Divorce: Grounds for Substance Use Screening

Half of first marriages in the U.S. end in divorce. To estimate the extent to which substance use during marriage contributes to divorce rates among young adults, researchers studied 454 individuals in California and Oregon who had married by age 23 and completed periodic surveys as part of a longitudinal study.

• Twenty-two percent had divorced by age 29.
• In unadjusted analyses, greater frequencies of past-year alcohol intoxication (odds ratio, [OR], 1.3) and marijuana use (OR, 1.2), as well as any past-year hard drug use (OR, 1.8; borderline significance), predicted divorce by age 29.
• In analyses adjusted for potential confounders, however, only frequency of alcohol intoxication was significantly associated with divorce (OR, 1.2).

Comments:

Greater frequency of alcohol intoxication at age 23 predicted marital dissolution by age 29.  Frequent substance use has many adverse effects on marital relationships, including partner violence, legal problems, job loss, and sexual dysfunction. A social or family history of divorce or marital problems should cue all clinicians to ask carefully about substance use disorders (although universal screening is preferable). Also, clinicians should consider discussing the risk of marital discord and divorce when talking about heavy drinking with young married people.

Peter D. Friedmann, MD, MPH

Reference:

Collins RL, Ellickson PL, Klein DJ. The role of substance use in young adult divorce. Addiction. 2007;102(5):786–794.