Behavior
Association of Stress on Ethanol Intake and Alcohol Use Disorder and the Role of Age at First Drink in this Relationship: An Epidemiological Study Tulshi Saha* Tulshi Saha NIH/NIAAA
Purpose: The link between alcohol drinking, stress, and the development of alcohol use disorder (AUD) is a critical and fascinating area in epidemiologic research. The purpose of this study is to examine the association of different types of stress on ethanol intake and AUD and the role of age at the onset of drinking in this relationship using nationally representative data.
Data: Data were derived from the National Institute of Alcohol Abuse and Alcoholism’s (NIAAA) 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)-III (n=36,309), 2001-2002 NESARC Wave 1 (n=43,093), and 2003-2004 NESARC Wave 2 (n=34,653).
Method: Bivariate and multivariate regression analyses were used to determine whether increased ethanol consumption volume and the risk of developing AUD increased with increasing exposure to multiple stressors, while controlling for socio-demographic variables. In addition, the age of onset of drinking was investigated as a modifying factor of the relationship between stress and alcohol use behavior.
Results: We found a positive association between stress and drinking behavior. Early-onset drinking increased the positive association of past-year stress level with the increased volume of ethanol intake or the probability of having AUD. The volume of ethanol intake increased proportionately at higher rates for a job or psycho-financial-related stress than for illness or death-related stress. Even after adjusting for background characteristics, increasing stress levels were associated with a more significant increase in alcohol consumption among individuals who started drinking at ages 14 and younger than among those who began drinking at older ages.
Conclusion: The results of this study have important implications for public health. They indicate that while experiencing stress predicts an increase in ethanol intake and the likelihood of developing AUD, this relationship differs by the nature of stress as well as the first drink. This understanding can guide the development of targeted interventions to address alcohol use disorder.