It should come as no surprise that divorce is linked to alcohol (ab)use. Research consistently shows that, compared to married people, divorced people drink more and in more harmful ways (e.g. binge drinking), are more likely to have a lifetime or recent alcohol use disorder (AUD) diagnosis, engage in more alcohol-related risky behaviors, and have higher alcohol-related mortality.
Past studies have found some evidence that this link might be causal, such that alcohol abuse increases the risk of subsequent divorce. Now a recent study published in the American Journal of Psychiatry in May 2017 strengthens the evidence that link might be causal in the other direction, too: Divorce increases the risk for subsequent alcohol abuse.
Based on a population-based Swedish study of almost 950,000 Swedes born between 1960 and 1990 who married in or after 1990 and who had no AUD diagnosis prior to marriage, this new study found that, after divorce, the rates of first-time AUD increased sixfold in men and over sevenfold in women. These rates remained greatly elevated even after controlling for potential confounding factors, including prior problem behavior, low parental education, and familial risk of AUD.
Additional analyses showed that divorce increased the risk for an AUD relapse among those who had already had an AUD registration prior to marriage, and that remarriage had a protective effect, leading to lower risk of AUD compared to those who remained divorced.
An increased risk for AUD onset began a few years prior to the divorce, consistent with marital dissolution reflecting a longer process rather than just a single event. But in both sexes and across age groups, the risk for AUD increased substantially in the year of the divorce and remained elevated for many years in those who did not remarry.
Researchers also compared AUD onset among twins, siblings, and cousins in the sample, all of whom had married but only some of whom had gotten divorced. The more closely genetically related people were, the weaker the relationship between divorce and AUD onset was, indicating that at least part of the relationship between divorce and alcohol was due to familial factor causing both issues. However, divorce was linked to higher rates of AUD even among identical twins who share 100% of their genes, the prenatal environment, and the early rearing environment, indicating that divorce indeed plays a causal role in AUD onset.
Not everyone was at similar risk for AUD following divorce: Divorce produced a greater increase in first AUD onset in those with a family history of AUD or with prior problem behaviors, or in those whose spouses did not have AUD themselves.
Finally, researchers found that widowhood was also strongly associated with an increased risk for AUD in both genders. Unlike divorce, spousal death is less likely to be precipitated by alcohol abuse itself, suggesting that there is something about spousal loss itself that causes alcohol abuse.
The study is an extension of a similar study from the same research team published in the American Journal of Psychiatry in May 2016, which showed that marriage was causally related to a lower risk for developing alcohol use disorders.
Interestingly, in both studies, alcohol use disorder was determined not by interviewing people about their alcohol use, but by linking nationwide medical, criminal, and pharmacy registries with the 10-digit identification number assigned at birth or immigration to all Swedish residents (something akin to the Social Security number in the U.S). (Needless to say, a study of this sort would be impossible to conduct in the U.S. where communication between the Social Security Administration, pharmacies, medical facilities, and the criminal-justice system is limited to nonexistent.)
According to the studies’ authors, what explains the link between divorce and alcohol is not so much the stress of the divorce. Instead, it is the loss of the protective powers of marriage, like spouses regulating each other’s alcohol consumption and encouraging healthy, stable lives. The protective effects of marriage on health have been established in other areas too, like smoking and exercise. Does that mean we should be working harder on saving failing marriages? I’ll let that stand as an open question.
You can find Dr. Zhana Vrangalova on Twitter, Facebook, Instagram, and at her website, drzhana.com.
