Abstinence from alcohol has been associated with higher mortality than a moderate consumption of alcohol. However, there is evidence to indicate that the abstainers constitute a select group which is exposed to various psychosocial risk factors.
A population-based sample (N=1978) from the study Young in Norway - longitudinal was followed with repeated surveys from their teens until approaching the age of 30. This data set was linked to various registries. The collection of data included their use of alcohol, social integration and symptoms of anxiety and depression, as well as sexual behaviour. Data on receipt of social benefits were collected from registries.
At age 21, altogether 211 individuals (10.7%) had remained abstinent from alcohol throughout their entire lives. At age 28, their number had fallen to 93 individuals (4.7%). At age 21, abstinence was associated with weak networks of friends, loneliness and a higher likelihood of not yet having had a sexual debut. At age 28, the abstainers also reported a higher prevalence of symptoms of anxiety and depression. They were also more frequent recipients of social benefits.
Abstinence from alcohol in adulthood is associated with psychosocial problems and weak integration. These may introduce confounding factors in studies of the health effects of alcohol consumption.
Comment In: Tidsskr Nor Laegeforen. 2013 Mar 5;133(5):50123463056
Comment In: Tidsskr Nor Laegeforen. 2013 Mar 5;133(5):50123463055
The purpose of this study was first to compare 18-19-year-old male abstainers with alcohol consumers, and especially light consumers, regarding degree of sociability as indicated by their (in)security in the company of others, their number of close friends, intimate conversations with friends and their popularity in school. Secondly, we analysed the importance of antecedents to and covariates of abstinence. In addition, the significant antecedents and covariates gave us information as to abstinence patterns. The study was based on a survey of all Swedish males, 18-19 years old, conscripted for military service in 1969-70. Data had been collected by means of questionnaires and psychological interviews, giving measures of each respondent's social background, psychiatric/psychological and psychosomatic health status, substance use, deviant behaviour and degree of sociability. Poor sociability was more common among the abstainers than among all the other categories of drinkers, including the light consumers. The conscripts' social background, and especially their fathers' drinking habits, had the strongest effects in explaining abstinence. Sixty-two per cent of all abstainers had non-drinking fathers, compared to 28% of the light consumers. As to the majority of abstainers, this indicates a link between the social background of temperance and their own reported abstinence. Their poor sociability could be a consequence of abstaining at a young age when abstinence is uncommon. Those who abstained despite a drinking father showed a worsening psychological status, suggesting a link between psychologically impaired health, poor sociability and abstinence. Though the abstainers were the least sociable, the difference between the abstainers, the light consumers and the moderate consumers in other categories were generally small.(ABSTRACT TRUNCATED AT 250 WORDS)
Although drinking patterns in women have received increased attention, few studies have focused on middle-aged women. Drinking patterns were investigated in a population sample of 513 Swedish women aged 50-59, and analysed in relation to social situation, and mental and physical health. The chi-square test was used to analyse differences in proportions. Variables showing significant differences were entered into a multivariate or multinomial logistic regression model. Abstainers and occasional drinkers had lower levels of education and more often regular medical control compared with weekly drinkers. Furthermore, abstainers more often had disability pension. Among women drinking alcohol, 56.6% affirmed binge drinking within the last year and 39.4% within the last month. Binge drinkers did not differ in terms of social situation, mental or physical health, compared with other drinkers. Drinking to relieve tension was affirmed by 7.2%. These women had more mental symptoms and less contact with friends compared with other drinkers; furthermore, they were more often binge drinkers. Binge drinking was common and health and social consequences of this drinking pattern in middle-aged women need to be further explored. Women drinking to relieve tension may need intervention for both drinking habits and mental health.
The present study was conducted to provide a nationwide survey of acceptance of nonabstinence goals and related alcoholism treatment practices by Canadian alcoholism treatment services.
A random sample of 335 Canadian alcoholism treatment service agencies were mailed a 4-page questionnaire designed to assess acceptance of moderate drinking as a drinking goal and related alcoholism treatment practices.
Acceptance varied by type of service, with considerably more acceptance by outpatient programs (62%) and mixed inpatient/outpatient programs (43%) than inpatient/detoxification/ correctional facilities (27%) and halfway houses (16%). Two-thirds of the respondents who reported moderate drinking as unacceptable in their own agencies categorically rejected moderation for all alcoholism clients.
Individuals seeking services in Canadian alcoholism treatment agencies are more likely to have a choice of drinking goals if they present to an outpatient program than a residential institution, and Canadian agencies appear more accepting of moderation goals than American programs, but less accepting than British and Norwegian service agencies.
Although many people recover from substance-use associated problems on their own, little is known about this phenomenon. The paper had two objectives: to use a new research method, computer-assisted content analysis, to understand alcohol and drug abusers' perceived reasons for self-change and to undertake a comparative evaluation across substances and cultures to validate previous findings about subjective appraisal processes. Three studies of natural recoveries of alcohol and drug abusers in two countries conducted tape-recorded interviews with 216 respondents. The taped responses were coded based on a content analytic dictionary approach using a computerized content analysis program. All three studies found several processes mediating the decision to change substance use. The computer content analysis confirmed a cognitive appraisal process regardless of the cultural setting or substance. The findings suggest that several procedures might have benefit in clinical interventions.
To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress.
Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire.
Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude.
Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.
This study compared whether self-reported mental health status was associated with likelihood of being abstinent from alcohol and drugs five years after baseline assessment for an addiction disorder in two representative samples; one from Sweden (n = 469) and one from the US (n = 667). Self-reported mental health status was measured through the ASI score of mental health symptoms and history of inpatient and/or outpatient treatment. Through logistic regression modeling the study controlled for demographic characteristics including age, gender, employment status and social network connection with individuals who do not use alcohol/drugs. For both the US and Swedish samples employment status and having a social network that does not use alcohol and drugs were associated with being likely to be abstinent from alcohol and drugs five years after initial assessment. For the US sample only, individuals who reported symptoms of anxiety were 50% more likely not to be abstinent from alcohol and drugs at follow-up. For the Swedish sample, current mental health status was not significantly associated with abstinence. However, reporting a lifetime history of inpatient psychiatric treatment at the baseline assessment was significantly associated with not being abstinent at 5 years post assessment; those with a lifetime history of inpatient mental health treatment were 47% less likely to report abstinence. While specific variables differ across Sweden and the US, psychiatric comorbid status, employment and social network are each associated with drug and alcohol abstinence cross-nationally.
The present study assessed mental well-being daily in 28 alcohol-dependent patients who underwent 28 days of Minnesota inpatient treatment. The Swedish Mood Adjective Check List (sMACL) with six bipolar dimensions was used for daily self-reports. At start of treatment, patients had lower levels in four dimensions of mental well-being compared to those of a norm group. Moreover, patients showed significant improvements in all levels of mental well-being during treatment, and at the end of treatment patients had values within the normal range, except for one dimension (activation/deactivation), in which the levels were significantly higher. The findings may suggest a beneficial effect of this type of treatment on mental well-being, although findings may also reflect a mere effect of adjustment to treatment or the social situation.
This study is based on interviews with 53 male alcoholics. Its purpose was to study the relationship between childhood conditions, history of alcohol and drug misuse and assaultive and suicidal behaviour. Fifty-seven per cent of the alcoholics reported a history of violent behaviour. Hidden violence, often towards women, was common. One-third of the violent patients had a history of attempted suicide compared to 17% in the non-violent group. The assaultive alcoholics also had a more violent childhood, a higher proportion of fathers with alcohol problems and had started drinking earlier in life. Drug addiction was much more common in this group too. We find support for our hypothesis that there is a positive correlation between violence in the parental home and assaultive and suicidal behaviour and drug misuse later in life. When violent and non-violent alcoholics are compared many of the same characteristics appear as when suicidal and non-suicidal and type 2 and type 1 alcoholics are compared. This study raises the question of adding attempted suicide as a characteristic of the type 2 alcoholic.
The role of co-twin dependence (twins' closeness or reliance on the co-twin) was examined as a moderator of genetic and environmental influences on alcohol use in adolescence and early adulthood in a large longitudinal population-based study of Finnish twins (FinnTwin16). The associations between co-twin dependence and alcohol use were studied first at an individual level in adolescence (n = 3362) and early adulthood (n = 2912). Then, maximum likelihood models were fit to the two waves of data from same-sex twin pairs to assess the differences and changes in genetic and environmental influences on alcohol use (abstinence, drinking frequency, intoxication frequency); N = 1342 pairs in adolescence, and N = 1078 pairs in early adulthood. Overall, no significant associations were found between co-twin dependence and individual alcohol use. However, co-twin dependence importantly modulated genetic effects on drinking habits, especially in adolescence, but also in early adulthood. Co-twin-dependent twins reported greater similarity in their alcohol-related behavior across all alcohol-use measures at both time points, and the role of genes and environments varied according to co-twin dependence. Shared environmental factors explained most of the variation in drinking among co-twin-dependent twins in adolescence and contributed to drinking to intoxication during early adulthood. In contrast, among co-twin-independent twin pairs, genetic variance contributed significantly to all alcohol-use measures at both time-points. An interdependent sibling relationship is an important modifier of drinking habits, and it appears to reduce the impact of inherited liabilities on alcohol-related behavior especially in adolescence.