Friday 9 December 2016

Why married life can help cut risk of alcohol misuse

Patricia Casey

Published 04/10/2016 | 02:30

Marital status influences alcohol consumption,
Marital status influences alcohol consumption,

Young people drink a lot. In Ireland we have massively high rates of binge drinking, according to the European School Survey Project on Alcohol and Other Drugs (ESPAD).

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If a report on teenage behaviour across Europe is correct, Irish teenagers will binge drink significantly more than their European counterparts. According to data from Alcohol Action Ireland, the overall per capita consumption of alcohol in Ireland almost trebled over the four decades from 1960 to 2001.

In 2015, the average Irish person aged 15+ drank the equivalent of 10.93 litres of pure alcohol, a slight decrease from 11 litres in 2014. Against that, one in five adults is a teetotaller; so the data shows that those who do drink, do so in quantity, amounting to the equivalent of 46 bottles of vodka, 130 bottles of wine, or 498 pints of beer annually.

We also know that marital status influences alcohol consumption, with single people imbibing far more that those who are married. The question is what is the explanation for this disparity? Is it that single people have more free time in which to drink; or perhaps the disposable income of single people is greater, or is there some other explanation relating to family responsibility? It is important to answer this question as it might assist in reducing the deleterious effects of alcohol on spouses and on families, particularly the negative impact of alcoholic parents on their children.

No such study has been carried out in Ireland, but the American Journal of Psychiatry has just published a study in its September 2016 issue carried out on a Swedish population of over 3 million subjects to attempt to answer these questions. Data was collected from one of the many state registers that are kept in Sweden. A study such as this could not be carried out in Ireland.

The researchers found that for men, marriage to a wife with no history of alcohol-use disorder was associated with a substantial reduction in risk for alcohol-related disorder, while marriage to a wife with a history of alcohol misuse increased the risk beyond that observed in single men.

The study also found that for men with a positive family history of alcoholism, who would thus be at greater risk of alcohol-use disorder, the benefits of being married were even greater, although if she did misuse alcohol, the risk was much higher than that in single men.

In women, the pattern was broadly similar in that marriage to a spouse without or with an alcohol-use disorder is associated with, respectively, a substantially reduced or an increased risk for alcohol-use disorder compared with the single state.

Overall, married men and women had, respectively, a 60pc and 71pc lower risk for onset of alcohol-use disorder compared with those who remained single. The data showed that this was not due to behavioural factors such as antisocial behaviour that might be more common in those who were alcoholic, and also reduce their chances of marriage.

Further detailed analysis of close relatives, comparing those who were married with those who were not, confirmed the link between having a spouse who didn't drink to excess and the decrease in risk.

These findings led the authors to conclude: "The protective effects of marriage on risk for alcohol-use disorder are likely to arise largely from direct spousal interactions, and they are stronger in individuals who have an elevated familial risk for alcoholism".

And this seems to apply to both men and women who are at risk. The authors decided that this was a direct effect of marriage and having a person with oversight of their partner's drinking habits.

Old fashioned though it may seem, a caring but vigilant spouse who places a limit on alcohol intake, and maybe even nags at times, is of benefit.

This is not to say that a vigilant spouse will always be able to monitor their partner's intake of alcohol, but they definitely have an impact. At a time when autonomy is the apparent password to happiness, perhaps we should instead be encouraging active monitoring and regular scrutiny. By reducing the risk of alcohol-use disorder, we are protecting the children of the next generation from the deleterious effects of parental alcohol misuse.

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