Bereavement and problematic alcohol use: Prevalence and predictors among a national sample of bereaved adults

Background: Problematic alcohol use (PAU) is highly prevalent in the United States. Although bereavement, a highly stressful and ubiquitous experience across the lifespan, is believed to increase the risk for PAU based on a small number of studies, research using large diverse samples of bereaved adults has yet to be conducted. Therefore, relations between PAU and bereavement remain poorly understood, hampering the reach and effectiveness of alcohol interventions. The current study addresses this limitation by investigating rates and correlates of PAU and service utilization among a large national sample of bereaved adults.

Methods: Participants were adults who reported the death of a significant other in their lifetime (N = 1529). Most participants identified as female (69.1%) and White (68.2%), with an average age of 44.7 (SD = 16.29). Online self-report surveys assessed the prevalence of PAU using the AUDIT-C, mental health service utilization, and associated characteristics.

Results: Nearly one-third (n = 463; 30.3%) screened positive for PAU, which surpasses rates found in the general US population. After accounting for other characteristics, time since the death (OR, 3.63; 95% CI, 2.59-5.08) and meeting presumptive criteria for depression (OR, 2.28; 95% CI, 1.64-3.18) and prolonged grief disorder (PGD; OR, 1.66; 95% CI, 1.13-2.25) significantly increased risk for PAU among the bereaved. Approximately half (n = 244; 52.7%) of bereaved adults with PAU received any mental health service since the death. Time since the death (OR, 4.19; 95% CI, 2.38-7.48) and presumptive depression (OR, 2.16; 95% CI, 1.25-3.74) were associated with service utilization after accounting for other characteristics.

Conclusions: The high prevalence of PAU among bereaved adults, particularly among those with a diagnosis of PGD, and limited use of support services underscore the need for greater empirical attention and integrated substance use care for bereaved adults.