On average, one in five men (18%) and one in ten women (10%) consume a daily amount of alcohol that poses a significant health risk (alcohol abuse and alcohol dependence). In the course of their lives, about 10% of Austrians become alcoholics. 5% of Austrians over the age of 16 can be classified as "chronically alcohol ill" (= 350,000 people)1.
Alcohol use disorder leads to increased mortality. Thus, for the year 2016, 1.4% of all deaths recorded in Austria were attributed to alcohol-associated diseases. These 80,000 deaths must be seen as a conservative estimate - due to the broad influence of alcohol on other diseases2.
The increased mortality is reflected in years of life lost, which includes the age of the deceased, as well as the life expectancy of the population. Estimates range from 10-12 years of life lost as a result of alcohol abuse3 to 28 years4. Data from Germany estimate the reduction in life expectancy as a result of alcohol dependence to be up to 17 years for alcoholics and up to 20 years for female alcoholics5.
The causes of alcohol dependence are mostly multifactorial and vary greatly between individuals. Nevertheless, commonalities can be identified in the addiction biographies of many of those affected, which promote the path to alcohol dependence.
In addition to genetic predisposition, which can promote addictive behavior, social circumstances, the individual's own personality and psychological stress and comorbidities are among the factors that promote an addictive disease.
Symptoms and diagnosis
Alcohol dependence is characterized by a number of different symptoms: First and foremost is the strong desire for alcohol (‘craving’). As a result, the procurement and consumption of alcohol are also central for alcohol-dependent patients and thus often determine the daily events, even neglecting other interests. This is accompanied by an increasing loss of control over drinking - both in terms of the time of day and the amount drunk. When the drinking quantity is reduced or alcohol consumption is discontinued, physical withdrawal symptoms occur. Furthermore, tolerance to the effects of alcohol develops. Finally, the consumption is continued despite obviously harmful consequences (health, psychological or social).
The diagnosis takes place on the basis of the symptoms mentioned above. These are mapped in the ICD-10 criteria. If at least three of the six criteria mentioned are met, alcohol dependence is present.
For an initial screening procedure, aides such as the AUDIT test, which comprises 10 questions, or the shortened AUDIT-C, which covers only three questions about consumption, and the CAGE interview with four questions, are available.
1) Bachmayer, 2021
2) Strizek, 2022
3) Leu, 1981
4) Singel, 1996
5) Bühringer, 2000