A new study supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, reports that nearly one-third of adults in the United States have an Alcohol use disorder, (AUD) at some time in their lives, but only about 20 percent seek AUD treatment. The study of AUD – the medical diagnosis for problem drinking that causes mild to severe distress or harm – also reveals a significant increase in AUDs over the last decade. The new findings are reported online today in the journal JAMA Psychiatry.
“These findings underscore that alcohol problems are deeply entrenched and significantly under-treated in our society,” said NIAAA Director George F. Koob, Ph.D. “The new data should provide further impetus for scientists, clinicians, and policy makers to bring AUD treatment into the mainstream of medical practice.”
A team of researchers led by Bridget F. Grant, Ph.D., Ph.D., of the NIAAA Laboratory of Epidemiology and Biometry, conducted more than 36,000 face-to-face interviews of U.S. adults, as part of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). NESARC III is a continuation of the largest study ever conducted on the co-occurrence of alcohol use, drug use, and related psychiatric conditions. The original NESARC survey was conducted in 2001-2002.
In NESARC III, researchers assessed alcohol problems using diagnostic criteria set forth in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM–5) in 2013. To allow direct comparisons with previous NESARC surveys, the researchers also assessed NESARC III participants using the previous DSM-IV diagnostic criteria. Although there is considerable overlap between DSM–5 and DSM–IV diagnostic criteria, there are several important differences. For example, while DSM–IV described two distinct disorders, alcohol abuse and alcohol dependence, with specific criteria for each, DSM–5 integrates alcohol abuse and alcohol dependence into a single disorder called alcohol use disorder with mild, moderate, and severe sub-classifications.
“We found that 13.9 percent of adults met DSM-5 AUD criteria for the previous year, while 29.1 percent met AUD criteria at some time in their life,” said Dr. Grant. “Only 19.8 percent of adults with lifetime alcohol use disorder sought treatment or help, while 7.7 percent of those with a 12-month alcohol use disorder sought treatment. Perhaps most importantly, we saw large increases in DSM-IV alcohol use disorder rates over the last decade.”
Past-year and lifetime DSM-IV AUD rates for NESARC III participants were 12.7 percent and 43.6 percent, respectively. By comparison, NESARC participants in 2001 through 2002 reported past-year and lifetime DSM-IV rates of 8.5 percent and 30.3 percent, respectively. Dr. Grant and her colleagues suspect that the past decade increases may reflect increases in heavy alcohol consumption during that period, but note the need for additional research on that question.
The researchers found that rates of AUD were greater among men than women, and that age was inversely related to past-year AUD diagnosis. Among adults between ages 18 and 29, more than 7 percent had an AUD within the past year, suggesting a need for more effective prevention and intervention efforts among young people. More broadly, the researchers note the urgent need for efforts aimed at educating the public about AUD and its treatment, as well as destigmatizing the disorder.
The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates research findings to general, professional, and academic audiences.
[TLS]
All a bunch of bunk. Everything depend on what you call alcohol use disorder. If someone decides that means “anyone who drinks alcohol” then the rate of his study goes to 100%
To #1 – no there is no depends here at all – DSM-IV and DSM-5 are each very specific on the necessary symptoms whether or not you take the trouble to look at them before commenting
Oh please. Alcohol Use Disorder?! Who thinks up this nonsense??
I have an immediate family of 61 people. None of us has a problem. None of us has been arrested for drunk driving. None of us has lost a job due to alcohol use. None of us has been suspended or expelled from school for alcohol use. I worked with hundreds of people. Maybe there were 6 or 7 that I would say had a problem. 30% is a ridiculous number. Perhaps if the question was, have you had more than one drink in your lifetime, you qualify for a problem. Combining alcohol abuse and alcohol dependence invalidates their findings. “Did you ever have more than two drinks in a given day? Yes. That’s abuse.
Perhaps someone can post the criteria for the disorder (in laymen’s terms) so that other voices of reason can recognize it.
One aspect of the disorder is denial. So it is not expected that those with the disorder will have the insight or be able to admit that they have this problem (even if the criteria are clearly posted). It is those around them, such as family and friends that may be alerted. Which leads to a suggestion that Mordechai Weinberger, LCSW perhaps devote some attention to this for the benefit of the suffering spouses and children of alcoholics.
To no 2
I didn’t say it’s not clearly defined. What I said was that the criteria & symptoms of this disorder adapted and revised at will. That makes this total nonsense. There’s no undisputed benchmark. It’s like the obesity problem. They keep changing what’s called obese and walla more & more people are becoming obese. Duh!!
I’ll drink to this!!
#6 – No and No – 1) the increase between the 2002 and 2013 studies was measured using the very SAME DSM-IV measures that’s a straight apples-to-apples comparison
2) the change from the older DSM-IV to the newer DSM-5 actually resulted in a lesser not greater lifetime percentage – under the old measure it is a staggering 43.6% while under the new DSM-5 it’s 29.1% which is the headline amount of nearly one third
I always maintained that I didn’t have a “drinking problem”. However, I did notice that when there was a kiddush in shul and I had a לחיים or two, or if I had one after the fish at home, I became just a bit more cantankerous, boisterous or just plain difficult.
It invariably led to a spousal argument, the children being unfairly disciplined, or just a general elevated level of tension in the home with everyone walking on the proverbial eggshells.
At a certain point I’d seem enough of the negative effects and just laid off the stuff. It’s just not worth the down-side.
#5 – AUD is indicated by any 2 out of following 11
1) Alcohol is often taken in larger amounts or over a longer period than was intended.
2) There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3) A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
4) Craving, or a strong desire or urge to use alcohol. 5) Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6) Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7) Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
8) Recurrent alcohol use in situations in which it is physically hazardous.
9) Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10) Tolerance, as defined by either of the following:
(a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect
(b) Markedly diminished effect with continued use of the same amount of alcohol
11) Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for alcohol
b. Alcohol is taken to relieve or avoid withdrawal symptoms.
To follow up on my previous post – 2 out of the above 11 qualifies for AUD with severity defined as follows:
The severity of the AUD is defined as:
Mild: The presence of 2 to 3 symptoms
Moderate: The presence of 4 to 5 symptoms
Severe: The presence of 6 or more symptoms
So, as a simple illustration if a person only had the single issue mentioned in #9’s post that would at worst qualify only for symptom 6) in the list of 11 and that would fail to meet the 2 symptom threshold of AUD
Dov w
Who came up with these criteria? It was made up by someone right? That’s why it has no credibility. He or someone else can change them at any time.
#13 – The 11 points are from DSM-5. You ask who came up with them or in other words “what is this whole DSM thing anyway?”
Valid question.
DSM is “The Diagnostic and Statistical Manual of Mental Disorders” – it’s the publication of the American Psychiatric Association and is the standard classification of mental disorders used by mental health professionals in the United States.
For many people the mental health profession in the United States has at least some credibility
#13 Anon:
As you can see, not everyone who drinks alcohol fit the criteria for a problem. Alcoholism is a serious problem that destroys lives: the lives of the ones with Alcohol Use Disorder and the lives of their loved ones.
Look in the mirror and ask yourself why you are fighting this. Better yet, if you drink alcohol sometimes, ask a close family member or (true) friend if they think any of the criteria apply to you.
None of the criteria apply to me.
To Dov w
Out of all the scientific departments the one that has the least credibilty for me is the mental health dept. so the fact that this was made up by a bunch of therapists means absolutely nothing.
#16 – firstly, Psychiatrists are MDs – Medical Doctors – not social workers – and secondly and more importantly let’s move away from generalities and be very specific here – are you suggesting that someone could have 2 out of the 11 symptoms described and not have an alcohol problem?