Alcoholism may be twice as fatal for women as for men, according to a new
study from Germany.
The women with alcohol addiction were five times more likely to die
during the 14-year period of the study than women in the general population
were. Among men with alcohol addiction, the death rate was about double that of
men in the general population. Additionally, alcoholics in the study who
underwent specialized medical treatments or detoxification programs were no
more likely to survive than those who did not seek intervention.
"The treatment system is not really suited yet to increase survival
time," said study author Ulrich John, an epidemiologist at the University
of Greifswald Medical School. Most previous studies of alcoholics' mortality
rates focused on alcoholics already in treatment, but the new study started
with a general population of 4,070 people in northern Germany. Researchers
interviewed the study participants and asked about alcohol use. Based on their
answers, and the criteria for alcoholism given in the Diagnostic and
Statistical Manual of Mental Disorders, 153 were defined as alcoholics. Fourteen
years later, the researchers followed up with 149 of the alcoholics.
Nearly a fifth of the alcoholics had died over the 14 years: seven of
the 30 women, and 21 of the 119 men. For the women, this translated to an
annual death rate of 1.67 percent; among women in the general population, the
annual death rate was 0.36 percent. For the alcoholic men, the annual death
rate was 1.26 percent, while the annual death rate for men in the general
population was 0.66 percent.
Women tend to develop more of the health risks associated with
alcoholism, but the reasons for this are not clear, John said. "Females,
in a more short time span, develop diseases such as liver cirrhosis," he
said.
Treatment & detox
Among the alcoholics, 34 had used treatments provided by the German
government aimed at helping patients remain alcohol-free over the long term,
such as addiction counseling and group therapy. Ten others had enrolled in
detoxification programs, in which people quit drinking "cold turkey"
and remained in treatment as long as their withdrawal symptoms occur.
Death rates among the alcoholics who had sought specialized treatments
were the same as those alcoholics not in treatment, the researchers found.
Those who entered detoxification programs had a higher death rate than
alcoholics who did not seek detox. Most likely to die were those with severe
alcoholism and those with alcohol-related health problems such as liver
disease, and those who rated their own health as poor.
However, the findings don't mean that treatments do not improve the
survival of alcoholics, John said. People who "suffer from lots of
diseases from their alcohol abuse — many more of them are getting into
detoxification treatments," which could explain why those in detox
programs had a higher mortality rate, he said.
Approximately 11 percent of alcoholics, typically the sickest ones, seek
help in treatment or detoxification programs, said Susan Foster, director of
policy research and analysis at the National Center on Addiction and Substance
Abuse at Columbia University. "Those with advanced disease are usually the
ones who cycle in and out of detox programs or end up in treatment programs,
many of which do not provide evidence-based care," Foster said. Further,
Foster said, addiction is disease that can include a range of substances.
"Treatment must address all manifestations of the disease — only providing
treatment for addiction involving alcohol will, by definition, limit the
efficacy of treatment results."
So what can be done?
Preventing alcoholism could lower mortality rates, said Jürgen Rehm,
director of social and epidemiological research at the Centre for Addiction and
Mental Health in Toronto. Training family doctors to test for alcoholism and
related problems might be the best solution, Rehm said. John said his future
research will focus on computer-based screening tests for alcoholism problems,
and subsequent counseling, in an effort to reach the entire population.
The study will be published in the January 2013 issue of the journal
Alcoholism: Clinical & Experimental Research.
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