Understand the individualities of treatment for alcohol use in relation to women's health.

How Many People Suffer from Alcoholism in Brazil and Around the World?

Alcohol Use Disorder (AUD), commonly known as alcoholism, is one of the most prevalent mental health conditions worldwide. However, its true extent is difficult to predict, as many cases remain undiagnosed (1) due to limited access to specialized healthcare services in various countries.

Global Alcohol Consumption and Health Impacts

Alcohol Use Disorder (AUD) is characterized by a problematic pattern of alcohol consumption, leading to significant distress or impairment in various areas of life, such as work, relationships, and physical health. In 2019, it was estimated that around 400 million people aged 15 years and older were living with alcohol use disorders, with 209 million (52.3%) diagnosed with dependence. Globally, the prevalence of AUD was 5.1%, with a marked gender difference: 8.6% of men and 1.7% of women were affected in 2016 (2).

The prevalence of AUD tends to be higher in high-income countries (8.4%) and upper-middle-income countries (5.4%), suggesting the influence of socioeconomic factors on consumption patterns and alcohol availability. In contrast, low-income countries generally have lower prevalence rates, but may suffer from limited access to treatment and a higher prevalence of alcohol-related deaths.

The Situation in Brazil

Alcohol Use Disorder (AUD) also affects a significant portion of the Brazilian population. According to data from the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease (2024), presented on the platform Our World in Data (3), approximately 3.3% of the Brazilian population had alcohol use disorder in the 2010s. However, this rate has slightly decreased over recent decades, standing at about 2.9% in 2021. This reduction may reflect changes in access to information, public policies, and consumption patterns, although the prevalence remains high compared to other mental health disorders.

As with the prevalence of AUD, alcohol-attributable deaths in Brazil have also shown a trend of reduction over the last decade. According to the CISA publication Álcool e Saúde dos Brasileiros - Panorama 2024, the alcohol-attributable death rate fell from 36.7 to 30.4 per 100,000 inhabitants between 2010 and 2019. However, this trend was interrupted by the COVID-19 pandemic, with a significant increase starting in 2020, reaching 32.5 per 100,000 inhabitants in 2022. These data emphasize the importance of sustainable and continuous public policies to address the impacts of alcohol on public health.

Facing the Problem: Challenges and Opportunities

Despite the existence of effective treatments, such as cognitive-behavioral therapies and medications, access to these interventions remains limited. In Brazil and other countries, addressing alcohol use disorder requires:

• Reducing stigma: Awareness campaigns can help promote a more informed and compassionate view of the disorder.
• Improving screening: The use of simple tools in primary healthcare units can facilitate early diagnosis.
• Investing in accessible treatments: Expanding specialized services and including innovative therapies is essential.

Alcohol Use Disorder is a public health issue with profound implications for individuals, families, and societies. Understanding its prevalence and associated factors is crucial for developing effective prevention and treatment policies. By addressing stigma, improving screening, and expanding access to health care, it is possible to significantly reduce the impact of AUD on global health.

Remember, those suffering from this issue in Brazil can seek free help at any Basic Health Unit (health clinic) linked to the SUS (Unified Health System) or at units of the Psychosocial Care Centers for Alcohol and Drugs (CAPS-AD).

References:

1. Divya Ayyala-Somayajula, Jennifer L. Dodge, Adam M. Leventhal, et al. Trends in Alcohol Use After the COVID-19 Pandemic: A National Cross-Sectional Study. Ann Intern Med. [Epub 12 November 2024]. doi:10.7326/ANNALS-24-02157
2. Rehm J, Shield KD. Global Burden of Alcohol Use Disorders and Alcohol Liver Disease. 2019 Dec 13;7(4):99. doi: 10.3390/biomedicines7040099. PMID: 31847084; PMCID: PMC6966598. 
3. IHME, Global Burden of Disease (2024) – with major processing by Our World in Data. “Share of population with an alcohol use disorder”. IHME, Global Burden of Disease, “Global Burden of Disease - Prevalence and Incidence” [original data]. Retrieved January 27, 2025 from https://ourworldindata.org/grapher/share-with-alcohol-use-disorders

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Can Physical Exercise Cure Alcoholism?

Physical activity has shown benefits for both physical and mental health in individuals with alcohol use problems. A study points to an increase in substances associated with pleasure and well-being, reducing the harmful effects of alcohol use.

A recent study, published in the scientific journal PLoS ONE, sought to compile the results of highly reliable clinical research that involved physical exercise interventions for patients with Alcohol Use Disorder (AUD). The authors aimed to provide stronger evidence on ways to treat alcohol dependence and the physical and mental health of this patient group.

The survey included only randomized clinical trials with patients diagnosed with AUD or post-traumatic stress disorder (PTSD) with symptoms of AUD. To be included in the survey, studies needed to compare "experimental groups" that underwent exercise interventions, with variations in type, intensity, and duration, against "control groups" that did not perform exercises.

The outcomes analyzed in the studies included the number of daily and weekly alcohol doses, questionnaires for alcohol consumption identification, aerobic capacity (VO2max), resting heart rate, symptoms of anxiety, depression, and stress, with interventions varying between aerobic exercises, resistance training, yoga, and combinations of these approaches, lasting from 3 to 24 weeks.

The survey obtained interesting results, with evidence highlighting that physical exercise had positive effects on daily alcohol consumption, with a significant reduction in the number of daily doses, but no impact on weekly consumption. There was also a significant reduction in the scores of the Alcohol Use Disorders Identification Test (AUDIT), indicating an improvement in alcohol use patterns.

Regarding physical and psychological effects, exercise increased VO2max and improved resting heart rate, as well as significantly reducing anxiety, depression, and stress levels. The subgroup analysis indicated that mixed exercises and an intervention duration of up to 12 weeks were effective in reducing anxiety.

Despite the interesting and promising results, one limitation identified was the assessment of risk of bias, as this raised concerns in 53% of the studies, particularly regarding the lack of blinding in the interventions, meaning participants and researchers knew which group they were in, which may have influenced the results.

References:

Li J, Zhou Z, Gao G, Zang L (2024) Effectiveness of exercise intervention in improving physical and mental status of patients with alcohol use disorders: A systematic review and metaanalysis. PLoS ONE 19(10): e0311166. https://doi.org/10.1371/journal.pone.0311166

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