Demographics of Alcohol Use Disorder in the United States

"Consistent with previous research, rates of AUD [Alcohol Use Disorder] were greater among men than women.1,2,5,14 Age was inversely related to 12-month AUD, a finding also observed in earlier epidemiologic studies.1-5,14 Whether this result is owing to cohort effects, differential mortality, or recall bias merits further investigation. The 12-month rate of 7.1% for severe AUD among 18- to 29-year-old respondents is especially striking. The rate is consistent with the earlier age at onset of severe relative to mild or moderate AUD (23.9 vs 25.9 or 30.1 years, respectively) and increasing rates of heavy drinking in this age group. For example, among men, past-year drinking of at least 5, at least 8, and at least 10 drinks/d increased from 60.7%, 41.0%, and 33.9%, respectively, in the NESARC [National Epidemiologic Survey on Alcohol and Related Conditions III] to 68.2%, 46.3%, and 38.0%, respectively, in the NESARC-III. In women, the increase was from 33.5%, 14.7%, and 8.7%, respectively, in the NESARC to 47.7%, 22.1%, and 14.2%, respectively, in the NESARC-III (R.B.G, unpublished data, February 2015). Thus, emerging adulthood is becoming an increasingly vulnerable period for AUD onset. Given the potential effect of young-adult AUD on long-term employment prospects in a changing economy and the risk for young-adult alcohol-related mortality, the increases suggest an urgent need to develop and implement more effective prevention and intervention efforts.

"Study findings indicate a lower risk for AUD among black, Asian or Pacific Islander, and Hispanic than white respondents. Although genetic factors affecting alcohol metabolism likely influence lower rates among Asian respondents,42,43 understanding risk factors among white respondents and protective factors among black and Hispanic respondents will be important to elucidate the etiology of AUD and design better prevention and intervention programs. In contrast, Native American respondents had high rates of 12-month and lifetime severe AUD. These results are consistent with regional studies of Native Americans showing high rates of alcohol-related morbidity and mortality44-46 and underscore the need for more extensive prevention and intervention efforts in this group."