Social Problems From Alcohol Abuse, Not Physical Injury, Biggest Threat to Long Life

A new study—following over 40,000 participants for 18 years—has found that the social and psychological issues stemming from drinking are more predictive of mortality rates than physically hazardous behaviors like drunk driving. The results are quite surprising—for instance, suggesting that experiencing things like withdrawal jitters is less of a concern than something like losing a job in terms of the risk of dying—and underline the importance of taking the psychological and social aspects of alcoholism into account when considering the risks. The results also show that even light drinkers experience issues related to their drinking, suggesting that cutting down might not be enough to avoid problems related to alcohol.

Drinking-Related Problems and the Risk of Death

The researchers compiled a list of 41 alcohol-related problems and used data from the 1988 National Health Interview Survey along with death records for the participants over the following 18 years, looking for links between specific drinking-related problems and mortality. The list included things like having friends or family suggest that you cut down on your drinking, getting physically ill or experiencing shakes during withdrawal, drinking more than intended, trying to cut down but being unable to, and losing your job. The researchers controlled statistically for other potentially relevant factors like demographic characteristics and how much each individual drank.

Important Warning Signs

Of all the problems considered, the biggest association observed was for those who’ve had a friend, family member or physician intervene to encourage them to reduce their drinking or stop altogether. Those people were 67 percent more likely to die over the course of the 18 years of follow-up. Those who stopped attending social or sporting activities as a result of drinking were 46 percent more likely to die over the study period. Another significant association was observed among those who’d lost a job because of drinking.

The research also revealed that those who’d been on a drinking “bender” within the year prior to the survey had a 54 percent higher death rate over the follow-up period, and anybody who’d blacked out during the study period had a 22 percent higher death rate. The current drinkers (at the time of the original survey) who found it difficult to stop drinking once they’d started (for example, not being able to open a bottle without finishing it) had 15 percent greater odds of dying. Additionally, the researchers were surprised to find that among the light drinkers, 48 percent reported some type of alcohol-related problem over the past year.

Some of the physical consequences of drinking also had significant associations with mortality over the study period. For example, experiencing withdrawal symptoms like the shakes or feeling sick increased the odds of death over the 18 years by 23 percent. However, there were some behaviors where you’d expect an association but one wasn’t observed, such as drinking and driving. While this means that people who have driven drunk aren’t statistically significantly more likely to die over an extended period of time than people who haven’t, it has no effect on the dangerous nature of drunk driving.

Overall, the psychological and social problems listed were equally or more predictive of mortality than the physically dangerous behaviors linked to drinking. This is the key surprise of the study: while we may more readily envision an increased risk of dying when we hear about somebody taking physical risks, the psychological and social issues are a bigger indicator of who will suffer physical consequences related to their drinking. This might seem counterintuitive, but addiction is a psychological issue, so signs of genuine psychological issues are really bound to be more important than occasionally doing something physically dangerous.

Is AA Attendance Associated With Death?

There was also a fairly weighty association observed with attendance of AA, with anybody who’d attended in the year prior to the survey having 45 percent greater odds of dying over the study period. This doesn’t detract from the fact that AA helps people; it’s a case of self-selection: people attend AA because they are having serious problems relating to alcohol, so it would be expected that they’d die more often than people who don’t need to attend AA to control their drinking.

Lead study author professor Richard Rogers described the AA findings: “AA is undoubtedly helping some people. I think this part of the study is capturing participants who also may have had alcohol-related work problems, substance abuse problems or were mandated to go to AA because of legal issues.”

Psychological and Social Issues

For those struggling with addiction or with a friend or family member experiencing problems, the lesson from this study is an important one: physically risky behavior might seem more worrying, but it really isn’t as big of a warning sign for premature death as something like losing a job or having a doctor concerned about your drinking. Remember that alcoholism is fundamentally a psychological issue, not a physical one, so you shouldn’t overlook something just because it doesn’t seem physically dangerous. Finally, the presence of drinking problems in light drinkers shows that the only way to completely free yourself from the burdens of drinking is to become abstinent.

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