Most Alcohol Abuse After Disaster Is Pre-Existing

Most alcohol use problems following a disaster represent preexisting problems rather than new disorders, according to a meta-analysis of 10 recent U.S. disasters.

Although studies have shown a high prevalence of problem drinking and alcohol use disorders following disasters, they have not determined whether a causal relationship exists.

Dr. Carol S. North, of the VA North Texas Health Care System, and her associates analyzed a large database of survivors of 10 different disasters to examine the relationship between pre- and post-disaster prevalence of alcohol use disorders. Their findings were published online Oct. 4 in Archives of General Psychiatry.

Of 811 participants in the index sample, 697 (86%) provided complete pre- and post-disaster alcohol data. Of the respondents, most were white (92%), and more than half (57%) were female. Mean age at the time of the disaster was 46 years, with 28% of patients between ages 18 and 35. More than one-third of subjects (38%) were injured during the disaster, with 20% diagnosed with a disaster-related post-traumatic stress disorder (Arch. Gen. Psychiatry 2010 Oct. 4 [doi:10.1001/archgenpsychiatry.2010.131]).

Researchers used the Diagnostic Interview Schedule for DSM-III-R to determine lifetime diagnoses of alcohol use and dependence, and onset and recency questions to determine if subjects had an alcohol use disorder before or after the disaster or both.

The prevalence of an alcohol use disorder (alcohol abuse/dependence) was 25% before the disaster and 19% afterward, wrote Dr. North, also of the University of Texas Southwestern, Dallas, and her colleagues.

Of the 567 individuals without post-disaster alcohol abuse/dependence at the start of the study, just 3% (20) developed an alcohol use disorder during the follow-up period. Twelve of these were new cases, for a 2% incidence. The rate of onset of new alcohol use disorders over the next 2 years (0.08 new cases per month) was the same as the post-disaster rate.

Among those with a pre-disaster alcohol use disorder, 83% consumed alcohol after the disaster, and 22% coped with their emotions by drinking.

“Despite evidence from other studies that alcohol use may increase after disasters, the findings from this study suggest that this increase in use may not regularly translate into new onset of post-disaster alcohol use disorders,” according to Dr. North and her colleagues.

“The distinction between alcoholic relapse and continuing or new alcohol problems is important, because people who are in recovery from alcoholism when a disaster strikes may be especially vulnerable to relapse when exposed to highly stressful events, thus constituting a population deserving of particular attention in the post-disaster period,” they added.

Disclosures: The study was funded by grants from the National Institute of Mental Health and the Center for Substance Abuse Prevention of the Substance Abuse and Mental Health Services Administration. Dr. North also disclosed grants from other federal health agencies, the American Psychiatric Association, and her university.

Most alcohol use problems following a disaster represent preexisting problems rather than new disorders, according to a meta-analysis of 10 recent U.S. disasters.

Although studies have shown a high prevalence of problem drinking and alcohol use disorders following disasters, they have not determined whether a causal relationship exists.

Dr. Carol S. North, of the VA North Texas Health Care System, and her associates analyzed a large database of survivors of 10 different disasters to examine the relationship between pre- and post-disaster prevalence of alcohol use disorders. Their findings were published online Oct. 4 in Archives of General Psychiatry.

Of 811 participants in the index sample, 697 (86%) provided complete pre- and post-disaster alcohol data. Of the respondents, most were white (92%), and more than half (57%) were female. Mean age at the time of the disaster was 46 years, with 28% of patients between ages 18 and 35. More than one-third of subjects (38%) were injured during the disaster, with 20% diagnosed with a disaster-related post-traumatic stress disorder (Arch. Gen. Psychiatry 2010 Oct. 4 [doi:10.1001/archgenpsychiatry.2010.131]).

Researchers used the Diagnostic Interview Schedule for DSM-III-R to determine lifetime diagnoses of alcohol use and dependence, and onset and recency questions to determine if subjects had an alcohol use disorder before or after the disaster or both.

The prevalence of an alcohol use disorder (alcohol abuse/dependence) was 25% before the disaster and 19% afterward, wrote Dr. North, also of the University of Texas Southwestern, Dallas, and her colleagues.

Of the 567 individuals without post-disaster alcohol abuse/dependence at the start of the study, just 3% (20) developed an alcohol use disorder during the follow-up period. Twelve of these were new cases, for a 2% incidence. The rate of onset of new alcohol use disorders over the next 2 years (0.08 new cases per month) was the same as the post-disaster rate.

Among those with a pre-disaster alcohol use disorder, 83% consumed alcohol after the disaster, and 22% coped with their emotions by drinking.

“Despite evidence from other studies that alcohol use may increase after disasters, the findings from this study suggest that this increase in use may not regularly translate into new onset of post-disaster alcohol use disorders,” according to Dr. North and her colleagues.

“The distinction between alcoholic relapse and continuing or new alcohol problems is important, because people who are in recovery from alcoholism when a disaster strikes may be especially vulnerable to relapse when exposed to highly stressful events, thus constituting a population deserving of particular attention in the post-disaster period,” they added.

Disclosures: The study was funded by grants from the National Institute of Mental Health and the Center for Substance Abuse Prevention of the Substance Abuse and Mental Health Services Administration. Dr. North also disclosed grants from other federal health agencies, the American Psychiatric Association, and her university.

Most alcohol use problems following a disaster represent preexisting problems rather than new disorders, according to a meta-analysis of 10 recent U.S. disasters.

Although studies have shown a high prevalence of problem drinking and alcohol use disorders following disasters, they have not determined whether a causal relationship exists.

Dr. Carol S. North, of the VA North Texas Health Care System, and her associates analyzed a large database of survivors of 10 different disasters to examine the relationship between pre- and post-disaster prevalence of alcohol use disorders. Their findings were published online Oct. 4 in Archives of General Psychiatry.

Of 811 participants in the index sample, 697 (86%) provided complete pre- and post-disaster alcohol data. Of the respondents, most were white (92%), and more than half (57%) were female. Mean age at the time of the disaster was 46 years, with 28% of patients between ages 18 and 35. More than one-third of subjects (38%) were injured during the disaster, with 20% diagnosed with a disaster-related post-traumatic stress disorder (Arch. Gen. Psychiatry 2010 Oct. 4 [doi:10.1001/archgenpsychiatry.2010.131]).

Researchers used the Diagnostic Interview Schedule for DSM-III-R to determine lifetime diagnoses of alcohol use and dependence, and onset and recency questions to determine if subjects had an alcohol use disorder before or after the disaster or both.

The prevalence of an alcohol use disorder (alcohol abuse/dependence) was 25% before the disaster and 19% afterward, wrote Dr. North, also of the University of Texas Southwestern, Dallas, and her colleagues.

Of the 567 individuals without post-disaster alcohol abuse/dependence at the start of the study, just 3% (20) developed an alcohol use disorder during the follow-up period. Twelve of these were new cases, for a 2% incidence. The rate of onset of new alcohol use disorders over the next 2 years (0.08 new cases per month) was the same as the post-disaster rate.

Among those with a pre-disaster alcohol use disorder, 83% consumed alcohol after the disaster, and 22% coped with their emotions by drinking.

“Despite evidence from other studies that alcohol use may increase after disasters, the findings from this study suggest that this increase in use may not regularly translate into new onset of post-disaster alcohol use disorders,” according to Dr. North and her colleagues.

“The distinction between alcoholic relapse and continuing or new alcohol problems is important, because people who are in recovery from alcoholism when a disaster strikes may be especially vulnerable to relapse when exposed to highly stressful events, thus constituting a population deserving of particular attention in the post-disaster period,” they added.

Disclosures: The study was funded by grants from the National Institute of Mental Health and the Center for Substance Abuse Prevention of the Substance Abuse and Mental Health Services Administration. Dr. North also disclosed grants from other federal health agencies, the American Psychiatric Association, and her university.