUTHOR]

Background: Little is known about remission, recovery, and other outcomes of alcohol use disorder (AUD) as defined by the DSM‐5. Methods: Data from a large representative sample of the United States was used to examine correlates of past‐year AUD status among individuals with prior‐to‐past‐year AUD: persistent AUD, symptomatic high‐risk drinking, asymptomatic high‐risk drinking, symptomatic low‐risk drinking, asymptomatic low‐risk drinking (nonabstinent recovery, NAR), and abstainer (abstinent recovery, AR). Multiple logistic regression analyses were conducted to compare: (i) AR and NAR with persistent AUD, (ii) AR with NAR, and (iii) asymptomatic and symptomatic high‐risk drinking with AR and NAR. Results: Among individuals with AUD prior to past year (n = 7,785), 34.2% were classified with persistent AUD, 8.8 and 1.6% were symptomatic high‐risk and symptomatic low‐risk drinkers, respectively, 21.5% were asymptomatic high‐risk drinkers, 17.9% were asymptomatic low‐risk drinkers, and 16.0% were abstainers. One‐quarter of individuals with AUD prior to past year achieved AR or NAR without the benefit of treatment, while a much greater percentage of individuals achieving AR (43.2%) reported receiving treatment relative to those with NAR (12.3%). The number of lifetime AUD symptoms was greater among those achieving AR (among the treated) and lower among those achieving NAR relative to persistent AUD. The number of AUD symptoms was also greater among those achieving AR than NAR and lower among asymptomatic and symptomatic risk drinkers relative to those achieving AR and NAR. Consumption was greater among those achieving AR relative to those achieving NAR and greater among asymptomatic and symptomatic risk drinkers relative to AR and NAR. Odds of achieving AR or NAR relative to persistent AUD were generally lower among non‐Hispanic Blacks and those with higher education, greater among women and married individuals, and lower among illicit drug users and individuals with histories of a personality disorder or mood/anxiety disorder. Conclusions: There appears to be a substantial level of recovery from AUD. Information on specific factors associated with AUD outcomes can be useful in targeting appropriate treatment efforts. [ABSTRACT FROM AUTHOR]

Background Heavy episodic drinking ( HED) or consuming 4+/5+ drinks in 1 occasion for women/men is linked consistently with alcohol-related harms. Recent research suggests that many individuals drink at levels more than twice this cutoff (8+/10+ drinks), commonly referred to as 'high-intensity drinking.' Prevalence rates of high-intensity drinking and its dynamic association with alcohol use disorder (AUD) across all ages, however, remain unknown. The current study used data from a nationally representative sample to document age-varying prevalence rates of HED-only drinking and high-intensity drinking, prevalence rates of AUD for HED-only drinkers and high-intensity drinkers, and relative odds of experiencing an AUD for high-intensity drinkers as compared to HED-only drinkers. Methods Data were from the National Epidemiologic Survey on Alcohol and Related Conditions- III. The final analytic sample consisted of past-year drinkers aged 18 to 64 years ( n = 22,776). Results Time-varying effect modeling revealed that high-intensity drinking and HED-only drinking were equally prevalent during young adulthood and prevalence rates of both types of drinking generally became less common with increasing age. At all ages, high-intensity drinkers were at 3 or more times greater odds of meeting criteria for an AUD than HED-only drinkers. The association between high-intensity relative to HED-only drinking was strongest earlier in adulthood with approximately 83% of 18-year-old high-intensity drinkers having AUD relative to 42% of HED-only drinkers. Conclusions Future research aiming to identify drinkers most at risk of harms and in need of treatment may benefit from assessing the extent to which an individual exceeds the 8+/10+ threshold of drinking. [ABSTRACT FROM AUTHOR]

Background This research extends prior epidemiological estimates for the United States and re-examines a previously described male excess in alcohol drinking. Its aim was to estimate fine-grained age-specific incidence of becoming a drinker among 12- to 24-year-old U.S. males and females, and to compare incidence estimates with prevalence proportions. Methods The study population is 12- to 24-year-old noninstitutionalized U.S. civilian residents. Estimates are from 12 successive U.S. National Surveys on Drug Use and Health ( NSDUH), with nationally representative samples drawn each year from 2002 to 2013 and assessed via computer-assisted self-interviews ( n ~ 390,000). Analysis-weighted incidence and prevalence estimates are generated using the NSDUH Restricted Data Analysis System for 6 year-pairs. Meta-analysis-derived summary estimates are provided, treating each year-pair as a replication. Results In this 21st century evidence, there no longer is male excess of incidence with respect to underage drinking. Indeed, in mid-adolescence, there is a clear female excess for the risk of becoming an underage drinker. Meta-analytic summaries disclosed no other male-female differences in incidence. Nevertheless, a male excess in the prevalence of recently active drinking can be seen after the age of 19 years. Conclusions This new evidence from the United States shows that the so-called 'gender gap' in risk of becoming a drinker has narrowed to the point of there being no gap at all. Indeed, in mid-adolescence, risk of starting to drink is greater for females than for males. [ABSTRACT FROM AUTHOR]