Recent research indicates that women and young people may experience an elevated risk of death as a result of alcohol use disorders.
A study published online by the journal Alcoholism: Clinical and Experimental Research (Volume 39, Issue 7, looked at the extent to which AUDs increased the risk of death by “external causes” among 18-64 year olds treated at public outpatient treatment centers in Spain. The authors observed that though the overall death rate among patients with AUD is higher among adult men, there have been studies suggesting that young people and women may have a higher risk of premature death compared to their peers. However, relatively few AUD studies have analyzed differences in mortality and the causes of AUD-related deaths according to gender and age, and this group of investigators hoped to fill this gap. The research was longitudinal in nature and the study was large. Investigators examined the records of 7, 012 patients who began treatment for AUD’s between 1997 and 2007. These patients were followed until the end of 2008 and death due to “external cause” was defined as death that occurred on account of intentional or unintentional injuries. The study also gauged how much time, on average, elapsed from the initiation of treatment to death of a patient due to his or her AUD.
Investigators recorded 114 deaths due to external causes. Unintentional injury was the most common cause of death (n= 65), and acute poisoning (n = 25; 38.5%) and traffic accidents (n = 15; 23.1%) accounted for most of these. Suicide accounted for most of the deaths that resulted from intentional injuries. “The excess of mortality between the AUD group and the general population was 9.5 higher than in the general population.”
The results of this study indicated that “there are important gender differences in premature mortality due to external causes among patients with AUD, with more than 20 times excess mortality among women than in the general population versus to 6 times excess mortality among men.” Moreover, the investigators found that, “Among women under 35 years with AUD, excess mortality was 31 times higher than among their peers.” They noted that “excess mortality due to suicide was remarkably high in both sexes and age groups”. AUD patients seem particularly vulnerable in the early years of treatment, especially with respect to suicide.
The results of this study are in line with what is known about women’s heightened vulnerability to the toxic and intoxicating effects of alcohol as compared to men, as well as the greater susceptibility of the developing brain to the impact of alcohol and other drugs. The authors of this study advocate for increased attention to screening and treatment of women and young people and note that, “it is essential to explore all opportunities offered by social and health services to detect, assess, and refer or treat individuals with AUD, either through emergency departments, or primary or specialized care…(and) a systematic assessment is recommended for all the patients who initiate treatment for AUD to check for the presence of concomitant mental disorders such as depression or suicidal behaviors and to provide the required treatment”. They also recommend “drink-driving counter measures, and large-scale preventive actions through taxation, advertising regulation, and reducing availability”, since these policies have proved effective in reducing the mortality associated with alcohol consumption. Psychoeducation is, in my opinion, also very important–not just for the affected populations, but for mental health and medical providers who serve these groups. I have found that many trainees and senior clinicians for example, are unaware of the special risks that women face with respect to alcohol consumption.