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Young adult drinkers experience negative effects years after remission
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Young adults who drank for 5 or more years and had three more alcohol dependence symptoms were more likely to have health problems later in life, according to study findings published in the Journal of Studies on Alcohol and Drugs.
The researchers also found these problems occurred even if a person controlled their drinking by age 30 years.
“The general assumption has been that the benefits of recovery are so great, that we simply assumed that they were great enough that we could justifiably assume that recovery would have benefits all the way in late life,” Jon Randolph Haber, PhD, Palo Alto Veterans Affairs Health Care System in Stanford, Calif., told Healio Family Medicine. “That assumption is not standing up to our examination, so we’re having to change our thinking, and think instead that there might be some permanent changes that occur when drinking is prolonged at the diagnostic level in young adulthood.”
Haber and colleagues used data from the Vietnam Era Twin (VET) Registry to evaluate whether diagnostic drinking during young adulthood had residual effects on health later in life. They classified veterans into three groups by alcohol dependence status: minimal (n = 368), chronic (n = 221) and remitted (n = 75). The minimal group had no alcohol dependence symptoms at any time, the chronic group had at least three symptoms as young adults, and the remitted group had symptoms in early adulthood, but not after age 30.
Researchers measured how the prior drinking impacted a patient’s health later in life, including diagnosis of 44 medical disorders; physical and mental health endorsements; general physical and mental health; disability, depression and resilience rates; amount of social support; and mortality risk in later years.
Haber and colleagues found significant contrasts between the chronic and minimal groups for all outcomes measured. They also found significant contrasts between the remitted and minimal groups — specifically, lower resilience in later years and higher rates of physical and mental difficulties among those in the minimal group. There were no significant contrasts found between the chronic and remitted groups.
They also found those with three more alcohol dependence symptoms as young adults in the chronic and remitted groups had lower household income and education levels, and their drinking variables were more severe than their counterparts. Those in the chronic group were also less likely to be married or working full time.
Haber envisioned physicians talking about the long-term impact of drinking with their patients.
“There seems to be less reserve, less resilience to disorder and disease in later life, so that might be an encouragement to think of the broader lifespan and desire to promote health in the patient throughout their lifespan,” Haber said. – by Janel Miller
Disclosures: Haber reports no relevant financial disclosures. Healio Family Medicine was unable to determine the other researchers’ relevant financial disclosures prior to publication.
Perspective
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Michael Munger
Diagnostic drinking at any age can have multiple, negative effects — physical, long-term, psychological, social, family interaction effects — and so that’s definitely something we recognize across the age spectrum. One of the things that family physicians do, and should do, is screen for any sort of alcohol use or misuse, and then for those who are determined to be at risk, provide intervention. The current AAFP recommendation is to screen all adults aged 18 years and older for alcohol use and misuse on an ongoing and continuous basis, and that if we identify anyone, we should give behavioral counseling interventions to help reduce the alcohol misuse.
We understand that in the adolescent age group that avoidance of alcohol is certainly desirable, and when there is any sort of evidence of that we continue to give advice and get that adolescent linked to the appropriate resources to address the issue.
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