Drinking despite health problems among individuals with liver disease across the United States

Abstract

Background Heavy drinking is harmful for individuals with liver disease. However, some of these individuals drink despite knowledge of the risks. The current study aims to identify factors underlying drinking despite health problems among individuals with liver disease. Methods The current study utilizes a subsample of individuals reporting past-year liver disease and at least one drink in the past year (n=331), taken from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a large nationally representative survey of the United States. Participants reported on drinking despite health problems, symptoms of psychopathology, and family history of alcohol problems in a cross-sectional survey. Results Drug use disorders (Adjusted Odds Ratio [AOR] =2.68), as well as borderline, antisocial, and schizotypal personality disorders (AORs = 2.50–4.10), were associated with increased likelihood of drinking despite health problems among individuals with liver disease, all ps<0.05. Any anxiety disorder trended toward significance (AOR=2.22), p=0.06, but major depressive disorder was not associated with increased risk, (AOR=0.99), ps=0.97. Individuals with a family history of alcohol problems were also more likely to drink despite health problems (AOR=2.79), p<0.05. Conclusions Several types of psychopathology, as well as a family history of alcohol problems, increased the likelihood of drinking despite health problems among individuals with liver disease. These findings highlight the need to intervene with heavily drinking individuals with liver disease, who may be drinking due to familial risk and/or comorbid psychopathology.

Reduction in Nonabstinent WHO Drinking Risk Levels and Change in Risk for Liver Disease and Positive AUDIT‐C Scores: Prospective 3‐Year Follow‐Up Results in the U.S. General Population

“…In addition, the increased risk of liver disease shown among Wave 1 moderate or low-risk drinkers who became abstainers at Wave 2 could be attributed to the “sick quitters” phenomenon (i.e., individuals who reduced or quit drinking based on the presence of liver disease). However, future surveys that include motives for continuing to drink despite health problems such as liver disease (Elliott et al, 2017, Elliott et al, 2018), and reasons for reducing drinking (Elliott et al, 2014) would provide valuable information on this question, especially among individuals with medical problems related to drinking. Also, the relationship between a reduction in WHO drinking risk levels and a change in additional indicators should be examined (in this or other datasets), including other more acute conditions, e.g., hypertension, and other substance use disorders, psychiatric disorders, and indicators of functioning.…”

Heavy drinking among individuals with HIV: who drinks despite knowledge of the risk?

“…A recent study evaluated predictors of drinking despite health problems among individuals with liver disease (Elliott et al, in press). Although both studies found family history to increase risk, psychopathology predictors differed.…”

“…Mental health disorders and family history of alcohol problems underlie drinking despite health problems among individuals with liver disease (Elliott, Stohl, & Hasin, in press), and depression and drug use predict heavy drinking among individuals with HIV (Cook et al, 2013). The current study evaluates whether such factors predict drinking despite health problems among individuals with HIV.…”