L’alcool en France et ses conséquences médicales et sociales : regard de l’entourage et des médecins généralistes

Abstract

Data on the frequency of high-risk alcohol consumption and its medical and social consequences in the French general population remain fragmented. Therefore, our aim was two-fold: (i) to assess the prevalence of different patterns of alcohol consumption using the AUDIT-C scale, according to two different perspectives, i.e., that of family circle members or friends, and that of the general practitioners (GPs), and (ii) to examine the prevalence of medical and social consequences associated with alcohol consumption profiles. Data were drawn from two national surveys conducted in 2013. Investigators were respectively GPs and family circle members or friends. These surveys were respectively representative of GPs (n=1308) and of the general adult population (n=1018). The 12-month prevalence rates of harmful or at risk alcohol consumption rose respectively to 11.1% in the GPs adult patients and to 11.9% in the general adult population. The majority of participants with "at risk" alcohol consumption presented with significant social and medical consequences. Thus, more than seven out of ten participants with chronic at risk consumption endorsed significant negative social event potentially associated with alcohol like withdrawal of driving licence, getting divorced or separated, and losing friends. Over 10% of these participants had liver disease and diabetes mellitus, more than 30% increased blood pressure and nearly 50% anxiety disorder or major depression. Following adjustments for sociodemographic characteristics and alcohol treatment, prevalences of numerous social and medical consequences significantly differed between alcohol-dependent participants, chronic at risk consumers and episodic at risk consumers. Our results suggest that more than one adult out of ten in France showed during the past year harmful or "at risk" alcohol consumption, which appears insufficiently detected and treated. In addition, the majority of at risk alcohol consumers already presents with serious medical and social consequences. Furthermore, we found that AUDIT-C scale can identify different patterns of alcohol consumption, which form a continuum in terms of medical and social consequences. Our study indicates the need for vigorous education efforts for the public, professionals and policy makers about alcohol use disorders, to encourage help-seeking among those who cannot stop drinking despite considerable harm to themselves and others, and ideally to promote early detection and treatment of individuals with at risk alcohol consumption before the development of social and medical consequences and alcohol dependence.