Background
Study definition of drinking above recommended limits:
| ≥5 drinks* in any single day** and/or exceeding gender-specific US recommendations for maximum average number of drinks* per week | |
Heavy episodic drinking:
| Drinking above recommended daily drinking limits (≥5 drinks in any single day, in this report; gender-specific US recommended limits below) | |
Alcohol use disorder:
| DSM-IV diagnosis of alcohol abuse or dependence | |
Unhealthy alcohol use:
| Drinking above recommended drinking limits and/or alcohol use disorder diagnosis | |
Gender-specific US recommended drinking limits:
|
Maximum number of drinks
*
in any single day
|
Maximum average number of drinks
*
per week
|
Men | 4 drinks | 14 drinks |
Women | 3 drinks | 7 drinks |
Questions used to define drinking above US recommended limits
| ||
> Weekly limits | AUDIT-C Questions #1-2 | |
Heavy episodic drinking | AUDIT-C Questions #2-3 |
Methods
Overview
Data sources and study population
US general population sample
US General Population Sample (2001–2002 NESARC Surveys)[24] | |
AUDIT-C Question #1 | During the last 12 months, about how often did you drink ANY alcoholic beverage? Never (0); 1 or 2 times in the last year (1); 3 to 6 times in the last year (1); 7 to 11 times in the last year (1); Once a month (1); 2 to 3 times a month (2); Once a week (2); 2 times a week (3); 3 to 4 times a week (3); Nearly every day (4); Every day (4) |
AUDIT-C Question #2 | Counting all types of alcohol combined, how many drinks did you USUALLY have on days when you drank during the last 12 months?* 1 or 2 (0); 3 or 4 (1); 5 or 6 (2); 7 to 9 (3); 10 or more (4) |
AUDIT-C Question #3 | During the last 12 months, about how often did you drink FIVE OR MORE drinks in a single day? Never (0); 1 or 2 times in the last year (1); 3 to 6 times in the last year (1); 7 to 11 times in the last year (1); Once a month (2); 2 to 3 times a month (2); Once a week (3); 2 times a week (3); 3 to 4 times a week (3); Nearly every day (4); Every day (4) |
VA Outpatient Sample (2004–2007 SHEP Surveys)
| |
AUDIT-C Question #1 | How often have you had a drink containing alcohol in the past 12 months ? Consider a “drink” to be a can or bottle of beer, a glass of wine, a wine cooler, or one cocktail or a shot of hard liquor (like scotch, gin, vodka). Never (0); Monthly or less (1); 2 to 4 times a month (2); 2 to 3 times a week (3); 4 to 5 times a week (4); 6 or more times a week (4) |
AUDIT-C Question #2 | How many drinks containing alcohol did you have on a typical day when you were drinking in the past 12 months ? 0 drinks (Did not drink in the past 12 months) (0 points); 1 to 2 drinks (0); 3 to 4 drinks (1); 5 to 6 drinks (2); 7 to 9 drinks (3); 10 or more drinks (4). |
AUDIT-C Question #3 | How often did you have 6 or more drinks on one occasion in the past 12 months ? Never (0 points); Less than monthly (1); Monthly (2); Weekly (3); Daily or almost daily (4). |
VA outpatient sample
Measures
The AUDIT-C
Screen results based on the total AUDIT-C score
Reported drinking above US recommended limits on the AUDIT-C questions
Other measures
Analyses
Results
US general population sample | VA outpatient sample | |||
---|---|---|---|---|
(N = 26,610) | (N = 467,416) | |||
Demographic characteristic | n | (%) | n | (%) |
Gender
| ||||
Male | 12,856 | (48.3) | 450,681 | (96.4) |
Female | 13,754 | (51.7) | 16,735 | (3.6) |
Age
| ||||
18-29 | 6,073 | (22.8) | 4,477 | (1.0) |
30-39 | 6,325 | (23.8) | 8,619 | (1.8) |
40-49 | 5,699 | (21.4) | 25,994 | (5.6) |
50-59 | 3,923 | (14.7) | 102,506 | (21.9) |
60-69 | 2,331 | (8.8) | 119,871 | (25.6) |
70-79 | 1,557 | (5.9) | 137,491 | (29.4) |
80+ | 702 | (2.6) | 68,458 | (14.6) |
Education* | ||||
High school/GED or less | 10,582 | (39.8) | 211,501 | (45.3) |
Some college/Associate’s degree | 8,619 | (32.4) | 146,837 | (31.4) |
College graduate or more | 7,409 | (27.8) | 104,703 | (22.4) |
Marital status* | ||||
Married/Living with significant other | 14,122 | (53.1) | 305,107 | (65.3) |
Widowed | 1,531 | (5.8) | 39,939 | (8.5) |
Divorced/separated | 4,375 | (16.4) | 90,794 | (19.4) |
Never married | 6,582 | (24.7) | 25,482 | (5.5) |
Race/ethnicity* | ||||
American Indian/Alaska Native | 410 | (1.5) | 9,756 | (2.1) |
Asian/Native Hawaiian/Pacific Islander | 656 | (2.5) | 3,723 | (0.8) |
Black/African American | 4,126 | (15.5) | 26,752 | (5.7) |
White | 16,542 | (62.2) | 401,149 | (85.8) |
Hispanic/Latino | 4,876 | (18.3) | 20,819 | (4.5) |
Positive AUDIT-C screens (among drinkers)
| ||||
Male (≥4 points) | 5,903 | (45.9) | 202,003 | (44.8) |
Female (≥3 points) | 4,783 | (34.8) | 6,202 | (37.1) |
US general population sample | VA outpatient sample | ||||||
---|---|---|---|---|---|---|---|
(N = 26,610) | (N = 467,416) | ||||||
Men
| |||||||
Positive screen based on AUDIT-C score
| |||||||
AUDIT-C score
|
% reporting < recommended limits
| ||||||
Total
|
Q#1
|
Q#2
|
Q#3
|
%
|
(95% CI)
|
%
|
(95% CI)
|
4
| 3 | 1 | 0 | 2.3 | (2.1–2.6) | 1.0 | (1.0-1.0) |
4
| 4 | 0 | 0 | 5.4 | (5.1–5.8) | 12.9 | (12.7–13.0) |
5
| 4 | 1 | 0 | 1.1 | (0.9–1.3) | 1.9 | (1.8–1.9) |
All inconsistent positive screens
| 8.9* | (8.4–9.4) | 15.8 | (15.6–15.8) | |||
Negative screen based on AUDIT-C score
| |||||||
AUDIT-C score
|
% reporting > recommended limits
| ||||||
Total
|
Q#1
|
Q#2
|
Q#3
|
%
|
(95% CI)
|
%
|
(95% CI)
|
2
| 1 | 0 | 1 | 1.1 | (0.9–1.2) | 2.0 | (2.0–2.0) |
3
| 1 | 1 | 1 | 2.0 | (1.7–2.2) | 0.6 | (0.6–0.6) |
3
| 1 | 0 | 2 | 0 | -- | 0.3 | (0.3–0.3) |
3
| 1 | 2 | 0 | 0 | -- | 0.1 | (0.01-0.1) |
3
| 2 | 0 | 1 | 1.9 | (1.7–2.2) | 2.3 | (2.2–2.3) |
All inconsistent negative screens
| 4.9 | (4.6–5.3) | 5.3 | (5.2–5.3) | |||
All inconsistent negative & positive screens
|
13.8
|
(13.2–14.4)
|
21.1
|
(20.9–21.1)
| |||
Women
| |||||||
Positive screen based on AUDIT-C score
| |||||||
AUDIT-C score
|
% reporting < recommended limits **
| ||||||
Total
|
Q#1
|
Q#2
|
Q#3
|
%
|
(95% CI)
|
%
|
(95% CI)
|
3
| 2 | 1 | 0 | 2.6 | (2.4–2.9) | 1.5 | (1.3–1.7) |
3
| 3 | 0 | 0 | 8.2 | (7.7–8.6) | 8.1 | (7.7–8.5) |
4
| 3 | 1 | 0 | 1.6 | (1.4–1.8) | 0.6 | (0.5–0.8) |
4
| 4 | 0 | 0 | 5.0 | (4.6–5.4) | 7.2 | (6.8–7.6) |
All inconsistent positive screens
| 17.5* | (16.8–18.1) | 17.4 | (16.9–18.0) | |||
Negative screen based on AUDIT-C score
| |||||||
AUDIT-C score
|
% reporting > recommended limits
| ||||||
Total
|
Q#1
|
Q#2
|
Q#3
|
%
|
(95% CI)
|
%
|
(95% CI)
|
2
| 1 | 0 | 1 | 0.8 | (0.7–1.0) | 3.3 | (3.0–3.6) |
All inconsistent negative screens
| 0.8 | (0.7–1.0) | 3.3 | (3.0–3.6) | |||
All inconsistent negative & positive screens
|
18.3*
|
(17.7–18.9)
|
20.7
|
(20.1–21.3)
|