Study Shows Association between Alcohol Screening Scores and Alcohol-Related Risks among Women Veterans
BACKGROUND:
Alcohol screening and brief intervention in primary care settings have been shown to increase identification of patients with alcohol misuse and to reduce alcohol consumption. Among male Veterans, extensive research has shown that adverse health outcomes increase as alcohol screening scores increase. However, little is known about the prevalence of adverse outcomes as alcohol screening scores increase among women, which becomes increasingly important as the numbers of women in the military rise. This study evaluated associations between scores on the 3-item Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire and self-reported alcohol-related risks and consequences among 2,670 women Veterans. Female Veterans receiving outpatient care from one urban VAMC between 10/96 and 1/98 were mailed an annual Women's Health Survey, which included a gender-specific AUDIT-C (increasing scores indicate increasing severity of alcohol misuse). The Survey also included questions on demographics, medical history, alcohol-related consequences, problem drinking or drug use, and health risks.
FINDINGS:
- Among the women Veterans in this study, 24% screened positive for alcohol misuse. Many of these women reported symptoms of alcohol misuse that would not be identified by VA's current required alcohol screening program because of their lower AUDIT-C scores.
- Increasing scores on the AUDIT-C reflected increasing prevalence of self-reported alcohol-related risks and consequences. For three out of the five alcohol-related consequences (i.e., tolerance of alcohol, blackouts, feeling the need to cut down on drinking), adjusted prevalence increased at AUDIT-C scores >3. The remaining alcohol-related consequences (i.e., morning drinking, family/friends worried) increased at scores >4, as did self-reported problem drinking and drug use.
- Associations between health risks (i.e., >2 sexual partners, sexually transmitted diseases, injuries, domestic violence, hepatitis/cirrhosis) and AUDIT-C scores were less consistent, but prevalence generally increased at scores >5.
LIMITATIONS:
- The AUDIT-C screening questionnaires were self-administered and not shared with providers; therefore, the prevalence of positive screens may be higher than what is observed clinically.
- Study respondents reported the lifetime prevalence of alcohol problems, while the AUDIT-C measures past-year consumption. This difference in data timeframes likely explains the higher prevalence of alcohol complications and treatment among women who reported no alcohol use (AUDIT-C = 0).
- This study sample included women Veterans from one VAMC, and data are 10 years old.
AUTHOR/FUNDING INFORMATION:
This study was funded through VA/HSR&D's Substance Use Disorders Quality Enhancement Research Initiative (SUD-QUERI) and HSR&D (GEN 97-022). Dr. Bradley is on the Executive Committee of SUD-QUERI.
Chavez L, Williams E, Lapham G, and Bradley K. The Association between Alcohol Screening Scores and Alcohol-Related Risks among Female Veterans Affairs Patients. Journal of Studies on Alcohol and Drugs May 2012;73(3):391-400.
