Health-related quality of life is a measurement that doctors and public health officials use to define each person’s ability to enjoy a productive, satisfying day-to-day lifestyle. People affected by alcoholism, one of two related conditions known together as alcohol use disorder, typically experience a substantial decline in this measurement. In a study published in May/June 2014 in the journal Alcohol and Alcoholism, a team of researchers from Switzerland and France investigated how much the quality of life improves over a two-year period for people who receive alcoholism treatment.
Alcoholism and Alcohol Use Disorder
Alcoholism is defined by a physical reliance on the regular, typically excessive intake of a baseline amount of alcohol (which varies from person to person), as well as by additional symptoms such as repeated cravings to keep drinking, diminishing susceptibility to alcohol’s intoxicating effects, the establishment of drinking as a prime life priority and the onset of withdrawal when the physically dependent brain does not receive the amount of alcohol it expects. People with alcoholism often also have symptoms associated with a non-dependent, dysfunctional pattern of alcohol abuse. Still, until 2013, the diagnostic guidelines used by doctors in the U.S. required the separation of alcoholism symptoms from alcohol abuse symptoms. In May of 2013, the American Psychiatric Association fundamentally changed this situation by creating the alcohol use disorder diagnosis, which includes separate or combined indications of both alcohol-related problems and calls upon doctors to note the severity of these problems based on the number of symptoms found in each person.
Quality of Life
The federal Centers for Disease Control and Prevention broadly define a person’s health-related quality of life (HRQOL) as the sum of all of the positive and negative factors that can increase or decrease at least one aspect of physical and mental well-being. On an individual level, this sum of positive and negative influences helps determine the risks for such things as debilitating illnesses, intentional or accidental injuries, and conditions that could be prevented through some sort of lifestyle alteration. On a public health level, HRQOL helps determine society’s general rates for illness (also known as morbidity) and mortality. The CDC uses a screening tool called Healthy Days to measure health-related quality of life. Another tool commonly in use, called the Medical Outcomes Study 36-Item Short-Form Survey (MOS-SF-36), was developed by the private RAND Corp.
How Much Improvement?
In the study published in Alcohol and Alcoholism, researchers from Switzerland’s Lausanne University Hospital and France’s International Epidemiology Department of Lundbeck used the MOS-SF-36 screening tool to assess the health-related quality of life in 160 people just beginning to receive treatment for alcoholism. The researchers then conducted follow-up surveys with the same tool every three months for the next two years. In addition, they used a separate interviewing process to determine how much alcohol each individual regularly consumed upon entering treatment. The average mental health score on the MOS-SF-36 screening is 50 out of 100. Upon entering treatment for their drinking, the study participants had an average mental health score of 35.7, which falls in line with expectations for reduced quality of life in people affected by serious alcohol problems. The people with the highest initial scores (an average of 40.4) identified themselves as mostly abstinent from alcohol use upon entry into treatment. People with relatively middling initial scores (an average of 35.6) identified themselves as mostly moderate alcohol consumers, while people with relatively low initial scores (an average of 30.1) identified themselves as mostly excessive alcohol consumers. All of these groups gradually improved their quality of life scores in the two-year period after entering treatment. At 24 months, the people originally self-identified primarily as alcohol abstainers had a mental quality of life score just a hair below average, while even those individuals originally self-identified as heavy drinkers had an average score of 43.7. Based on their findings, the study’s authors concluded that people who receive treatment for their alcoholism experience a notable improvement in their mental quality of life during the first stages of their program involvement. They also concluded that the quality of life gains made during this initial phase remain in effect two years later. Generally speaking, the people with the greatest chances of experiencing a treatment-related return to near-normal mental quality of life do not drink heavily at the time their treatment first begins. However, even heavy drinkers will typically experience some improvement. The authors note that the average person enrolled in the study had not experienced a significant decline in his or her physical quality of life.