>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Alcohol Consumption and Problem Behavior Continued..

What effect has the drop in alcohol use had on self-reported social consequences of alcohol use and dependence symptoms? To explore this relationship between alcohol consumption and alcohol-related problems, data were examined from the most recent National Alcohol Survey (NAS) conducted in 1995 and compared to the prevalence rates of alcohol-related problems (social consequences and dependence symptoms) for the 1984 and the 1990 NAS.

Data were obtained from national household probability samples of selected housing units in 100 primary sampling units within 48 contiguous states. The instrument used for all three surveys included identical items on respondents' background, alcohol consumption, and alcohol-related problems.

In summary, at a broad level very few changes in reports of social consequences and dependence symptoms were found for the study period of 1984 through 1995. No significant differences were found for the overall index of social consequences and dependence symptoms; three of the five subscales of social consequences (fights/arguments, health, and negative reactions) also showed no changes. Two consequence subscales, legal/accidents and work problems, demonstrated significant decreases in prevalence rates from 1984 to 1990 only, but not from 1990 to 1995. Further, few overall changes were found over the eleven year period among demographic subgroups.

What do these findings imply given the continued downward shift in alcohol use based on sales data? One explanation is that due to cultural shifts in attitudes and norms, lowered alcohol use in the population provides the context for problem amplification. Thus, both serious and less serious problems stand out more and are more likely to be identified and reported. For example, a significantly higher frequency of drunkenness was reported in 1995, as opposed to 1979, based on national survey data, yet the number of drinks needed to be considered "drunk" was substantially less: 8.2 versus 6.3 drinks. This suggests a greater awareness of problematic behavior associated with alcohol and a stronger tendency to both recognize it and report it. There may also be more license given in dryer environments for people to express concern about drinking. Some researchers have demonstrated that concerns about drinking expressed by family members and friends increased dramatically from 1979 to 1990, a time period when alcohol consumption was decreasing in the population. Moreover, in a cross-cultural study of diagnosis and assessment of substance use, it was noted that... "In an environment where drinking is relatively infrequent and limited by finances and social disapproval, respondents may also give a level of attention...to the effects and possible consequences of drinking which those from a "wetter" cultural environment might find exaggerated." This suggests that as the U.S. gets "dryer," the tendency to "notice and name" alcohol problems is enhanced.

The data suggest that the rates of self-reported alcohol-related social consequences and dependence symptoms are stable, despite decreases in alcohol use in the U.S. Future research should continue to monitor these trends, as well as other indicators of cultural shifts in alcohol use, e.g., attitudes towards alcohol use, or situational norms.

Excerpted from Lorraine Midanik and Tom Greenfield (2000), "Trends in Social Consequences and Dependence Symptoms in the United States: The National Alcohol Surveys, 1984-1995," American Journal of Public Health 90(1). Lorraine Midanik on Alcohol Consumption and Problem Behavior "The data suggest that the rates of self-reported alcohol-related social consequences and dependence symptoms are stable despite decreases in alcohol use in the U.S."