Long-Term Mortality in People Treated for Alcoholism

Few studies have assessed the long-term mortality of a group of people with alcoholism who received treatment at the same program. Researchers in this study tracked, for over 33 years, state and national death records of 500 people with alcoholism who had been admitted to a comprehensive, community-based alcohol treatment program in San Antonio. Most subjects were white, male, unemployed, and unmarried; they had a mean age of 47 years at enrollment and 61 years at death.

• During follow-up, 449 subjects died. The overall case-fatality rate was 0.057 deaths per person-year.
• Cancer and lung-related death rates were lower than expected in the early years of follow-up and higher than expected in the later years.
• Conversely, death rates of liver disease and “lifestyle-related” causes (accidents, car crashes, homicide, suicide, overdose, and AIDS) were higher than expected in the early years of follow-up and lower than expected in the later years.
• Ethnic and racial differences in mortality included (1) longer survival among whites than blacks and Hispanics, and (2) greater than expected frequency of deaths from liver disease and lifestyle causes in Hispanics than in blacks and whites.

Comments:

This long-term follow-up of people with alcoholism admitted to the same treatment program indicates a relatively high mortality rate, early occurrence of liver disease and lifestyle-related deaths, and some differences among ethnic/racial groups. The author acknowledges that findings from this group of urban poor will likely differ from findings in other populations with alcoholism. However, the study illustrates that treatment providers should understand the mortality risks for their patients and incorporate appropriate linkages to medical care and other services.

Kevin L. Kraemer, MD, MSc

Reference:

Costello, RM. Long-term mortality from alcoholism: a descriptive analysis. J Stud Alcohol. 2006;67(5):694–699.