Alcohol Use Disorders: Chronic or Not?

From Alcohol, Other Drugs, and Health: Current Evidence:

Alcohol Use Disorders: Chronic or Not?
Interviews of a representative sample of 43,093 U.S. adults provide new information on the usual course of alcohol use disorders (abuse or dependence).

• Approximately 5% of adults had past-year abuse while 4% had past-year dependence. Lifetime prevalences were 18% and 13%, respectively.
• Of those with lifetime alcohol dependence, only 24% reported ever having received alcohol treatment, even though treatment was defined broadly and included (but was not limited to) participation in 12-step programs, care in an emergency department, and assistance by clergy or other professionals.
• The mean age of onset of an alcohol use disorder was 22 years.
• Most patients with lifetime abuse or dependence had only 1 episode (72%). Those with more than 1 episode had a mean of 5 episodes. The mean duration of the longest episode was about 3 years for abuse and 4 years for dependence.

Comments:
This nationally representative survey tells us that alcohol use disorders begin in young adulthood and usually go untreated. They are characterized by recurrence for relatively few patients (though patients with recurring episodes are the ones that physicians are most likely to encounter and remember). More commonly, alcohol use disorders consist of 1 symptomatic episode, even when not treated, lasting up to several years.

Richard Saitz, MD, MPH

So, alcohol use disorders are generally not chronic. What would be nice to know is what the breakdown looks like for abuse versus dependence.