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Divorce increases risk for alcohol use disorder
Spousal loss through divorce or death was associated with an increased risk for alcohol use disorder, particularly among those with a family history of addiction or prior externalizing behaviors.
“In epidemiological samples, divorce is consistently associated with levels of alcohol consumption and risk for alcohol use disorder,” Kenneth S. Kendler, MD, of Virginia Commonwealth University, Richmond, and colleagues wrote. “However, the causes of the divorce-[alcohol use disorder] association are likely complex and remain poorly understood. The association could result from confounding factors, including social class, genetic liability, and personality traits that predispose to both [alcohol use disorder] and divorce. This association could also arise from a causal pathway from [alcohol use disorder] divorce as suggested by longitudinal studies showing that heavy-drinking individuals have an increased risk for divorce.”
To clarify the relationship between divorce and risk for alcohol use disorder, researchers assessed medical, criminal and pharmacy registries for a population-based Swedish sample of 942,366 married individuals.
Divorce was strongly associated with risk for first alcohol use disorder onset in men (HR = 5.98; 95% CI, 5.65-6.33) and women (HR = 7.29; 95% CI, 6.72-7.91).
Among discordant monozygotic twins, divorce was associated with a hazard ratio of 3.45 among men and 3.62 among women for alcohol use disorder.
Widowhood increased risk for alcohol use disorder in men (HR = 3.85; 95% CI, 2.81-5.28) and women (HR = 4.1; 95% CI, 2.98-5.64).
Among divorced individuals, remarriage was associated with a decrease in alcohol use disorder in men (HR = 0.56; 95% CI, 0.52-0.64) and women (HR = 0.61; 95% CI, 0.55-0.69).
Individuals with a family history of alcohol use disorder or prior externalizing behaviors had a greater risk following divorce, compared with those with no such history.
“The pronounced elevation in [alcohol use disorder] risk following divorce or widowhood, and the protective effect of both first marriage and remarriage against subsequent [alcohol use disorder], speaks to the profound impact of marriage on problematic alcohol use and the importance of clinical surveillance for [alcohol use disorder] among divorced or widowed individuals,” the researchers wrote. – by Amanda Oldt
Disclosure: The researchers report no relevant financial disclosures.