Disclosures: Shmulewitz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
January 29, 2021
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WHO risk drinking levels provide metric for nonabstinent reduction, study finds

Disclosures: Shmulewitz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Risk drinking levels increased significantly from 2001 and 2002 to 2012 and 2013, according to an analysis of nationally representative surveys published in American Journal of Psychiatry.

“Recent studies and a meta-analysis of time trends in alcohol consumption among U.S. adults show increases in any alcohol use and in heavy use, specifically among women,” Dvora Shmulewitz, PhD, of the department of psychiatry at Columbia University Irving Medical Center, and colleagues wrote. “However, none of these studies measured consumption using the WHO risk drinking level definitions. What is known about the prevalences of the WHO levels was estimated in older data (2001–2002), in which 2.5% of current drinkers were at very high risk, 2.5% at high risk, 4.8% at moderate risk and 90.2% at low risk.”

shot glasses with alcohol
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According to the researchers, data are sparse regarding the change over time in the prevalence of WHO risk drinking levels and their relationship to health conditions, overall and by gender. In the current study, they aimed to examine these potential links, as well as whether health conditions associated with alcohol were linked to WHO risk drinking level within each survey, using two sets of nationally representative U.S. survey data. Specifically, they used logistic regression to analyze data of 26,655 current drinkers who were included in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and of 25,659 included in the 2012 to 2013 NESARCIII. They estimated between-survey prevalence differences for each drinking level overall and by gender. Further, they estimated prevalence differences by WHO risk drinking level within each survey for alcohol use disorder, drug use disorders, functional impairment, liver disease and depressive and anxiety disorders.

Results showed prevalences of moderate, high and very high-risk drinking increased from 1%, 0.6% and 0,9%, respectively, in the 2001 to 2002 survey to 5.9%, 3.2% and 3.5%, respectively, in the 2012 to 2013 survey. Men exhibited a smaller increase (0.5%) for very high risk drinking vs. women (1.4%). The researchers noted a significant association within both surveys between health conditions and very high risk, high risk and moderate risk drinking compared with low-risk drinking. Although men had stronger effects for alcohol use disorder and women for functional impairment and depressive and anxiety symptoms, associations were similar by gender.

“If clinicians and the general public became more aware that nonabstinent drinking reduction is feasible, sustainable and beneficial to health, more individuals could be engaged in treatment, which is of great public health importance,” Shmulewitz and colleagues wrote. “The WHO risk drinking levels can be leveraged in prevention and intervention strategies for the public health goal of decreasing the personal and societal toll of risky alcohol use.”