Abstract
Epidemiologic survey studies suggest that people with disabilities are vulnerable to excessive alcohol use and alcohol use disorder (AUD), yet little is known about potential differences in clinical AUD diagnosis by disability status. Our objective was to examine trends in annual AUD diagnoses in the US from 2016-2023 among adults with commercial insurance, and to investigate potential differences by disability status/type, and by disability status/type and sex.
Retrospective cross-sectional study using MarketScan commercial insurance claims from 2016-2023. Population-based sample of adults age 18-64 with commercial insurance across all 50 states. AUD diagnoses were identified with ICD-10 diagnosis codes. Age-adjusted annual AUD diagnosis rates per 10,000 population, stratified by disability status/type, and disability status/type and sex. Average annual percentage change of AUD rates over time.
The rate of AUD increased steadily from 85/10,000 persons in 2016 to 128/10,000 persons in 2023; average annual percentage change of 5.41% per year (CI 3.82% - 7.03%). Adults with disability had greater than threefold higher rates of AUD, and males and females with disabilities had a persistently higher rate of AUD compared to non-disabled males and females. Adults with serious mental illness and acquired brain injury were particularly likely to have AUD; rates were over 10 and 5 times higher than adults without these types of disabilities, respectively.
Adults with disabilities had higher than three times the rate of AUD diagnoses compared to adults without disabilities. Interventions are needed inclusive of person-centered care for disabled people with comorbid AUD
•Age-adjusted annual AUD diagnosis rates increased from 2016-2023 in the US•Adults with disabilities had 3 times the rate of AUD than non-disabled adults•Males with disabilities had the highest rates of AUD•Women with disabilities had higher rates of AUD than non-disabled males or female•AUD treatment should address the unique needs of people with disabilities