Alcohol Use Disorders: More Deadly Than Previously Thought

Alcohol use disorders (AUDs)—comprising alcohol dependence and abuse—affect up to 12% of men and 5% of women in the United States. A seminal review of AUD and all-cause mortality from 1998 indicated a standardized mortality ratio of 1.8 for men and 3.8 for women, but many studies have appeared since then. This meta-analysis of studies up to August, 2012 seeks to update those findings.

• Eighty-one studies included 221,683 observed deaths among 853,722 people with AUDs.
• The overall relative risk of death was 2.98 for men and 4.64 for women.
• Among treatment samples with diagnosed AUD, relative risk of death was 3.38 for men and 4.57 for women.
• Among people aged 40 or younger, the relative risk of death increased 9-fold for men and 13-fold for women.

Comments:

All-cause mortality from alcohol use disorders is higher than previously estimated. The higher risk among treatment samples is probably the result of higher severity of AUDs and more comorbidity, whereas the higher risk among young people is likely the result of lower mortality among the age-specific general population. It remains uncertain whether earlier identification and intervention could reduce these fatalities.

Peter D. Friedmann, MD, MPH

Reference:

Roerecke M, Rehm J. Alcohol use disorders and mortality: a systematic review and meta-analysis. Addiction. April 30, 2013 [Epub ahead of print]. doi: 10.1111/add.12231.