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Open Access Research article

Alcohol abstinence, non-hazardous use and hazardous use a decade after alcohol-related hospitalization: registry data linked to population-based representative postal surveys

Kozma Ahacic12*, Robert F Kennison3 and Ingemar Kåreholt45

Author Affiliations

1 Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden

2 Centre for Epidemiology and Community Medicine, Health Care Services, Stockholm County Council, Box 1497, 171 29 Solna, Sweden

3 Department of Psychology, California State University, Los Angeles, California

4 Aging Research Centre (ARC), Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden

5 Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden

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BMC Public Health 2014, 14:874  doi:10.1186/1471-2458-14-874

Published: 24 August 2014

Abstract

Background

Although there is evident association between alcohol-related hospitalization and alcohol use, the relationship has not been well examined. This study analyzed the extent of alcohol abstinence, non-hazardous use and hazardous use among people who had experienced alcohol-related hospitalization during the preceding decade.

Method

Registry data concerning alcohol-related hospitalizations between 1996 and 2007 were linked to two representative surveys, in 2006 and 2007, of residents of Stockholm County. Relevant contrasts were modeled, using logistic regression, in the pooled sample (n = 54 955). Ages were 23–84 years at follow-up.

Results

Among persons previously hospitalized (n = 576), half reported non-hazardous use. Non-hazardous use was less prevalent than in the general population – and the extent of non-hazardous use did not change over time following hospitalization. There were no significant age differences, but non-hazardous use was less frequent among people with repeated episodes of care. One in six was abstinent. Abstinence was more common among the old, while hazardous use (exceeding 14 drinks per week for men, and 9 drinks per week for women) decreased with age. Abstinence also increased over time; among persons hospitalized ten years ago, the abstinence rate was twice that of the general population. Associations with hazardous use over time were less conclusive. Hazardous use among those previously hospitalized decreased over time in one sample but not in the other. After pooling the data, there were indications of a decrease over time following hospitalization, but more prevalent hazardous use than in the general population.

Conclusions

Following alcohol-related hospitalization, abstinence increased, and there was no evidence of regression towards the mean, i.e., towards non-hazardous use. Abstinence was also more widespread among previously hospitalized persons of older ages. With advancing age, changing hazardous alcohol habits among previously hospitalized appears to yield a trend towards promotion of abstinence.

Keywords:
Treatment; Rehospitalization; Alcohol use disorder (AUD); Controlled drinking; Alcohol dependence; Harmful use of alcohol