Prevalence and correlates of alcohol dependence in adult prisoners vary according to Indigenous status

Objective: To estimate the prevalence and identify independent correlates of alcohol dependence among Indigenous and non- Indigenous adult prisoners in Queensland. Methods: A confidential, cross-sectional survey of 1,155 adult prisoners (n=274 Indigenous, n=881 non-Indigenous) in seven adult prisons in Queensland. The usual alcohol consumption in the year before prison was assessed using the Alcohol Use Disorders Identification Test (AUDIT); scores =20 are considered consistent with alcohol dependence. Results: Indigenous prisoners were significantly more likely than non- Indigenous prisoners to report patterns of alcohol consumption consistent with dependence. Separate multivariable analyses revealed different independent correlates of alcohol dependence according to Indigenous status. Among Indigenous prisoners, significant independent correlates of alcohol dependence included income below the poverty line and daily cannabis use before incarceration. Daily heroin use and history of injecting drug use were protective. Among non-Indigenous prisoners, significant independent correlates included history of mental illness or self harm, and daily tobacco or cannabis use before incarceration. Older age and daily heroin use before incarceration were protective. Conclusions and Implications: The prevalence of risky alcohol use and dependence is high in Australian prisoner populations, particularly among Indigenous prisoners. Risk factors for alcohol dependence differ according to Indigenous status, indicating that separate, culturally appropriate interventions to reduce alcohol-related harm for Indigenous prisoners may be required.