Abstract
BackgroundThe evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia.MethodsA cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs) and former IDPs. Two alcohol use disorder outcomes were measured: (i) having at least hazardous alcohol use (AUDIT score ≥8); (ii) episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week). Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only).ResultsOf the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386), 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use).ConclusionThe findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for stronger alcohol control policies in Georgia.
Highlights
There is a substantial body of evidence of the high prevalence of mental health disorders among populations affected by armed conflict, post-traumatic stress disorder (PTSD), depression and anxiety [1,2,3]
A total sample size of 3600 men and women aged 18 years and over was determined to meet the statistical requirements of the overall study. This consisted of 1200 respondents from each of the 3 main conflict-affected populations in Georgia: those displaced as a result of conflicts in the 1990s (‘1990s internally displaced persons (IDPs)’); those displaced after the 2008 conflict (‘2008 IDPs’); and former 2008 IDPs who have been able to return to their home areas (‘returnees’)
Our study highlights the links between trauma exposure, depression and alcohol use disorder among conflict-affected populations in Georgia
Summary
There is a substantial body of evidence of the high prevalence of mental health disorders among populations affected by armed conflict, post-traumatic stress disorder (PTSD), depression and anxiety [1,2,3]. There are a number of reasons why alcohol use disorder may be a concern among conflict-affected civilian populations. They are often exposed to high levels of violent and traumatic events that are strongly associated with mental disorders such as PTSD, depression and anxiety [2,3,9]. The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors.
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