Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey.

OBJECTIVE The purpose of this study was to present updated estimates of the prevalence of, and to examine the correlates of, alcohol use and DSM-IV alcohol dependence in a representative sample of the U.S. population. METHODS This study was based on the National Institute on Alcohol Abuse and Alcoholism's National Longitudinal Alcohol Epidemiologic Survey (NLAES), a representative sample (N = 42,862) of the United States population aged 18 years and older. RESULTS The prevalence of lifetime alcohol use was 66.0%, with 44.4% of the respondents reporting alcohol use during the past 12 months. Lifetime and 12-month prevalences of alcohol dependence were estimated at 13.3% and 4.4%, respectively. Men were significantly more likely than women to use alcohol, and alcohol use and dependence were much more common among cohorts born after Prohibition and after World War II. Members of the youngest cohorts, between the ages of 18 and 24 years at the time of the interview, were more likely to use drugs, to become dependent and to persist in dependence compared to the older cohorts. In addition, the conditional probability of dependence among users was greatest in Cohort 1 (born between 1968 and 1974) after early adolescence compared to Cohort 2 (born between 1958 and 1967), despite the finding that the probability of lifetime use was lower in Cohort 1 compared to Cohort 2. The sociodemographic correlates of first use, onset of dependence and persistence of dependence varied as a function of the stage of progression. CONCLUSIONS Implications of these findings are discussed in terms of changes over time in drinking patterns, dependence liability and vulnerability among recent alcohol users.