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Among individuals with an average daily consumption of about 1 large beer, the risk for alcohol use disorder (AUD) is almost threefold the risk for nondrinkers, according to study results published in Addiction. That same level of alcohol consumption was also associated with a nearly twofold increased risk for AUD mortality.
Although AUD is relatively common globally, it remains largely undertreated – despite the significant health and social consequences associated with the disorder. The current study aimed to explore the relationships between alcohol consumption, AUD incidence, and AUD-related mortality. In their systematic review and meta-analysis, the researchers sought to understand the nuanced interactions between alcohol use and AUD outcomes across age, sex, race/ethnicity, and socioeconomic status.
The researchers searched publication databases to identify observational studies published between January 2000 and July 2022 on alcohol use, AUD incidence, and mortality, using relevant search terms and no language restrictions. Relevant studies focused on adults in general or AUD patient cohorts, used cohort or case-control designs, and reported on specific alcohol-related outcomes and risk ratios. The researchers used grams of pure alcohol per day as the exposure measure and conducted random-effects dose-response models to examine the relationship between levels of alcohol consumption and the outcomes of interest.
Overall, 10 studies met the inclusion criteria and were included in the systematic review and 7 were eligible for quantitative synthesis. Additionally, the researchers included 2 secondary United States data sources for the quantitative synthesis: the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) and the National Health Interview Survey (NHIS).
“In conclusion, there is a clear dose-response relationship between levels of alcohol consumption and the risk of AUD incidence and mortality.
In the qualitative assessment, the researchers found that both binge drinking and risky drinking were associated with a significantly elevated risk for incident AUD, relative to individuals who never engaged in these drinking behaviors.
In the quantitative analyses, the researchers observed a dose-response relationship between alcohol consumption and the risk for incident AUD. The relative risk (RR) was 1.67 (95% CI, 1.09-2.54) for an average daily consumption of 10 grams per day, increasing to 2.74 (95% CI, 1.48-5.08) for 20 grams per day, 7.14 (95% CI, 5.13-9.93) for 40 grams per day, and 17.64 (95% CI, 6.95-44.76) for 60 grams per day.
Similarly, the researchers observed a dose-response relationship between alcohol consumption and risk for AUD-related mortality. At just 20 grams per day – the equivalent of about 1 large beer – the risk for AUD-related mortality was twofold (RR, 1.99; 95% CI 1.88–2.10) that of nondrinkers. Accordingly, the risk increased at 40 grams per day (RR, 3.94; 95% CI 3.53–4.40), 60 grams per day (RR, 7.82; 95% CI 6.63–9.22), and 80 grams per day (RR, 15.52; 95% CI, 12.46–19.34).
These findings demonstrated exponential risk relationships between alcohol use and both AUD incidence and AUD-related mortality. The researchers stated, “In conclusion, there is a clear dose-response relationship between levels of alcohol consumption and the risk of AUD incidence and mortality.”
Limitations of the study include the exclusion of lifetime abstainers, reliance on self-reported alcohol consumption, relevant data mostly came from high-income countries, and the definition of AUD-related mortality encompassed both acute and chronic alcohol-attributable causes, which may have introduced heterogeneity due to varying coding practices and potential stigmatization.
This article originally appeared on Psychiatry Advisor