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BACKGROUND: Excessive alcohol consumption contributes to 88,000 deaths annually and cost the United States $223.5 billion in 2006. It is often assumed that most excessive drinkers are alcohol dependent. However, few studies have examined the prevalence of alcohol dependence among excessive drinkers.
METHODS: Data were analyzed from the 138,100 adults who responded to the National Survey on Drug Use and Health in 2009, 2010, or 2011. Drinking patterns (i.e., past-year drinking, excessive drinking, and binge drinking) were assessed by sociodemographic characteristics and alcohol dependence (assessed through self-reported survey responses and defined as meeting ≥3 of 7 criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).
RESULTS: Excessive drinking, binge drinking, and alcohol dependence were most common among men and those aged 18-24. Binge drinking was most common among those with annual family incomes of ≥$75,000, whereas alcohol dependence was most common among those with annual family incomes of <$25,000. The prevalence of alcohol dependence was 10.2% among excessive drinkers, 10.5% among binge drinkers, and 1.3% among non–binge drinkers. A positive relationship was found between alcohol dependence and binge drinking frequency.
CONCLUSIONS: Most excessive drinkers (90%) did not meet criteria for alcohol dependence. A comprehensive approach to reducing excessive drinking that emphasizes evidence-based policy strategies and clinical preventive services could have an impact on reducing excessive drinking in addition to focusing on the implementation of addiction treatment services.