Academic journal article Alcohol Research

The 12-Month Prevalence and Trends in DSM-IV Alcohol Abuse and Dependence: United States, 1991-1992 and 2001-2002

Academic journal article Alcohol Research

The 12-Month Prevalence and Trends in DSM-IV Alcohol Abuse and Dependence: United States, 1991-1992 and 2001-2002

Article excerpt

Background: Alcohol abuse and dependence can be disabling disorders, but accurate information is lacking on the prevalence of current Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) alcohol abuse and dependence and how this has changed over the past decade. The purpose of this study was to present nationally representative data on the prevalence of 12-month DSM-IV alcohol abuse and dependence in 2001-2002 and, for the first time, to examine trends in alcohol abuse and dependence between 1991-1992 and 2001-2002. Methods: Prevalences and trends of alcohol abuse and dependence in the United States were 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) and NIAAA's 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES: n = 42,862). Results: Prevalences of DSM-IV alcohol abuse and dependence in 2001-2002 were 4.65 and 3.81 percent. Abuse and dependence were more common among males and among younger respondents. The prevalence of abuse was greater among Whites than among Blacks, Asians, and Hispanics. The prevalence of dependence was higher in Whites, Native Americans, and Hispanics than Asians. Between 1991-1992 and 2001-2002, abuse increased while dependence declined. Increases in alcohol abuse were observed among males, females, and young Black and Hispanic minorities, while the rates of dependence rose among males, young Black females, and Asian males. Conclusions: This study underscores the need to continue monitoring prevalence and trends and to design culturally sensitive prevention and intervention programs. KEY WORDS: DSM-IV alcohol abuse and dependence; Epidemiology; Secular trends

INTRODUCTION

Alcohol use disorders are among the most prevalent mental disorders worldwide and rank high as a cause of disability burden in most regions of the world (World Health Organization, 2001). In 2003, the prevalence of alcohol use disorders was estimated at 1.7 percent globally, and these disorders accounted for 1.4 percent of the total world disease burden (World Health Organization, 2003).

Alcohol use disorders (i.e., alcohol abuse and dependence) also are among the most prevalent mental disorders in the United States and are associated with substantial personal and societal costs (Goetzel et al., 2003; Roy-Byrne et al., 2000; Sanderson and Andrews, 2002; Stewart et al., 2003). These alcohol use disorders have enormous consequences not only for the health and welfare of those afflicted with the disorders, but also for their families and children, their employers, and the larger society. For example, approximately one in four children under 18 years old in the United States is exposed to alcohol abuse or alcohol dependence in the family (Grant, 2000). More than one-half of American adults have a family member who has or has had alcohol dependence (Dawson and Grant, 1998). Of the 11.1 million victims of violent crime each year, almost one in four, or 2.7 million, report that the offender had been drinking prior to the crime (Greenfield, 1998). The economic costs of alcohol abuse and dependence were $184.6 billion for 1998 (the last year for which figures are available), or roughly $638 for every man, woman, and child living in the United States (Harwood, 1998). Thus, alcohol use disorders impose a staggering, but potentially preventable, burden.

Despite the importance of accurate prevalence information on alcohol abuse and dependence, especially on changes in the prevalence of these disorders over time, the information available to date has been surprisingly sparse. Time (secular) trends in yearly per capita alcohol consumption have been available from the founding days of the United States. However, these are not informative about whether time trends have occurred in lower or higher consumption levels, which have considerably different public health implications. …

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