Some researchers have cast serious doubts on the data used in a study after its findings were published in JAMA Psychiatry on August 9, 2017. They contend that the federal survey on which the data was based underwent substantial methodological changes between 2001-02 and 2012-13. The findings suggested that America was in the midst of a “public health crisis”, with alcohol use disorders (AUDs) among adults increasing sharply by 49.4 percent between the two periods. The results also showed that overall alcohol use increased from 65.4 percent to 72.7 percent and high-risk drinking increased by 29.9 percent during the same time.
The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) was based on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The findings were significantly different from those of the National Survey on Drug Use and Health (NSDUH), which showed that 7.7 percent Americans (aged 12 and older) suffered from AUD in 2002, which declined to 6.6 percent in 2013.
A key variation between the two data sets is that the NESARC considers individuals 18 years and older whereas the NSDUH evaluates individuals 12 years and older. Even if the NSDUH data is adjusted for this difference, it would still show that the rate of AUDs declined or remained nearly the same, contradicting the significant increase shown by the NESARC data.
Researchers put “more weight” on NSDUH data due to its consistency
“The NSDUH methods are much more consistent from year-to-year, and it is administered annually. So I tend to put more weight on NSDUH data,” said Richard Grucza, associate professor in the department of psychiatry at Washington University School of Medicine, in an interview. He has previously found discrepancies in the survey methodologies of NESARC and NSDUH. He also highlighted some of the following variations in the NESARC data between the 2001-02 and 2012-13 waves:
- Questions were changed between waves, which could result in participants responding differently.
- NESARC respondents were given monetary rewards in 2012-13, which was not the case in 2001-02. This could have motivated more people to respond in the second wave.
- Although no biological samples were collected in 2001-02, saliva samples were collected in 2012-13. Since respondents were informed about this before conducting the survey, it could have changed their responses given that they knew about being tested for alcohol use.
Even one of these factors can meaningfully impact survey results. The NSDUH also does not include certain demographic data which can be quite meaningful. It cannot justify the significant differences between the two surveys.
The JAMA Psychiatry study has also been disputed by the Distilled Spirits Council (DSC). Samir “Sam” Zakhari, senior vice president and former division director of the NIAAA, commented that “while any amount of alcohol abuse is too much”, the JAMA Psychiatry findings “do not comport with findings” of the NSDUH. He added that the NSDUH data showed a decline in AUDs among all age groups.
High alcohol use remains a concern
Despite claims that the study’s findings are flawed, high alcohol consumption is a grave concern. According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use resulted in nearly 88,000 American deaths each year between 2006 and 2010. In 2015, 15.7 million Americans aged 12 or older reported an AUD in the past year, and nearly 1 in 2 current users reported binge-drinking in the past month. The health effects of alcohol consumption are enormous and it is important to arrest the growing rates of this addiction.
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