Flexibly modeling alcohol use disorder risk: How many drinks should we count?

Area of Science:

• Addiction research
• Public health
• Epidemiology

Background:

• The 4+/5+ drinks definition for heavy episodic drinking (HED) is widely used but may not capture the full spectrum of alcohol-related risks.
• Significant heterogeneity exists among individuals who engage in heavy drinking, challenging the validity of current thresholds.

Purpose of the Study:

• To investigate the relationship between the number of drinks consumed and the prevalence of past-year alcohol use disorder (AUD) among young adults.
• To identify sex-specific drinking thresholds beyond which the risk for AUD no longer significantly increases.

Main Methods:

• Spline regression analysis was applied to data from the National Epidemiologic Survey on Alcohol and Related Conditions-III.
• The study analyzed a sample of 6,422 young adult past-year drinkers, examining typical and heaviest drinking occasions.

Main Results:

• For typical drinking occasions, AUD risk plateaued at approximately 10 drinks for women and 11 drinks for men.
• On heaviest drinking occasions, AUD risk increased for men and tapered around 14 drinks for women.
• Significant incremental risk for AUD was observed at drinking levels well above the traditional 4+/5+ HED thresholds.

Conclusions:

• The traditional 4+/5+ HED definition may obscure the substantial risks associated with higher levels of alcohol consumption in young adults.
• More nuanced thresholds are needed to accurately assess and understand the harms of heavy drinking and predict alcohol use disorder.