The risk relationships between alcohol consumption, alcohol use disorder and alcohol use disorder mortality: A systematic review and meta‐analysis

Author:

Carr Tessa1ORCID,Kilian Carolin1ORCID,Llamosas‐Falcón Laura1,Zhu Yachen2ORCID,Lasserre Aurélie M.3,Puka Klajdi14,Probst Charlotte1567ORCID

Affiliation:

1. Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Ontario Canada

2. Alcohol Research Group Public Health Institute Emeryville California USA

3. Addiction Medicine, Department of Psychiatry Lausanne University Hospital Lausanne Switzerland

4. Department of Epidemiology and Biostatistics Western University London Ontario Canada

5. Centre for Addiction and Mental Health Campbell Family Mental Health Research Institute Toronto Ontario Canada

6. Department of Psychiatry University of Toronto Toronto Ontario Canada

7. Heidelberg Institute of Global Health, Medical Faculty and University Hospital Heidelberg University Heidelberg Germany

Abstract

AbstractBackground and aimsIncreasing levels of alcohol use are associated with a risk of developing an alcohol use disorder (AUD), which, in turn, is associated with considerable burden. Our aim was to estimate the risk relationships between alcohol consumption and AUD incidence and mortality.MethodA systematic literature search was conducted, using Medline, Embase, PsycINFO and Web of Science for case–control or cohort studies published between 1 January 2000 and 8 July 2022. These were required to report alcohol consumption, AUD incidence and/or AUD mortality (including 100% alcohol‐attributable deaths). The protocol was registered with PROSPERO (CRD42022343201). Dose–response and random‐effects meta‐analyses were used to determine the risk relationships between alcohol consumption and AUD incidence and mortality and mortality rates in AUD patients, respectively.ResultsOf the 5904 reports identified, seven and three studies from high‐income countries and Brazil met the inclusion criteria for quantitative and qualitative syntheses, respectively. In addition, two primary US data sources were analyzed. Higher levels of alcohol consumption increased the risk of developing or dying from an AUD exponentially. At an average consumption of four standard drinks (assuming 10 g of pure alcohol/standard drink) per day, the risk of developing an AUD was increased sevenfold [relative risk (RR) = 7.14, 95% confidence interval (CI) = 5.13–9.93] and the risk of dying fourfold (RR = 3.94, 95% CI = 3.53–4.40) compared with current non‐drinkers. The mortality rate in AUD patients was 3.13 (95% CI = 1.07–9.13) per 1000 person‐years.ConclusionsThere are exponential positive risk relationships between alcohol use and both alcohol use disorder incidence and mortality. Even at an average consumption of 20 g/day (about one large beer), the risk of developing an alcohol use disorder (AUD) is nearly threefold that of current non‐drinkers and the risk of dying from an AUD is approximately double that of current non‐drinkers.

Funder

National Institute on Alcohol Abuse and Alcoholism

Publisher

Wiley

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