Alcohol Use Patterns and DSM-5 Alcohol Use Disorder on Both Sides of the US-Mexico Border

Abstract

Background

Alcohol consumption patterns on the US-Mexico border and their relationships with DSM-5 Alcohol Use Disorders (AUDs) have been understudied. Yet, effects of drinking by Mexican-origin individuals may differ between cities on vs. off the border both in the US and Mexico. We characterize prior 12-months drinking patterns, and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states.

Methods

Data come from the US-Mexico Study of Alcohol and Related Conditions (UMSARC) involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the WHO Composite International Diagnostic Interview (CIDI) core. Separately by gender, five logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country.

Results

A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume-groups, each partitioned by an empirically selected maximum, helped identify a drinking pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the US. Border vs. interior differences implied more AUD for given patterns at the border in the US and the reverse in Mexico, with some city differences also evident.

Conclusion

Drinking pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the US and Mexico, possibly related to economic and psychological stresses specific to respective communities.