Alcohol, the intoxicating ingredient found in beers, wines, and liquors throughout the world, may deliver a temporary lift, but in the long run effects may be quite the opposite. Dependence and abuse of alcohol rank among the most prevalent of mental health disorders… but what are the numbers, exactly? Just over 29 percent of Americans — 68.5 million people — meet the criteria for lifetime prevalence of alcohol use disorder, new research finds. In particular, the researchers discovered 18- to 29-year-olds are most vulnerable to developing an unhealthy relationship with this drug.

When the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (commonly known as DSM-5) was released in May 2013, the American Psychiatric Association made changes to the criteria doctors use to diagnose alcohol abuse. First, whereas the previous edition described two distinct disorders — alcohol abuse and alcohol dependence — with specific criteria for each, the DSM-5 integrates these into a single disorder called alcohol use disorder (AUD) and then applies mild, moderate, and severe sub-classifications. Second, the authors of the new edition eliminated legal problems from the criteria, while adding in craving — a strong desire or urge to use alcohol. (This comparison chart shows the differences between old and new.)

Though considerable overlap exists between the two editions, researchers from the National Institute on Alcohol Abuse and Alcoholism and other institutions, wanted to apply the new definition in their investigation of alcohol use disorder prevalence, co-existing illness, disability, and treatment. They derived their data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), with a total sample size of 36,309 adults.


What did the investigators discover? Twelve-month prevalence of alcohol use disorder totaled 13.9 percent, about 32.6 million people, while lifetime prevalence was 29.1 percent or 68.5 million people. About one in five of those with lifetime AUD sought treatment or help, while less than one in 10 of those with a year-long AUD did the same.

Generally, prevalence of AUD was highest for younger adults (27 percent for 12-month and 37 percent for lifetime), previously married adults (11 percent and 27 percent), and never married adults (25 percent and 36 percent). Men (18 percent and 36 percent, respectively), white adults (14 percent and 33 percent respectively), and Native Americans (19 percent and 43 percent, respectively) showed higher numbers as well. Severe AUD was greatest among the lowest income level respondents.

Alcohol use disorders were linked to other substance use disorders, major depressive and bipolar I disorders, and antisocial and borderline personality disorders. Interestingly, the researchers compared the recent rates with those from the 2001-2002 data and found an increase, particular within the 18- to 29-year-old group.

“Emerging adulthood is becoming an increasingly vulnerable period for AUD onset,” concluded the researchers in their report.

Source: Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015.