ICD-10 harmful use of alcohol and the alcohol dependence syndrome: prevalence and implications

Data from a 1988 survey on United States drinking practices and related problems was used to derive the prevalence and population estimates of harmful use of alcohol and the alcohol dependence syndrome as defined in the ICD-10 Clinical Descriptions and Diagnostic Guidelines Version (ICD-10-CDDG). Corresponding estimates were also presented for ICD-10-CDDG diagnoses that incorporated the duration criterion of the ICD-10-Diagnostic Criteria for Research Version (ICD-10-DCR). The prevalence of ICD-10 harmful use and dependence combined, with and without the duration criterion, were 5.2% and 7.1%, respectively. Corresponding harmful use rates were negligible (0.27%). Implications of the extremely low prevalence of harmful use in the US population and the impact of the duration criterion on the rates are discussed in terms of the fundamental nature of alcohol use disorders as syndromes and the viability of the harmful use of alcohol category as originally conceptualized.