Predictors of transitions across stages of alcohol use and alcohol-use disorders in South Africa.

OBJECTIVE High rates of alcohol use and alcohol-use disorders have been noted in South Africa. Although a number of risk factors for alcohol use and abuse/dependence have been identified, there is a lack of information regarding risk factors for progression through the different stages of alcohol use and alcohol-use disorders. Our aim was to examine sociodemographic predictors of transition across stages of alcohol use, abuse and dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and remission in the South African population. METHOD A national probability sample of 4,315 adult South Africans was administered Version 3.0 of the World Health Organization Composite International Diagnostic Interview. RESULTS We found high rates of transition from regular alcohol use to abuse but low rates from alcohol abuse to dependence. All stages of alcohol use and alcohol-use disorders were more common in younger than in older respondents at comparable time points. Younger age (below 50), male gender, lower education, and having been a student were all associated with ever using alcohol, but only male gender was associated with the transition to regular use and abuse. Furthermore, younger age and late age at onset of alcohol abuse were associated with remission from abuse. CONCLUSIONS The importance of socio-demographic predictors appears to vary across stages of alcohol use and could be used to guide the precision of intervention strategies.