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Associations of antidepressant use with alcohol use and problem drinking: Ontario population data from 1999 to 2017

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Abstract

Objective

This study investigated the rates of and change in past-year antidepressant use from 1999 to 2017 among a representative sample of Ontario adults and past-year alcohol users and problem drinkers. It examined whether alcohol use and problem drinking are associated with antidepressant use over time, whether gender moderated the effect of problem drinking on antidepressant use, and the potential correlates of past-year antidepressant use.

Method

This study utilized data from the Centre for Addiction and Mental Health Monitor study, a repeat cross-sectional telephone survey of the Ontario general adult population. Data are from 15 annual cycles of the survey 1999–2017 (where relevant variables were included), resulting in a sample size of N = 35,210. Variables of interest included demographic variables, past-year antidepressant use, past-year alcohol use, and past-year problem drinking (e.g., 8+ on the Alcohol Use Disorders Identification Test).

Results

Past-year antidepressant use increased from 1999 to 2017 similarly among the full sample, past-year alcohol users, and past-year problem drinkers. Approximately 9% of Ontarians reported past-year antidepressant use in 2017. Overall, past-year problem drinkers were 1.5 times more likely to use antidepressants than non-problem drinkers. Past-year alcohol use was not associated with antidepressant use. Gender moderated the association between past-year problem drinking and antidepressant use.

Conclusion

This study determined that past-year antidepressant use increased from 1999 to 2017, that past-year problem drinkers are more likely to use antidepressants than non-problem drinkers, and that past-year problem drinking is associated with past-year antidepressant use among women but not among men.

Résumé

Objectif

Cette étude a examiné les taux et l’évolution de la consommation d’antidépresseurs au cours de la dernière année de 1999 à 2017 parmi un échantillon représentatif d’adultes de l’Ontario et de consommateurs d’alcool et de buveurs problématiques au cours de l’année précédente. Il a examiné si la consommation d’alcool et la consommation problématique d’alcool sont associées à la consommation d’antidépresseurs au fil du temps, si le sexe modère l’effet de la consommation problématique d’alcool sur l’utilisation d’antidépresseurs, et les corrélats potentiels de l’utilisation d’antidépresseurs au cours de l’année précédente.

Méthode

Cette étude a utilisé les données de l’étude Monitor du Centre de toxicomanie et de santé mentale, une enquête téléphonique transversale répétée auprès de la population adulte générale de l’Ontario. Les données proviennent de 15 cycles annuels de l’enquête 1999–2017 (où les variables pertinentes ont été incluses), ce qui donne une taille d’échantillon de N = 35 210. Les variables d’intérêt comprenaient les variables démographiques, la consommation d’antidépresseurs au cours de la dernière année, la consommation d’alcool au cours de la dernière année et la consommation excessive d’alcool au cours de la dernière année (par exemple, 8+ au Alcohol Use Disorders Identification Test).

Résultats

La consommation d’antidépresseurs au cours de la dernière année a augmenté de 1999 à 2017 de la même manière parmi l’échantillon complet, les consommateurs d’alcool de l’année précédente et les buveurs à problèmes de l’année précédente. Environ 9 % des Ontariennes et Ontariens ont déclaré avoir utilisé des antidépresseurs au cours de l’année précédente en 2017. Dans l’ensemble, les buveurs à problèmes au cours de la dernière année étaient 1,5 fois plus susceptibles de prendre des antidépresseurs que les buveurs sans problème. La consommation d’alcool au cours de la dernière année n’a pas été associée à l’utilisation d’antidépresseurs. Le sexe a modéré l’association entre la consommation abusive d’alcool et l’utilisation d’antidépresseurs au cours de l’année précédente.

Conclusion

Cette étude a déterminé que l’utilisation d’antidépresseurs au cours de la dernière année a augmenté de 1999 à 2017, que les buveurs à problèmes de l’année précédente sont plus susceptibles d’utiliser des antidépresseurs que les buveurs sans problème, et que la consommation excessive d’alcohol au cours de la dernière année est associée à l’utilisation d’antidépresseurs au cours de la dernière année pour les femmes mais pas pour les hommes.

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Data and code availability

It is our policy that external researchers require a user agreement and approval to use our data. Contact Yeshambel Nigatu (Yeshambel.Nigatu@camh.ca) to inquire about obtaining the data. Contact Jesus Chavarria (jesus.chavarria@camh.ca) to inquire about obtaining the analysis code.

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Funding

Dr. Jürgen Rehm and Dr. Tara Elton-Marshall acknowledge funding from Canadian Institutes of Health Research (CIHR) for the Ontario CRISM Node Team (grant # SMN-139150).

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Authors and Affiliations

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 100 Collip Circle, Suite 200, ON, N6G 4X8, London, Canada

    Jesus Chavarria, Samantha Wells, Tara Elton-Marshall & Jürgen Rehm

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Samantha Wells, Tara Elton-Marshall & Jürgen Rehm

  3. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Samantha Wells & Jürgen Rehm

  4. Department of Epidemiology and Biostatistics, Western University, London, ON, Canada

    Samantha Wells & Tara Elton-Marshall

  5. School of Psychology, Deakin University, Geelong, Australia

    Samantha Wells

  6. Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany

    Jürgen Rehm

  7. Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation

    Jürgen Rehm

Authors
  1. Jesus Chavarria
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  4. Jürgen Rehm
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Contributions

All authors contributed to the study conception and design. Jesus Chavarria conducted the analyses and developed the full draft of the manuscript. Dr. Jürgen Rehm conducted the analyses and provided edits on all drafts. Drs. Tara Elton-Marshall and Samantha Wells provided feedback on all drafts.

Corresponding author

Correspondence to Jesus Chavarria.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at both CAMH (#305-2009) and York University (#2019-017) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Verbal informed consent was provided by all participants in the current study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Chavarria, J., Wells, S., Elton-Marshall, T. et al. Associations of antidepressant use with alcohol use and problem drinking: Ontario population data from 1999 to 2017. Can J Public Health 112, 919–926 (2021). https://doi.org/10.17269/s41997-021-00526-3

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  • DOI: https://doi.org/10.17269/s41997-021-00526-3

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