What Is Alcohol Dependence? Some Forms Of Alcoholism May Be Hard To Spot In Millennials

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All those craft breweries and drunk brunches may seem harmless, but for some, the hallmarks of a millennial weekend could be part of a larger problem. A Drinking problem isn't always DUIs and waking up in Canada without your passport. Alcoholism — particularly, alcohol dependence — can be so subtle that it comes as a total surprise to friends and family. Unfortunately, according to a recently published study, alcohol misuse is a growing problem in America.

In a paper published in JAMA Psychiatry, researchers looked at data from the National Epidemiologic Survey on Alcohol and Related Conditions at two points: between 2001 and 2002, and again in 2012 to 2013. When researchers compared alcohol use over time, they came up with disturbing results. Between the first and second surveys, 12-month alcohol use increased from 65 to 72 percent, and alcohol use disorder (AUD) increased by nearly 50 percent. In 2001-'02, about eight percent of the survey's participants fit the criteria for AUD, but in 2012-'13, that number rose to 12.7 percent.

The rise in AUD, also known as alcoholism, was seen across the board, but it was particularly pronounced in certain groups: women, ethnic minorities, older adults, those with a high school education or less, those earning incomes of $20 000 or less, those living near the poverty threshold, and those residing in urban areas. It's worth noting that all of these groups are socioeconomically disadvantaged, and there's a link between stress and alcohol abuse.

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To put it simply, Americans are drinking more than they used to. What's particularly unsettling is the increase in risky alcohol consumption from 9.7 to 12.6 percent. "High-risk" drinking isn't necessarily full-blown alcoholism; basically, it's defined as surpassing the suggested limits for alcohol consumption. The problem is that the limit might be lower than you realize; the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests no more than three drinks per day for women and four drinks for men.

In the study, participants who passed this limit at least once a week over the course of a year were considered risky drinkers — and this often leads to alcoholism later on. High-risk drinkers may not fit the criteria for alcohol abuse yet, which includes symptoms like continuing to drink despite problems at work or in relationships, but they're likely to go on to develop alcoholism. Researchers saw this effect in their study:

So what does all this have to do with millennials? According to the JAMA Psychiatry study, adults under 30 years old saw a 14 percent uptick in high-risk drinking, and historically, high-risk drinking has been a public health problem among young adults. Meanwhile, the number of millennial women who drink has increased drastically compared to past generations.

Alcohol dependence, a form of alcoholism that is not as severe as alcohol abuse, may be particularly hard to spot in millennials. Whereas alcohol abuse is characterized by more apparent signs like the use of alcohol repeatedly impairing a person's ability to go to work or a person repeatedly putting themselves in hazardous situations while intoxicated, alcohol dependence is more subtle. The National Institutes of Health characterizes alcohol dependence as a growing tolerance to alcohol, a persistent need to go to lengths to obtain it, withdrawal symptoms in the absence of it, and repeated failure to cut back on alcohol consumption. As a person with alcohol dependence can easily slip under the radar as "high functioning" or exhibit fewer obvious symptoms of alcoholism, it is easy to overlook or dismiss.

But there's good news! Research on millennial drinking habits tends to be contradictory. Just last year, a study found that three out of four millennial drinkers limited how much they drink most of the time, which is a pretty effective way to avoid alcoholism. (The difference in each study's results could be due to methodology.) Studies have also suggested that light drinking has some health benefits.  

As always, the key appears to be moderation. Basically, pay attention to how much you drink, and if you find that you're spending a little too much time hungover, you may want to cut back. For those concerned about their drinking habits, the NIAAA has resources available on its website.