MU researchers: The way to determine alcohol use disorders must change

Most daily binge drinkers are being missed with the current diagnosis criteria

December 4th, 2018

COLUMBIA, Mo. – By even the broadest of definitions, psychology researchers at the University of Missouri say the current methods for diagnosing an alcohol use disorder will, surprisingly, leave many daily binge drinkers undiagnosed.

“The published scientific literature on daily drinking consequences are often not based upon the actual number of drinks on a given drinking day,” said Kenneth J. Sher, MU Curators Distinguished Professor of Psychological Sciences in the MU College of Arts and Science. “Researchers often determine the total number of drinks per week and divide by seven. Therefore, much of the limited data that are published is not identifying real daily drinking patterns.”

For this study, a data sample from the National Epidemiologic Survey on Alcohol and Related Conditions was examined. Persons who reported drinking every day during a 12-month period were classified as daily drinkers and put into three categories, according to established drinking guidelines, based on their level of drinking: light, heavy and binge. Those levels are:

• Women: light (1 drink), heavy (2-3 drinks), and binge (4 or more drinks)
• Men: light (1-2 drinks), heavy (3-4 drinks), and binge (5 or more drinks)

MU researchers discovered that of the 399 persons identified in the data sample as daily binge drinkers, 174 of them, or 44 percent, were diagnosed with alcohol dependence.

Researchers noted current diagnostic methods do not consider how many drinks a person consumes in a specified timeframe. The team suggests it may be useful to add a measure of daily drinking to current diagnostic standards, so that persons who might have alcohol damaging their health, but who are not showing any visible side effects of drinking, could be diagnosed with an alcohol use disorder.

“The usual concern people have with the current diagnostic classification is with over diagnosis,” said Alvaro Vergés, who was a doctoral student at MU during the study. “But we are showing the opposite part of this problem, the idea that we might not only have false positives, but also false negatives as well. People are probably experiencing consequences of drinking that we are not getting to by the current diagnostic classification.”

The study, “Intensity of Daily Drinking and Its Relation to Alcohol Use Disorders,” was published in Alcoholism: Clinical and Experimental Research. Funding was provided by National Institutes of Health grants (AA024133, AA016392, AA017242 and AA013526). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

The publication was co-written by Jarrod M. Ellingson, Stephanie A. Schroder and Wendy S. Slutske with the Department of Psychological Sciences at MU. Vergés is currently an assistant professor at Pontificia Universidad Católica de Chile.

Editor’s Note: For more on the story, please see: Searching for the gold standard