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BACKGROUND: A World Trade Center Health Registry (Registry) study found frequent binge drinking (5+ episodes in the last 30 days) six-to-seven years after 9/11 was associated with 9/11-related posttraumatic stress disorder (PTSD) and a greater number of 9/11 exposures. We examined prevalence, frequency and intensity of binge drinking among Registry enrollees ten-to-eleven years post-9/11.
METHODS: Participants included 35,341 enrollees aged ≥18 who completed Wave 1 (2003-04), Wave 2 (2006-07) and Wave 3 (2011-12) surveys. We examined drinking, PTSD, and depression measured at Wave 3. Binge drinking was defined as consuming 5+ (men) or 4+ (women) drinks on at least one occasion in the last 30 days. Among binge drinkers, frequency was calculated as the mean number of binge drinking episodes in the past 30 days; intensity was calculated as the mean of the largest number of drinks consumed on one occasion in the last 30 days. Probable PTSD was defined as scoring ≥44 on the PTSD Checklist. Depression was defined as scoring ≥10 on the Patient Health Questionnaire (PHQ-8). Number of 9/11 exposures (e.g., witnessing horror, sustaining an injury) were categorized as very high (6-12), high (4-5), medium (2-3) and one/none. Odds ratios were adjusted for gender, age, race/ethnicity, income, education, rescue/recovery worker status, 9/11-related PTSD, depression, 9/11 exposure and current smoking.
RESULTS: Binge drinking prevalence among enrollees (26.8%) was 8% higher than among adults in the United States (18.4%) and New York City (18.1%) in 2011. Binge drinking was more common among enrollees with PTSD (32.9%), depression (32.2%) or very high exposure (35.1%), and rescue/recovery workers (30.1%). The overall mean frequency was 4.5 episodes and intensity was 6.8 drinks. The largest mean frequencies reported were among enrollees with PTSD (6.1) or depression (6.3). The highest intensities were reported by rescue/recovery workers (7.3), enrollees with PTSD (7.8), depression (7.7), and very high exposure (7.5). After adjustment, the odds of binge drinking were greater among enrollees with PTSD (AOR: 1.22; 95% CI: 1.11-1.33) compared to those without, depression (1.18; 1.08-1.29) compared to those without, and those very high exposure (1.64; 1.48-1.81) compared to those with one/no exposure.
CONCLUSIONS: These findings suggest 9/11-related PTSD, depression and higher levels of 9/11 exposure are associated with increased odds, frequency, and intensity of binge drinking. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and treatment.