Cutting societal alcohol use may prevent alcohol disorders

Society must take collective responsibility to reduce the harm caused by alcohol use disorders, a University of Otago academic says.

Dr. Charlene Rapsey, of the Dunedin School of Medicine's Department of Psychological Medicine, says while alcohol is commonly enjoyed by many people and only a minority of people develop an alcohol use disorder, the negative consequences of such a disorder can be severe and long-lasting.

Her research paper, published in Alcohol and Alcoholism, used data from Te Rau Hinengaro, The New Zealand Mental Health Survey, to study transitions from alcohol use to disorder.

Of the nearly 13,000 participants, 94.6 per cent had used alcohol at least once, 85.1 per cent had had at least 12 drinks in the past year, and 16 per cent had developed an alcohol disorder.

Of concern was that with each 10 per cent rise in the number of people who use alcohol in an individual's age and gender group, there was an increased likelihood of them developing an alcohol disorder in the following year.

"We already knew that for young people, peer group norms influence drinking. If people in my peer group drink then I am more likely to drink, but it was interesting that the broad social context of general alcohol consumption – alcohol consumption by people I don't even know – was associated with an increased likelihood of the subsequent onset of a disorder," she says.

Most people's drinking started in high school and transitioned rapidly from consuming alcohol to having an alcohol use disorder.

"Considering many teenagers leave high school at 18 years of age, by then 79 per cent of 18-year-olds had used alcohol, with 57 per cent regularly drinking," Dr. Rapsey says.

Of those to develop an alcohol use disorder, 50 per cent did so by age 20 and 70 per cent by age 25.

Another key finding was that people live with alcohol use disorders for a long time before they experience remission – 45 per cent of people still met criteria for an alcohol disorder after 10 years.

Men are also at greater risk of developing a disorder and are less likely to quit.

"This research highlights our collective responsibility to each other; by reducing the drivers of overall levels of consumption, we have the opportunity to reduce harm to others.

"Relatively small inconveniences, such as limiting availability of alcohol and higher alcohol prices, can have significant influences on reducing alcohol related harms," she says.

Dr. Rapsey argues the research adds to a body of work pushing for policies aimed at reducing overall consumption.

"The Law Commission Report Alcohol in our Lives: Curbing the Harm made a number of evidence-based recommendations to reduce alcohol related harms in New Zealand. Unfortunately the Sale and Supply of Alcohol Act (2012) did not adopt many of the recommendations that had the potential to change people's lives. There is clear research to guide policy makers if there is social and political will.

"This latest research also indicates that resources to prevent and to treat alcohol use disorders need to focus on those under 25 years of age in particular.

"In addition, while the majority of disorders develop in young people, an alcohol disorder is a chronic condition and therefore treatment needs to be available over many years."