Academic journal article Alcohol Research

Alcohol Consumption in Demographic Subpopulations: An Epidemiologic Overview

Academic journal article Alcohol Research

Alcohol Consumption in Demographic Subpopulations: An Epidemiologic Overview

Article excerpt

Alcohol consumption is common across diverse populations in the United States; however, the level of consumption and its consequences vary considerably across major demographic subgroups. This review presents findings on the distribution and determinants of alcohol use and its aspects (i.e., age of onset, abstention vs. any drinking, binge drinking, and heavy drinking), alcohol abuse and dependence as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (American Psychiatric Association 1994),1 and related health consequences. The health consequences considered include a selection of those often linked to alcohol consumption, such as unintentional and intentional injuries as well as liver disease (World Health Organization 2011). The article aims to summarize recent research and provide a comprehensive depiction of alcohol consumption and alcohol-related group differences across age, race/ethnicity, and gender. The growing emphasis on these group differences in alcohol epidemiologic research can expand our understanding of the etiology of alcohol use disorder (AUD), including the contribution of social contextual risk factors, and the receipt of prevention and treatment services.

The information presented in this article is based primarily on self-reported alcohol use as ascertained in two large surveys of the U.S. general population- the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the National Survey on Drug Use and Health (NSDUH). The NESARC, funded by the National Institute on Alcohol Abuse and Alcoholism, with supplemental funding from the National Institute on Drug Abuse, is a two-wave, longitudinal study of adults ages 18 and older that provides rich information on the epidemiology of alcohol and drug use disorders, psychiatric disorders, other health-related conditions and characteristics, and risk and protective factors (Grant et al. 2004). To ascertain these conditions, the survey used the interviewer-administered Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV) (Grant 1997). Wave 1 was conducted in 2001-2002 and Wave 2 in 2004-2005. The NSDUH, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), is a national cross-sectional survey conducted annually of people ages 12 and older that is designed to track trends in substance use and other variables and collects data on substance use through self-administered computerized interviews (SAMHSA 2014).

The estimates presented throughout this article were derived across both waves of the NESARC as well as across several years of the NSDUH. Use of both of these datasets gives readers a comprehensive overview of findings from large-scale U.S. surveys on the epidemiology of alcohol consumption. In addition, the NESARC and NSDUH complement one another in several ways:

* Both surveys include adults age 18 and older. In addition, the NSDUH assesses alcohol and other drug use among adolescents (i.e., ages 12-17). Therefore, incorporating information from both surveys presents a picture of alcohol consumption across the life course.

* Test-retest reliability coefficients for AUDADIS-IV alcohol consumption and AUD diagnoses have been shown to be good to excellent (kappa ≥ 0.60) in a wide range of studies in the United States (Canino et al. 1999; Grant et al. 1995, 2003; Hasin et al. 1997) and elsewhere (Chatterji et al. 1997; Vrasti et al. 1998). AUDADIS-IV alcohol dependence also demonstrated fair to very good concordance with a clinician- administered interview (Cottler et al. 1997) and psychiatrist re- interviews (Canino et al. 1999). The alcohol-dependence factor structure was significantly associated with external criterion variables (Grant et al. 2007), offering further support for the validity of the diagnosis. Less reliability and validity information is available on the NSDUH measure of AUD.

* The NSDUH data have been collected annually on a cross-section of the population, thus supplying a different type of information (i. …

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