Feelings of Guilt and Remorse After Alcohol Consumption Among People Who Drink at Increasing and Higher-Risk Levels: A Population Study in England

Introduction:
Feelings of guilt and remorse after drinking alcohol may act as barriers to seeking support. This study aimed to estimate the prevalence and frequency of such feelings among adults in England who drink at increasing and higher-risk levels, and differences by socio-demographic and drinking subgroups.

Methods:
We analysed data from 40,708 adults (≥ 18 years) who drink at increasing and higher-risk levels (AUDIT-C score ≥ 5) from a monthly cross-sectional survey in England from 2014 to 2022. Feelings of guilt and remorse after drinking in the past 6 months were assessed using the AUDIT. Logistic regression models were used to examine associations with socio-demographic characteristics, alcohol consumption and harm to oneself or others as a result of drinking.

Results:
Overall, 13.3% (95% CI 12.9%–13.6%) reported experiencing feelings of guilt or remorse after drinking in the past 6 months. Among those who reported such feelings, 95.3% (95% CI 91.4%–94.9%) experienced them less than once a month. The prevalence of guilt and remorse increased non-linearly with higher AUDIT-C scores from 9.3% (95% CI 8.8%–9.9%) among those drinking at the lightest levels within the increasing/higher-risk range [AUDIT-C = 5] to 20.9% (95% CI 17.2%–24.8%) among the heaviest [AUDIT-C = 12]. After adjusting for alcohol consumption and alcohol-related injury, these feelings were more common among women (aOR 1.38; 95% CI 1.31–1.46) and people from more advantaged social grades (aOR 1.27; 95% CI 1.20–1.36), and much less common among older than younger adults (e.g., ≥ 65 vs. 16–24 years: aOR 0.23; 95% CI 0.20–0.26).

Discussion and Conclusions:
In England, around one in eight adults who drink at increasing and higher-risk levels report experiencing guilt or remorse after drinking. These feelings are more common in women, younger adults and those of a more advantaged social grade.