Risks of abusing or becoming dependent on alcohol over a lifetime are high for men, reveals a Californian doctor in the Lancet today.
Overall in men, the lifetime risk of alcohol-use disorders is over 20%, risk of alcohol abuse 15% and for alcohol dependence, 10%.
In women, the lifetime risk is just 8-10%.
The research follows an Office for National Statistics report showing that over a third of adults in the UK exceed the daily limits for regular drinking at least once a week.
But treatments can work despite public perceptions that they do not – and even a simple intervention by a GP can kickstart the process to recovery.
Dr Marc Schuckit, a psychiatrist at the University of California in San Diego sets out the problem globally in his seminar based on research published in English from 2000-2007.
Whilst developing countries and those in northern and Eastern Europe have higher prevalence of alcohol-use disorders than elsewhere, the drug is linked to significant health care problems in most populations.
Most people indulge in their heaviest drinking from 18 to 22 years of age but alcohol abuse and dependence tends to start in the early to mid-20s when many are turning away from drinking as they concentrate more seriously on work, relationship or other commitments.
Repeated heavy drinking in alcohol-use disorders is associated with a 40% risk of short periods of depression, and as many as 80% of alcohol-dependent people are regular smokers. This could reflect either use of the second drug to deal with effects of the first or overlapping genetic predispositions, Dr Schuckit says.
But different countries have different strategies to tackle the problem. The US health system tries to get people to stop drinking completely whilst in the UK controlling drinking or reducing harm are often the goals.
About 40–60% of the risk of alcohol-use disorders is explained by genes and the rest through gene–environment associations such as availability of alcohol, attitudes towards drinking and drunkenness, peer pressures, levels of stress and related coping strategies, models of drinking, and laws and regulatory frameworks.
But his research has shown that efforts to treat people with alcohol use disorders are usually effective – with around 50–60% of men and women with alcohol dependence abstaining or showing substantial improvements in functioning the year after treatment.
"Such outcomes are excellent predictors of their status at 3–5 years," he comments.
A doctor can start the process using the principles of motivational interviewing, brief interventions and cognitive-behavioural therapies, he suggests, to help patients recognise they have a problem and start changing their behaviour.
Drugs such as naltrexone, used in America for alcohol dependence, can also play a part in recovery - diminishing cravings and relapses.