Prevalence of alcohol dependence among US adult drinkers, 2009-2011

Abstract

Introduction: Excessive alcohol consumption is responsible for 88,000 deaths annually and cost the United States $223.5 billion in 2006. It is often assumed that most excessive drinkers are alcohol dependent. However, few studies have examined the prevalence of alcohol dependence among excessive drinkers. The objective of this study was to update prior estimates of the prevalence of alcohol dependence among US adult drinkers.

Methods: Data were analyzed from the 138,100 adults who responded to the National Survey on Drug Use and Health in 2009, 2010, or 2011. Drinking patterns (ie, past-year drinking, excessive drinking, and binge drinking) were assessed by sociodemographic characteristics and alcohol dependence (assessed through self-reported survey responses and defined as meeting ≥3 of 7 criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).

Results: Excessive drinking, binge drinking, and alcohol dependence were most common among men and those aged 18 to 24. Binge drinking was most common among those with annual family incomes of $75,000 or more, whereas alcohol dependence was most common among those with annual family incomes of less than $25,000. The prevalence of alcohol dependence was 10.2% among excessive drinkers, 10.5% among binge drinkers, and 1.3% among non-binge drinkers. A positive relationship was found between alcohol dependence and binge drinking frequency.

Conclusion: Most excessive drinkers (90%) did not meet the criteria for alcohol dependence. A comprehensive approach to reducing excessive drinking that emphasizes evidence-based policy strategies and clinical preventive services could have an impact on reducing excessive drinking in addition to focusing on the implementation of addiction treatment services.

Figure

Prevalence of alcohol dependence among US adult binge drinkers, by binge drinking frequency during the past 30 days, National Survey on Drug Use and Health, 2009–2011. Alcohol dependence for adults was defined as meeting at least 3 of 7 criteria for alcohol dependence (ie, tolerance, withdrawal, impaired control, unsuccessful attempts to cut down or stop drinking, continued use despite problems, neglect of activities, time spent in alcohol-related activity) in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and consumed at least 1 drink on 6 or more days in the past 12 months. Binge drinking was defined as consuming 5 or more drinks (men) or 4 or more drinks (women) during a single occasion in the past 30 days. Data set used for 2010 was revised in March 2012. Error bars indicate 95% confidence intervals. [Table: see text]