Alcohol use disorders linked to decreased 'work trajectory'

John D. Meyer, MD, MPH, of Icahn-Mount Sinai School of Medicine, New York, and Miriam Mutambudzi, PhD, MPH, of Johns Hopkins School of Medicine, Baltimore, studied the relationship between occupation and AUDs in workers followed up from early adulthood to middle age. The study focused on the "substantive complexity" of work as an indicator of work trajectory - whether individuals were progressing in their careers in terms of factors such as decision latitude and expanded work abilities.

Based on factors such as drinking more than intended or unsuccessful attempts to cut down on drinking, AUDs were initially present in about 15 percent of men and 7.5 percent of women. Lower work trajectory was linked to a higher rate of AUDs - both initially and during follow-up. For both men and women, AUD rates were decreased with higher work trajectory.

But even men though had higher AUD rates, the association between AUD and flat or downward occupational trajectory appeared stronger in women. In contrast, higher education was more strongly associated with lower AUD risk in men.

Together with previous reports, the study suggests that "declining occupational trajectory is a consequence of AUD development," rather than a predictor.

However, the link between AUDs and occupation appears to be "complex and reinforcing," Drs Meyer and Mutambudzi write. They add that women's career paths "may be more readily disrupted" by AUDs, compared to men's.

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When does drinking become a problem?

For most adults, moderate alcohol use - no more than two drinks a day for men and one for women and older people - is relatively harmless. (A "drink" means 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of alcohol.

Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence:

Alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work, or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking.

People with alcoholism - technically known as alcohol dependence - have lost reliable control of their alcohol use. It doesn't matter what kind of alcohol someone drinks or even how much: Alcohol-dependent people are often unable to stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same "high") and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations and convulsions.