Screening for alcohol use disorder in high-prevalence demographics

Please note, this communication applies to Anthem HealthKeepers Plus, Medallion and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) offered by HealthKeepers, Inc.

 

High-prevalence demographics

 

The lifetime prevalence of alcohol use disorder (AUD) in the U.S. population is approximately 29.1%. However, only 19.8% of people with AUD receive treatment. Prevalence of AUD is high in white and Indigenous people, younger men (age < 65), unmarried people, and those with low incomes.¹

 

Some 22.8 million people over the age of 12 reported having a substance use disorder (SUD) in 2019; AUD accounted for 63% of this population. An additional 12% presented with AUD and another SUD (excluding nicotine) according to the National Survey on Drug Use and Health (NSDUH).²

 

AUD and COVID-19

 

Evidence suggests that alcohol consumption increased during the COVID-19 pandemic. One study found that 60% of respondents reported increased alcohol-intake.³ In 2020, alcohol sales increased by 262% online and 21% in stores, which participants reported was due to increased stress, alcohol availability, and lockdown boredom.⁴ This increase was most substantial between March to April 2020. The study suggests those most affected by COVID-19 (job loss, friend loss, family loss, and isolation) may be more at risk of AUD.³

 

AUD co-occurring with mental health conditions

 

People with a variety of mental health conditions are at increased risk of developing an AUD or have an existing co-occurring AUD.⁵ While the rates are higher for co-occurring disorders with mental health conditions, there is also a higher risk of greater severity and a worse prognosis for both the mental condition and AUD. 

 

Trauma, including adverse childhood events (ACEs) and post-traumatic stress disorder (PTSD), are often precursors for AUD.⁶ Traumatic brain injuries (TBI) are also associated with AUD. Alcohol intoxication is one of the strongest predictors of a TBI. In addition, people with a TBI are more likely to abuse alcohol.⁷

 

In most co-occurring disorders, the mental health condition preceded the AUD. This indicates that people diagnosed with a mental health condition should be screened for AUD. Preventive work should begin at the onset of symptoms of a mental health condition.⁵

 

What if I need assistance?

 

If you have difficulty connecting patients with AUD to treatment, call Anthem HealthKeepers Plus, Medallion Provider Services at 800‑901‑0020 or Anthem CCC Plus Provider Services at 855‑323‑4687.

 

¹ Recovery Research Institute, 2019 https://www.recoveryanswers.org/addiction-101/epidemiology

² Substance Abuse and Mental Health Services Administration, 2020Results from the 2019 National Survey on Drug Use and Health

³ Pollard, Tucker, and Green (2020) https://doi.org/10.1001/jamanetworkopen.2020.22942

⁴ The Neilsen Company (2020) https://www.nielsen.com/us/en/insights/article/2020/rebalancing-the-covid-19-effect-on-alcohol-sales

⁵ Glantz et al., (2020) https://doi.org/10.1016/j.addbeh.2019.106128

⁶ Brady and Back (2012) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860395

⁷ Weil, Corrigan, and Karelina (2018) https://pubmed.ncbi.nlm.nih.gov/31198656

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