Alcohol dependence: A public health perspective

Aims: To review epidemiological research on alcohol dependence and to propose a public health approach to address this problem. Design and setting: The research under review is basically constituted by general population surveys. Participants: Individuals in the community 18 years of age and older. Measurement: Twelve-month rates of alcohol dependence are estimated using DSM criteria. Findings: The prevalence of alcohol dependence has been stable in the United States, at around 6% for men and 2% for women. The risk of alcohol dependence begins at low levels of drinking and increases linearly with alcohol consumption. Mean group level of consumption shows some relationship to prevalence of dependence. Alcohol-dependent individuals are responsible for about 50% of the social, legal and interpersonal alcohol-related problems in society. Conclusion: Alcohol dependence is present at relatively high levels in the community. Alcohol-dependent individuals are responsible for a fair proportion of alcohol-related problems in society. A public health approach to this problem, emphasizing prevention and group level interventions to lower prevalence levels, is warranted.