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Adult low-risk drinkers and abstainers are not the same.

ABSTRACT: BACKGROUND:Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12?years and older drink alcohol but don't exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain. METHODS:Data from the 2013 National Drug Strategy Household Survey were used. In the past 12?months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk). RESULTS:Multivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers. CONCLUSIONS:The socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.

SUBMITTER: Mugavin J

PROVIDER: S-EPMC6954507 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Adult low-risk drinkers and abstainers are not the same.

Mugavin Janette J MacLean Sarah S Room Robin R Callinan Sarah S

BMC public health 20200110 1

<h4>Background</h4>Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don't exceed these recommended limits, yet adult low-risk drinkers have been largely o ...[more]

PMID: 31924194

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Project description:AimsTo estimate differences in the strength and shape of associations between alcohol use and diagnosis-specific sickness absence.DesignA multi-cohort study. Participants (n = 47?520) responded to a survey on alcohol use at two time-points, and were linked to records of sickness absence. Diagnosis-specific sickness absence was followed for 4-7 years from the latter survey.Setting and participantsFrom Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000-02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985-88 and 1991-94, respectively.MeasurementsWe used standard questionnaires to assess alcohol intake categorized into 0, 1-11 and > 11 units per week in women and 0, 1-34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio-economic status, smoking and body mass index.FindingsWomen who reported drinking 1-11 units and men who reported drinking 1-34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22-1.88], musculoskeletal disorders (1.22, 95% CI = 1.06-1.41), diseases of the digestive system (1.35, 95% CI = 1.02-1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29-1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13-1.83).ConclusionsIn Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at-risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

Project description:Background Reductions in substance use are associated with positive long‐term treatment outcomes such as psychosocial functioning; substance use–related consequences; and mental, physical, and neurobiological health. Therefore, nonabstinent clinical trial endpoints have received growing attention from substance abuse treatment experts. Regional brain tissue volumes in alcoholism treatment seekers increase during abstinence, in parallel to cognitive performance. Methods We examined the relationships of drinking levels in those who did not maintain abstinence after treatment with magnetic resonance imaging‐derived gray matter (GM) volumes measured 8 months after baseline assessments while in outpatient treatment. The complex drinking behavior during the interval was operationalized as World Health Organization risk drinking levels (WHO‐RDL), derived from the number of standard alcoholic drinks per day. We compared the volumes of addiction‐relevant cortical and subcortical brain regions at long‐term follow‐up among abstainers and 2 groups of relapsers with low and higher WHO‐RDL. Results We found that: (i) relapsers with low WHO‐RDL at follow‐up, who as a group had reduced their risk levels by 2.8 units (by consuming <40 g of ethanol per day over the recovery interval), had regional brain tissue volumes indistinguishable from those of abstainers tested after the same time period and that (ii) relapsers with higher WHO‐RDL, with only 1.2 units average risk‐level reductions, had significantly smaller frontal GM and thalamic volumes than abstainers and relapsers with low WHO‐RDL. Despite many drinking days during recovery, including several with >10 drinks per day, relapsers with low WHO‐RDL at follow‐up tended to perform better than those with higher WHO‐RDL on cognitive domains of working memory and visuospatial skills assessed over the recovery interval. Conclusions Nonabstinent recovery is characterized by addiction‐relevant GM volumes comparable to those of complete abstainers. The WHO‐RDL has meaningful structural neuroimaging correlates potentially suitable as cognitively relevant biomarkers of treatment response and general brain health, perhaps even as objective clinical trial endpoints. Non‐abstinent recovery after treatment for alcohol use disorder (AUD) has been shown to be beneficial for psychological and physical health. Here, researchers demonstrate by MRI that non‐abstinent recovery also benefits frontal gray matter volume, a brain region important for cognitive control. Treated AUD individuals have smaller volumes than healthy controls (CON), but the volumes are similar for total abstainers (ABST) and relapsers with low drinking severity (WHO low). Only severe relapsers (WHO higher) show dramatically less frontal gray matter.

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Adult low-risk drinkers and abstainers are not the same.

Publications

Adult low-risk drinkers and abstainers are not the same.

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