SAN DIEGO – Alcohol-dependent patients who were older than age 30 and met certain DSM-IV criteria for alcohol dependence–including tolerance and continuing to drink despite its negative impact on important events–had less dramatic reduction in heavy drinking over time.
The findings suggest that alcohol-dependent patients with those characteristics may benefit from more aggressive intervention efforts, according to results from an analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
“There have been a number of studies that examined the predictors of change in heavy drinking status over time in the general population,” Khaled Sarsour, Ph.D., said in an interview after presenting the findings in a poster at the annual scientific conference of the Research Society on Alcoholism.
“However, to the best of our research team's knowledge, this was the first study that examined the predictors of change in the number of heavy drinking days within a U.S. nationally representative population of alcohol-dependent patients.”
Dr. Sarsour, a research scientist in the epidemiology and health services research group at Eli Lilly & Co., and his associates examined predictors of the change in frequency of heavy drinking among 1,053 alcohol-dependent patients from baseline (NESARC Wave 1, conducted in 2001-2002) to about 3 year later (NESARC Wave 2, conducted in 2004-2005). Frequency of heavy drinking was defined was the number of heavy drinking days (five drinks or more per day for men; four drinks or more per day for women) in the past year.
The researchers used an analysis of covariance model, adjusting for baseline heavy drinking days, to examine factors associated with change in the frequency of heavy drinking. More than half of patients (64%) were younger than age 39 years, 63% were male, 61% were white, and 37% were married.
Overall, the mean number of heavy drinking days among patients with alcohol dependence fell from 114 per year during NESARC Wave 1 to 84 per year during NESARC Wave 2.
Dr. Sarsour and his associates reported that the factors significantly associated with an increase of heavy drinking days between the two time periods were being older than age 30, being a current smoker, and fulfilling three DSM-IV criteria for dependence: tolerance, giving up or cutting back on important activities to drink, and drinking despite having physical and/or psychological problems.
Alcohol-dependent patients diagnosed with comorbid depression and/or dysthymia reported an additional significant mean decrease of 19 heavy drinking days, compared with their counterparts who were not diagnosed with those conditions.
“We were expecting sociodemographic variables such as level of education, marital status, gender, and ethnicity to be associated with change in heavy drinking over time,” Dr. Sarsour said. “However, in this study, none of these variables were significant predictors of change in heavy drinking status over time. This may have been due to the fact that the study population consisted of alcohol-dependent patients. We will do a follow-up analysis to see if these predictors are significant in predicting change in heavy drinking in non–alcohol-dependent patients from the same national data set.”
Dr. Sarsour and four other members of the research team are employees of Eli Lilly. The other member of the research team was Dr. Howard B. Moss of the National Institute on Alcohol Abuse and Alcoholism, which sponsored the study.