The number of persons with alcohol problems in the Danish population

Abstract

Aims: A) To qualify the existing estimates of the prevalence of heavy drinking, harmful alcohol use and alcohol dependency by applying adjustment for non-participation. B) To describe socio-demographic correlates of heavy drinkers. Methods: Data came from the Danish Health Interview Survey 2005, which included a personal interview of 14,566 individuals (response rate 66.7 %), and of 5,552 individuals who completed a self-administered questionnaire containing the Alcohol Use Disorder Test (AUDIT) (response rate 50.9%). Heavy drinkers were defined as consuming >14/21 drinks/week (women/men). Identification of harmful alcohol users and dependent drinkers was based on the score of specific AUDIT questions (harmful alcohol use a score of ≥4 in questions 7—10, dependent drinkers ≥4 in questions 4—6). Adjustment for non-participation was performed using data from the Danish National Patient Registry. Results: In the Danish population, 20% were heavy drinkers (862,876 persons 95% confidence interval (95% CI): 672,002—1,195,069), 14% had harmful alcohol use (620,301 persons 95% CI: 439,221—944,992), 3% were dependent drinkers (147,528 persons 95% CI: 118,196—188,384). Being male was associated with heavy drinking (odds ratio (OR): 1.70; 95% CI: 1.53—1.89), as was being a single male (OR: 1.27; 95% CI: 1.01—1.61) and being a smoker (men: OR: 1.96; 95% CI: 1.67—2.30 / women: OR: 2.08; 95% CI: 1.72—2.52). Conclusions: The number of heavy drinkers in the Danish population and the number of people with harmful alcohol use is considerably higher than earlier prevalence estimates. The number of dependent drinkers is similar to earlier estimates.

Keywords

Adjusting for non-participation alcohol alcohol dependency AUDIT Denmark epidemiology harmful alcohol use heavy drinking non-participation analysis

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References

Rehm J. , Room R. , Graham K. , Monteiro M. , Gmel G. , Sempos CT The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview. Addiction 2003;98:1209-28.

Juel K. , Sørensen J. , Brønnum-Hansen H. Risk factors and public health in Denmark -summary report. National Institute of Public Health, University of Southern Denmark; 2007. pp. 1-66.

Rehm J. , Taylor B. , Patra J. Volume of alcohol consumption, patterns of drinking and burden of disease in the European region 2002. Addiction 2006 ;101:1086-95.

Ekholm O. , Kjøller M. , Davidsen M. , Hesse U. , Eriksen L. , Christensen AI , et al. The Danish health interview survey 2005 and trends since 1987 [in Danish]. Copenhagen: National Institute of Public Health ; 2006.

Thygesen LC , Johansen C. , Keiding N. , Giovannucci E. , Gronbaek M. Effects of sample attrition in a longitudinal study of the association between alcohol intake and all-cause mortality. Addiction 2008;103:1149-59.

Gundgaard J. , Ekholm O. , Hansen EH , Rasmussen NK The effect of non-response on estimates of health care utilisation: linking health surveys and registers. Eur J Public Health 2008;18:189-94.

Tolonen H. , Laatikainen T. , Helakorpi S. , Talala K. , Martelin T. , Prattala R. Marital status, educational level and household income explain part of the excess mortality of survey non-respondents. Eur J Epidemiol 2010;25:69-76.

Grant BF , Dawson DA , Stinson FS , Chou SP , Dufour MC , Pickering RP The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug Alcohol Depend 2004;74:223-34.

Pedersen MU , Vind L. , Milter M. , Grønbæk M. Alcohol treatment in Denmark compared to Sweden [in Danish]. Copenhagen: Centre for Alcohol and Drug Research and National Institute of Public Health, Center For Alcohol Research; 2004.

10.

Ekholm O. , Hesse U. , Davidsen M. , Kjoller M. The study design and characteristics of the Danish national health interview surveys. Scand J Public Health 2009;37:758-65.

11.

Gronbaek MN , Iversen L. , Olsen J. , Becker PU , Hardt F. , Sorensen TI [Sensible drinking limits]. Ugeskr Laeger. 1997;159:5939-45.

12.

Babor T. , Higgins-Biddle JC , Saunders J. , Monteiro M. AUDIT - The Alcohol Use Disorders Identification Test: guidelines for use in primary care, 2nd edn. Geneva : World Health Organization; 2001 .

13.

Andersen TF , Madsen M. , Jorgensen J. , Mellemkjoer L. , Olsen JH The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 1999;46:263-8.

14.

Hasin D. , Hatzenbuehler ML , Keyes K. , Ogburn E. Substance use disorders: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10). Addiction 2006;101(Suppl 1):59-75.

15.

Wilsnack RW , Vogeltanz ND , Wilsnack SC , Harris TR , Ahlstrom S. , Bondy S. , et al. Gender differences in alcohol consumption and adverse drinking consequences: cross-cultural patterns. Addiction 2000;95:251-65.

16.

Casswell S. , Pledger M. , Hooper R. Socioeconomic status and drinking patterns in young adults. Addiction 2003;98:601-10.

17.

Bloomfield K. , Grittner U. , Kramer S. , Gmel G. Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action ‘‘Gender, Culture and Alcohol Problems: a Multi-national Study’’ . Alcohol Alcohol Suppl . 2006;41:i26-i36.

18.

Ronzani TM , Higgins-Biddle J. , Furtado EF Stigmatization of alcohol and other drug users by primary care providers in Southeast Brazil . Soc Sci Med 2009;69:1080-4.

19.

Fortney J. , Mukherjee S. , Curran G. , Fortney S. , Han X. , Booth BM Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers . J Behav Health Serv Res 2004;31:418-29.

20.

Smothers BA , Yahr HT , Ruhl CE Detection of alcohol use disorders in general hospital admissions in the United States. Arch Intern Med 2004;164:749-56.

21.

Moore RD , Bone LR , Geller G. , Mamon JA , Stokes EJ , Levine DM Prevalence, detection, and treatment of alcoholism in hospitalized patients . JAMA 1989;261:403-7.

22.

Fleming J. The epidemiology of alcohol use in Australian women: findings from a national survey of women’s drinking. Addiction 1996;91:1325-34.

23.

Knibbe RA , Derickx M. , Kuntsche S. , Grittner U. , Bloomfield K.

A comparison of the Alcohol Use Disorder Identification Test (AUDIT) in general population surveys in nine

European countries. Alcohol Alcohol Suppl 2006;41:i19-i25.

24.

Nilssen O. , Averina M. , Brenn T. , Brox J. , Kalinin A. , Archipovski V. Alcohol consumption and its relation to risk factors for cardiovascular disease in the north-west of Russia: the Arkhangelsk study. Int J Epidemiol 2005;34:781-8.

25.

Shevlin M. , Smith GW The factor structure and concurrent validity of the alcohol use disorder identification test based on a nationally representative UK sample. Alcohol Alcohol 2007;42:582-7.

26.

Rist F. , Glockner-Rist A. , Demmel R. The Alcohol Use Disorders Identification Test revisited: establishing its structure using nonlinear factor analysis and identifying subgroups of respondents using latent class factor analysis. Drug Alcohol Depend 2009;100:71-82.

27.

Reinert DF , Allen JP The Alcohol Use Disorders Identification Test: an update of research findings. Alcohol Clin Exp Res 2007;31:185-99.

28.

Gmel G. , Heeb JL , Rehm J. Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland. Drug Alcohol Depend 2001 ;64:151-63.

29.

Rumpf HJ , Hapke U. , Meyer C. , John U. Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires. Alcohol Alcohol 2002;37:261-8.