It is well established that having a current alcohol use disorder is a tremendous risk to physical and emotional health.
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It is well established that having a current alcohol use disorder is a tremendous risk to physical and emotional health.
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Alcohol consumption can cause harm in multiple ways:
While clinical guidelines recommend asking about current drinking, a history of problem drinking might also be important to know in terms of health risks. This study investigated whether having a prior alcohol use disorder – in remission for at least 5 years – was related to a series of medical problems in a large, demographically and geographically representative sample in the United States.
The study focused on individuals in sustained remission from alcohol use disorder for 5 years – a period of time that has been shown to mark stable remission, and the reduction of risk for re-developing substance use disorder similar to that of the general population.
Sustained remission: someone once met diagnostic criteria for an alcohol use disorder, and then no longer meets the threshold for the disorder for at least 1 year.
Authors used data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). They excluded individuals that were 18-29 years old and those that had an active alcohol use disorder, or were in remission but for less than 5 years. They were interested in the relationships between alcohol use disorder that has been in remission for 5+ years (N = 5566) versus no alcohol use disorder history (N = 20,274) on a series of self-reported medical conditions that were “confirmed by a doctor in the past 12 months.”
Possible conditions included:
The analyses which tested whether remitted alcohol use disorder was related to having these medical conditions adjusted for many other factors that could also be related both to having an alcohol use disorder as well as to one’s medical condition.
These adjusted factors included, for example, other substance use and mental health disorders, and whether one was a current or former smoker. The participants with remitted alcohol use disorder, on average, were in remission for 22 years and had active alcohol use disorder for 7 years.
First, compared to those who never had an alcohol use disorder, the remitted alcohol use disorder group (which we refer to just as the remitted group) had more drinking days on average (56 vs. 40 days) and a lower percentage of individuals who were abstinent from alcohol in the past year (30 vs. 44%). They were more likely to be current and former smokers, and to have other psychiatric disorders, including other drug use and mood and anxiety disorders during their lifetime.
While effects were modest – about 1.05 to 1.35 times greater likelihood – the potential health consequences of these conditions make even small increases in the odds of having the condition very meaningful.
Another important set of findings was, just among those in the remitted group, having active alcohol use disorder for a longer period of time (5+ years) was related to increased likelihood of arteriosclerosis (thickening of the blood vessels which can have serious consequences including heart attack), myocardial infarction, other heart disease, and arthritis.
Doctors should assess not only for current alcohol use, but former use as well, focusing on any lifetime history of problematic use. As one gets older, the risks related to alcohol use disorder could become graver, including heart attack, for example.
Also, what may be most significant to assess is the amount of time lived with an active alcohol use disorder, rather than the mere presence or absence of the disorder, per se. In other words, the sooner one gets into remission the lower the likelihood of developing these conditions during recovery.
The design of the study cannot confirm definitively that it is the person’s history of alcohol use disorder that specifically caused these conditions. Nevertheless, three points are important, to consider:
Next potential steps include longitudinal studies to understand the causal nature of these relationships. This might optimally occur when medical diagnoses’ presence can be more accurately obtained by researchers or in a health care setting where medical diagnoses can be determined clinically and/or by chart review.
In addition, it may be important to develop and validate a screening questionnaire that adequately captures past history of an alcohol use disorder. In this study, there was an extensive diagnostic questionnaire administered to determine alcohol use disorder history. It would be very helpful to known whether that kind of extensive questionnaire is necessary or whether a shorter one would be sufficient. This strategy might help address the problem while limiting the time burden for medical staff administering the questionnaire.
Udo, T., Vasquez, E., & Shaw, B. A. (2015). A lifetime history of alcohol use disorder increases risk for chronic medical conditions after stable remission. Drug Alcohol Depend, 157, 68-74. doi:10.1016/j.drugalcdep.2015.10.008
l
Alcohol consumption can cause harm in multiple ways:
While clinical guidelines recommend asking about current drinking, a history of problem drinking might also be important to know in terms of health risks. This study investigated whether having a prior alcohol use disorder – in remission for at least 5 years – was related to a series of medical problems in a large, demographically and geographically representative sample in the United States.
The study focused on individuals in sustained remission from alcohol use disorder for 5 years – a period of time that has been shown to mark stable remission, and the reduction of risk for re-developing substance use disorder similar to that of the general population.
Sustained remission: someone once met diagnostic criteria for an alcohol use disorder, and then no longer meets the threshold for the disorder for at least 1 year.
Authors used data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). They excluded individuals that were 18-29 years old and those that had an active alcohol use disorder, or were in remission but for less than 5 years. They were interested in the relationships between alcohol use disorder that has been in remission for 5+ years (N = 5566) versus no alcohol use disorder history (N = 20,274) on a series of self-reported medical conditions that were “confirmed by a doctor in the past 12 months.”
Possible conditions included:
The analyses which tested whether remitted alcohol use disorder was related to having these medical conditions adjusted for many other factors that could also be related both to having an alcohol use disorder as well as to one’s medical condition.
These adjusted factors included, for example, other substance use and mental health disorders, and whether one was a current or former smoker. The participants with remitted alcohol use disorder, on average, were in remission for 22 years and had active alcohol use disorder for 7 years.
First, compared to those who never had an alcohol use disorder, the remitted alcohol use disorder group (which we refer to just as the remitted group) had more drinking days on average (56 vs. 40 days) and a lower percentage of individuals who were abstinent from alcohol in the past year (30 vs. 44%). They were more likely to be current and former smokers, and to have other psychiatric disorders, including other drug use and mood and anxiety disorders during their lifetime.
While effects were modest – about 1.05 to 1.35 times greater likelihood – the potential health consequences of these conditions make even small increases in the odds of having the condition very meaningful.
Another important set of findings was, just among those in the remitted group, having active alcohol use disorder for a longer period of time (5+ years) was related to increased likelihood of arteriosclerosis (thickening of the blood vessels which can have serious consequences including heart attack), myocardial infarction, other heart disease, and arthritis.
Doctors should assess not only for current alcohol use, but former use as well, focusing on any lifetime history of problematic use. As one gets older, the risks related to alcohol use disorder could become graver, including heart attack, for example.
Also, what may be most significant to assess is the amount of time lived with an active alcohol use disorder, rather than the mere presence or absence of the disorder, per se. In other words, the sooner one gets into remission the lower the likelihood of developing these conditions during recovery.
The design of the study cannot confirm definitively that it is the person’s history of alcohol use disorder that specifically caused these conditions. Nevertheless, three points are important, to consider:
Next potential steps include longitudinal studies to understand the causal nature of these relationships. This might optimally occur when medical diagnoses’ presence can be more accurately obtained by researchers or in a health care setting where medical diagnoses can be determined clinically and/or by chart review.
In addition, it may be important to develop and validate a screening questionnaire that adequately captures past history of an alcohol use disorder. In this study, there was an extensive diagnostic questionnaire administered to determine alcohol use disorder history. It would be very helpful to known whether that kind of extensive questionnaire is necessary or whether a shorter one would be sufficient. This strategy might help address the problem while limiting the time burden for medical staff administering the questionnaire.
Udo, T., Vasquez, E., & Shaw, B. A. (2015). A lifetime history of alcohol use disorder increases risk for chronic medical conditions after stable remission. Drug Alcohol Depend, 157, 68-74. doi:10.1016/j.drugalcdep.2015.10.008
l
Alcohol consumption can cause harm in multiple ways:
While clinical guidelines recommend asking about current drinking, a history of problem drinking might also be important to know in terms of health risks. This study investigated whether having a prior alcohol use disorder – in remission for at least 5 years – was related to a series of medical problems in a large, demographically and geographically representative sample in the United States.
The study focused on individuals in sustained remission from alcohol use disorder for 5 years – a period of time that has been shown to mark stable remission, and the reduction of risk for re-developing substance use disorder similar to that of the general population.
Sustained remission: someone once met diagnostic criteria for an alcohol use disorder, and then no longer meets the threshold for the disorder for at least 1 year.
Authors used data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). They excluded individuals that were 18-29 years old and those that had an active alcohol use disorder, or were in remission but for less than 5 years. They were interested in the relationships between alcohol use disorder that has been in remission for 5+ years (N = 5566) versus no alcohol use disorder history (N = 20,274) on a series of self-reported medical conditions that were “confirmed by a doctor in the past 12 months.”
Possible conditions included:
The analyses which tested whether remitted alcohol use disorder was related to having these medical conditions adjusted for many other factors that could also be related both to having an alcohol use disorder as well as to one’s medical condition.
These adjusted factors included, for example, other substance use and mental health disorders, and whether one was a current or former smoker. The participants with remitted alcohol use disorder, on average, were in remission for 22 years and had active alcohol use disorder for 7 years.
First, compared to those who never had an alcohol use disorder, the remitted alcohol use disorder group (which we refer to just as the remitted group) had more drinking days on average (56 vs. 40 days) and a lower percentage of individuals who were abstinent from alcohol in the past year (30 vs. 44%). They were more likely to be current and former smokers, and to have other psychiatric disorders, including other drug use and mood and anxiety disorders during their lifetime.
While effects were modest – about 1.05 to 1.35 times greater likelihood – the potential health consequences of these conditions make even small increases in the odds of having the condition very meaningful.
Another important set of findings was, just among those in the remitted group, having active alcohol use disorder for a longer period of time (5+ years) was related to increased likelihood of arteriosclerosis (thickening of the blood vessels which can have serious consequences including heart attack), myocardial infarction, other heart disease, and arthritis.
Doctors should assess not only for current alcohol use, but former use as well, focusing on any lifetime history of problematic use. As one gets older, the risks related to alcohol use disorder could become graver, including heart attack, for example.
Also, what may be most significant to assess is the amount of time lived with an active alcohol use disorder, rather than the mere presence or absence of the disorder, per se. In other words, the sooner one gets into remission the lower the likelihood of developing these conditions during recovery.
The design of the study cannot confirm definitively that it is the person’s history of alcohol use disorder that specifically caused these conditions. Nevertheless, three points are important, to consider:
Next potential steps include longitudinal studies to understand the causal nature of these relationships. This might optimally occur when medical diagnoses’ presence can be more accurately obtained by researchers or in a health care setting where medical diagnoses can be determined clinically and/or by chart review.
In addition, it may be important to develop and validate a screening questionnaire that adequately captures past history of an alcohol use disorder. In this study, there was an extensive diagnostic questionnaire administered to determine alcohol use disorder history. It would be very helpful to known whether that kind of extensive questionnaire is necessary or whether a shorter one would be sufficient. This strategy might help address the problem while limiting the time burden for medical staff administering the questionnaire.
Udo, T., Vasquez, E., & Shaw, B. A. (2015). A lifetime history of alcohol use disorder increases risk for chronic medical conditions after stable remission. Drug Alcohol Depend, 157, 68-74. doi:10.1016/j.drugalcdep.2015.10.008
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