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The Demographic Distribution of Drinking Patterns in 1984
Abstract
The demographic distribution of drinking and heavy drinking in a 1984 survey are presented to provide updated prevalence estimates for these phenomena. Several measures of drinking patterns are used, including: the frequency of drinking, the monthly volume consumed, the frequency of drinking five or more drinks on an occasion, the frequency of drinking eight or more drinks in a day, and the frequency of self-reported drunkenness. In most cases, the present results confirm earlier findings. However, the present data give better information on Black and Hispanic drinking patterns than was available in earlier surveys. Results not consistent with earlier studies are that there are contradictory findings regarding the relationship between socio-economic status and drinking and that the drinking patterns of divorced and separated men diverge from those of divorced and separated women.
... Further, among couples presenting for marital therapy, heavy drinking, particularly among the men, is very prevalent, and alcohol is often cited as a source of problems and disagreements (Halford & Osgarby, 1993). General population studies have often found that rates of heavy drinking, alcohol problems, and alcohol diagnoses are higher among individuals who are separated or divorced (Cahalan, Cisin, & Crossley, 1969;Hilton, 1991;Hasin, Stinson, Ogburn, & Grant, 2007), although these findings are sometimes stronger for men than women (e.g., Clark & Midanik, 1982;Hilton, 1991). Studies of alcoholics have consistently suggested that the rates of divorce and separations are considerably higher among alcoholics than among individuals in the general population. ...
... Further, among couples presenting for marital therapy, heavy drinking, particularly among the men, is very prevalent, and alcohol is often cited as a source of problems and disagreements (Halford & Osgarby, 1993). General population studies have often found that rates of heavy drinking, alcohol problems, and alcohol diagnoses are higher among individuals who are separated or divorced (Cahalan, Cisin, & Crossley, 1969;Hilton, 1991;Hasin, Stinson, Ogburn, & Grant, 2007), although these findings are sometimes stronger for men than women (e.g., Clark & Midanik, 1982;Hilton, 1991). Studies of alcoholics have consistently suggested that the rates of divorce and separations are considerably higher among alcoholics than among individuals in the general population. ...
... Despite its common-sense appeal, direct support for the hypothesis that excessive and problem drinking lead to divorce is, in fact, difficult to find. Much of the research linking alcohol and separation or divorce is cross-sectional in nature (e.g., Hilton, 1991), raising the possibility that the association may be due, at least in part, to other factors that may lead to both excessive drinking and marital instability. Several behavioral genetics studies using different approaches have found evidence for a shared genetic risk for alcohol disorders and divorce (Dick et al., 2006;Osler, McGue, Lund, & Christensen, 2008;Prescott & Kendler, 2001). ...
This study examined concordant and discrepant alcohol, tobacco, and marijuana use among couples to determine whether they predicted marital separation or divorce over 9 years. The study recruited 634 couples as they applied for their marriage licenses; we assessed them at that time and reassessed them with mailed questionnaires at their first, second, fourth, seventh, and ninth wedding anniversaries. Approximately 60% of the men and women were European American, and approximately 33% were African American. The frequency of drinking to intoxication and binge drinking (more than 5 drinks in an occasion) was assessed, as was the use of cigarettes and marijuana. At each assessment, each member of the couple was asked about the occurrence of marital separations and divorce. Bivariate analyses indicated that tobacco and marijuana use, whether discrepant or concordant, were associated with marital disruptions. However, discrepant heavy drinking was associated with disruptions, but concordant heavy drinking was not. Concordant and discordant marijuana use were not associated with divorce when analyses controlled for alcohol and tobacco use. Concordant and discordant tobacco use was not associated with divorce when analyses controlled for sociodemographic and personality factors. However, discrepant alcohol use was related to divorce after controlling for the other substances in 1 analysis and after controlling for the sociodemographic factors in a separate analysis. Tobacco and marijuana use were related to divorce through their associations with other variables. However, results suggest that discrepant alcohol use may lead to marital disruptions and should be addressed with couples seeking marital treatment. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
... Most research points to a negative association between age and alcohol outcomes, with younger adults consuming more alcohol and therefore being at greater risk of negative alcohol-related consequences compared to older adults. Alcohol consumption tends to peak when adults are in their twenties with gradual decreases in use over the remaining life-course (Hilton, 1991). ...
... Marital status has often been linked to drinking patterns. Married individuals generally drink less in terms of overall consumption (Dee, 2002;Fillmore et al., 1997;Wilsnack and Wilsnack, 1991), are less likely to engage in binge drinking (Dee, 2002;Herd and Grube, 1993;Hilton, 1991;Schulenberg et al., 1996), and more likely to be abstainers when compared to single or divorced individuals. Thus, a set of dummy variables consisting of single, divorced/separated, widowed, and married (omitted category) will be utilized in the multivariate models. ...
... Gender is also an important variable to include in models of drinking behavior because research has consistently documented significant differences between women and men. Research has demonstrated that women are more likely to abstain from alcohol (Blum and Roman, 1997;Hilton, 1991), to consume less (Blum and Roman, 1997;Fillmore et al., 1997;Rodgers et al., 2000;Shore, 2001;Shore, 1997), to be less likely to binge drink (Dee, 2001;Shore, 1990;Wechsler et al., 1995a), and to be less likely to be a problem drinker (Rodgers et al. 2000;Smart et al. 1991). ...
While the risky drinking practices of college students have been well documented, less attention has focused on their peers who are employed in the full-time labor force. Young workers between the ages of 18 and 24 are expected to drink in patterns similar to that of college students, which will be substantially different from older workers. In addition, this research models the associations of job-related stressors, such as low job autonomy, low substantive complexity, and high job pressure, on alcohol-related measures using the "self-medication" framework. It also examines the relationship between abusive supervision and alcohol outcomes. It is hypothesized that young workers are more likely to experience negative working conditions, which results in greater alcohol consumption and greater problem drinking than older workers. Furthermore, interactions between age and these work-related variables on the alcohol-related measures are estimated to test the argument at younger workers face unique risks due to having limited coping resources. Using data from a nationally representative sample of full-time American workers, the results indicate support for the argument that young workers engage in drinking behaviors similar to those of college students. In addition, younger workers consume more alcohol, engage in more binge drinking, and are more likely to be alcohol dependent than older workers. There is general support for the "self-medication" model of drinking behaviors, such that stressful working conditions are associated with greater alcohol consumption and problem drinking. Compared to older workers, younger workers are at greater risk of experiencing negative working conditions. There is modest support for a model that includes interaction effects, suggesting several instances where the associations are stronger for younger workers. These findings suggest that younger worker drinking is a social problem on par with that of college student drinking, and therefore warrants a similar public health response. The devotion of greater research resources towards studying younger workers and the development of targeted prevention and intervention techniques may yield important public health benefits and benefit employers.
... While separation may provide some escape from a poor relationship, the transition to divorce may bring a change in life circumstances that induces depression (Menaghan & Lieberman, 1986). Empirical research has also shown a relationship between marital status and use of alcohol (Fecaces, Harford, Williams, & Hanna, 1999;Hanna, Faden, & Harford, 1993;Hilton, 1991;Power & Estaugh, 1990;Stack & Bankowski, 1994). Results from cross-sectional studies have found that separated or divorced people drink more alcohol than married people (Cahalan & Cisin, 1976;Hilton, 1991). ...
... Empirical research has also shown a relationship between marital status and use of alcohol (Fecaces, Harford, Williams, & Hanna, 1999;Hanna, Faden, & Harford, 1993;Hilton, 1991;Power & Estaugh, 1990;Stack & Bankowski, 1994). Results from cross-sectional studies have found that separated or divorced people drink more alcohol than married people (Cahalan & Cisin, 1976;Hilton, 1991). A meta-analysis of 12 longitudinal studies conducted in North ...
... " Response categories were yes, and no (Cronbach's alpha for the five items was .68). The respondent was coded as a non-problematic drinker (i.e., coded 1) if they answered " no " to all of the questions; otherwise, if the respondent answered " yes " to any of the questions the respondent was coded 0. Descriptive statistics for the weighted analytic sample indicated that 12% of respondents were classified as problem drinkers, closely mirroring reports from other national samples (CDC, 1997; Hilton, 1991b) (seeTable 1). We found that more men than women (18% versus 7%, respectively) reported an alcohol related problem (CDC, 1997; Hilton, 1991b). ...
... The respondent was coded as a non-problematic drinker (i.e., coded 1) if they answered " no " to all of the questions; otherwise, if the respondent answered " yes " to any of the questions the respondent was coded 0. Descriptive statistics for the weighted analytic sample indicated that 12% of respondents were classified as problem drinkers, closely mirroring reports from other national samples (CDC, 1997; Hilton, 1991b) (seeTable 1). We found that more men than women (18% versus 7%, respectively) reported an alcohol related problem (CDC, 1997; Hilton, 1991b). ...
... Alcohol is commonly mixed with marriage. According to a recent national survey, 73% of married men and 63% of married women drink alcohol (Hilton, 1991). Thus, for a majority of couples, drinking has the potential to both affect and be affected by marital events. ...
... drinks, 17%, 11%; 0-14.9 drinks, 36%, 62%; abstainers, 9%, 15%. The sample has a somewhat lower proportion of abstainers than in data collected from nationally representative sam-ples (e.g., Hilton, 1991), but this may be accounted for by the younger age of this newlywed sample and perhaps even by the fact that some individuals who would have otherwise abstained in the past year consumed alcohol at their wedding celebration. With the exception of rates of abstention, the sample otherwise evidences drinking rates comparable with national averages for both men and women. ...
Using cluster analysis, we identified a natural typology of drinking partnerships in early marriage. We found an interpretable five-cluster solution that evidenced significant and meaningful relationships with both marital functioning and drinking consequences. Cluster profiles were derived from husbands' and wives' drinking frequencies, typical quantities, the percentage of couple's total drinking done in each other's presence, and the percentage of couples' drinking done in the home. Clusters characterized by high levels of consumption were not uniformly associated with lower marital quality. Moreover, significant relationships between the drinking partnerships and both marital functioning and alcohol consequences held after statistically controlling for husbands' and wives' monthly alcohol volumes. The multidimensional notion of a drinking partnership may be useful in future efforts to understand the implications of alcohol use for marriage and family life.
... Of course, drinking becomes problematic and even tragic for many young people and for those around them. When viewed across the life span, heavy drinking, problems caused by drinking (e.g., physical and emotional distress, school and work difficulties), and alcoholrelated risky behaviors and illegal activities (e.g., alcohol-related traffic and other accidents, unprotected sexual activity, violence) peak during late adolescence and early adulthood (Baer, 1993;Hilton, 1991;Fillmore, Johnstone, Leino, & Ager, 1993;Wilsnack, Wilsnack, & Klassen, 1984), as do problems with substance abuse in general (e.g., Glantz, Weinberg, Miner, & Colliver, 1999;Johnston et al., 1999). This period in life is an important juncture in the etiology of adult alcohol abuse and alcoholism, a time when initiation and escalation of heavy drinking may set the stage for lifelong difficulties with alcohol (e.g., Babor et al., 1992;Cloninger, 1987;Zucker, 1987). ...
https://deepblue.lib.umich.edu/bitstream/2027.42/137876/1/occ51.pdf
... • (Solo para chicas) provenir de familias con altos niveles de ingresos y disponer de mayor cantidad de dinero al mes (Wiesner y cols., 2007). Hilton, 1991), los problemas para hacer frente a las tareas de desarrollo (Pandina, Labouvie, Johnson y White, 1990) y un mayor número de problemas de salud (Baer, 2002;Parker, Parker, y Harford, 1991). ...
Factores que incrementan la vulnerabilidad hacia el alcoholismo 1. Prevalencia del consumo de alcohol en la juventud española 144 2. Factores que predisponen al inicio en el consumo de alcohol 144 2.1. Ámbito familiar 146 2.2. Ámbito comunitario o ambiental 148 2.3. Ámbito de relaciones con iguales 150 2.4. Ámbito escolar 151 2.5. Ámbito personal 153 3. Factores que favorecen la vulnerabilidad hacia el alcoholismo 157 4. Bibliografía 167
... Another important finding, largely consistent with Zerbini et al. [19] and Holmgren and Jones [20], is that BAC levels among male and female suicide decedents were surprisingly similar. In other words, although general living population data have consistently showed that men are more likely than women to drink and to drink in excess [21][22][23], among suicide decedents there appeared to be virtual gender parity in acute alcohol use immediately prior to their death. One possible explanation for this finding is that women are more likely than men to poison themselves and alcohol may be used as one of the poisoning agents in combination with other substances. ...
Purpose:
Few studies have compared acute use of alcohol in suicide decedents with that in a nonsuicide group. This study provides the first national analysis of acute use of alcohol before suicide compared with an estimate of acute use of alcohol in a living sample.
Methods:
Pooled 2003-2011 National Violent Death Reporting System data were used to estimate the prevalence of postmortem blood alcohol content positivity (blood alcohol content >0.0 g/dL) and intoxication (blood alcohol content ≥0.08 g/dL). Population estimates of comparable use of alcohol (within the past 48 hours) were based on the National Epidemiologic Survey on Alcohol and Related Conditions.
Results:
Compared with the living sample, male and female suicide decedents showed, respectively, a 1.83-fold (95% confidence interval [CI], 1.73-1.93) and 2.40-fold (95% CI, 2.24-2.57) increased risk of alcohol ingestion before their death after age, race/ethnicity, and chronic alcohol problems were controlled. Furthermore, male and female decedents exhibited, respectively, a 6.18-fold (95% CI, 5.57-6.86) and a 10.04-fold (95% CI, 8.67-11.64) increased risk of being intoxicated before their death after confounders were considered.
Conclusions:
The findings underscore the crucial need to include among the essential components of suicide prevention policies programs that minimize the use of alcohol, particularly drinking to intoxication.
... In Table 5 we extend the analysis of the problem score to the question of variations by age. Argentinian males show the pattern which is commonly found in studies in the U.S. (Hilton, 1991) and some other developed countries (though not all): the highest rate of alcohol-related problems in young adulthood, a substantial drop-off after that, and a further drop-off in older age. Costa Rican females also show this pattern, but elsewhere in the table the patterns are diverse. ...
... An exception in the U.S. population is the Hispanic group, who also report hi-gher levels of consumption during middle age, especially among men (Caetano, 1991). Thus, higher levels of consumption in the U.S. population have been associated with a youthful lifestyle (Hilton, 1991). Among U.S. Hispanics, the freedom to drink is more associated with the maturity that comes during the middle age years (Caetano, 1989;Caetano & Kaskutas, 1995). ...
This paper describes patterns of alcohol consumption and associated problems in Brazil. Data came from a multicluster random sample of 2,346 Brazilians 18 years of age and older. The survey was conducted in 2005-2006 and had a response rate of 66.4%. About 35% of the men and 59% of the women did not drink in the past 12 months, while 39% of the men and 13% of the women consumed alcohol at least once a week. Further, 38% of the men and 17% of the women consumed 5 or more drinks "usually", and 40% of the men and 18% of the women reported binge drinking in the past 12 months. The prevalence of alcohol use disorders (DSM-4 abuse and/or dependence) was 19% among men and 4% among women. Although abstinence in Brazil is relatively high, binge drinking is frequent and, thus, alcohol problems and alcohol use disorders are also frequent.
... Longitudinal research has demonstrated that the transition to and first year of marriage serves a buffering function, with respect to heavy drinking, alcohol problems, and AUDs (Bachman, Wadsworth, O'Malley, Johnston, & Schulenberg, 1997;Chilcoat & Breslau, 1996). Findings from national cross-sectional and longitudinal surveys indicate that married individuals drink less than those who are single, separated, or divorced, and that the presence of AUD symptoms was significantly lower among individuals who became or stayed married over time relative to those who remained single or became divorced (Chilcoat & Breslau, 1996;Hilton, 1991). Moreover, this decline in heavy drinking emerges in the year prior to marriage (Leonard & Mudar, 2000), suggesting that as these individuals anticipated the transition into a new social role, heavy drinking decreased. ...
This article reviews current literature examining problematic alcohol use and marital distress and introduces a new alcohol and marriage model within the theoretical framework of interdependence theory. Although marriage is generally associated with decreased heavy drinking and alcohol problems, many couples develop and maintain alcohol use disorders during committed relationships and marriage. When one person is affected by an alcohol use disorder, it both affects and is affected by their close relationships, particularly the relationship with their partner or spouse. While the causal connections between problematic drinking and marital distress are complex and only partially understood, available evidence demonstrates that the two problems often exacerbate each other, forming a detrimental cycle. Research using cross-sectional and longitudinal methods reveals covariation between the two as well as support for both causal directions. New models using the Actor–Partner Interdependence Model (APIM) are presented and structured around the concept that these reverse temporal effects may be operating through different mechanisms and with different moderators. Thus, determinants are presented for each directional effect. Finally, avenues for future research are discussed.
... Lower educational level was associated with higher rates of both abstainers and heavy drinkers, while higher educational levels were associated with higher levels of light and moderate drinking. In the national US study of drinking in the general population (Hilton, 1991), the higher the social class the higher the numbers who drank above 60 drinks per month. But for heavy session drinking (8+ drinks per day or weekly intoxication) the class differences tended to disappear or reverse. ...
The association between light drinking and reduced mortality compared to lifetime abstinence is robust. Confounders, such
as unhealthy diet, social class, and social isolation, which are associated both with abstaining and with poorer health, have
made it difficult for doctors to assess the meaning of the association, and to know how to respond to individual patients
seeking advice on ‘drinking for health’. This paper attempts to bring up to date the evidence concerning the confounders.
The evidence for a preventive effect is reviewed according to pattern of alcohol use and type of patient. The balance of risk
to benefit appears to favour giving medical advice to some patients in middle life with uncontrollable risk factors for coronary
heart disease (and probably of ischaemic stroke), who are very infrequent drinkers, to increase slightly the frequency of
drinking (not the per session amount) and for some abstainers to consider starting to take alcohol. However, caveats render
quite small the number of patients to whom physicians will give this advice. There is also the theoretical risk of a ripple
in the population such that more people may move into harmful drinking.
... Nevertheless, epidemiological studies show that younger women have higher rates of heavy drinking and alcohol-related problems than do older women (CDC, 2004;Wilsnack et al., 1994). Women ages 21 to 30 have the highest rates of intoxication, problem drinking, heavy episodic drinking, and alcohol dependency symptoms (Hilton, 1991;Wilsnack & Wilsnack, 1993), and have a low number of abstainers compared with older age groups (Graham, Wilsnack, Dawson, & Wogeltanz, 1998). ...
... Of course, drinking becomes problematic and even tragic for many young people and for those around them. When viewed across the life span, heavy drinking, problems caused by drinking (e.g., physical and emotional distress, school and work difficulties), and alcoholrelated risky behaviors and illegal activities (e.g., alcohol-related traffic and other accidents, unprotected sexual activity, violence) peak during late adolescence and early adulthood (Baer, 1993;Hilton, 1991;Fillmore, Johnstone, Leino, & Ager, 1993;Wilsnack, Wilsnack, & Klassen, 1984), as do problems with substance abuse in general (e.g., Glantz, Weinberg, Miner, & Colliver, 1999;Johnston et al., 1999). This period in life is an important juncture in the etiology of adult alcohol abuse and alcoholism, a time when initiation and escalation of heavy drinking may set the stage for lifelong difficulties with alcohol (e.g., Babor et al., 1992;Cloninger, 1987;Zucker, 1987). ...
... This phenomenon seems to be linked with acknowledgment of religious affiliation as well as the report of religious practices. Alcohol and drug use-related problems are associated with a current lack of religious affiliation and involvement (Larson and Wilson, 1980; Hilton, 1991). A national study in the United States concluded that persons for whom religion was important were less likely to have drinking problems (Midanik and Clark, 1995). ...
... There is considerable evidence published about the association between alcohol consumption and related social consequences (Jellinek 1946, Straus and Bacon 1953, Knupfer 1967, Cahalan and Room 1974, Hilton 1991a, 1991b, Edwards et al. 1994, Rehm and Fischer 1997, Leifman 2000. Nonetheless, there have been surprisingly few studies that address the question of how these measures of harm in survey research can be combined into summary measures. ...
Despite the long tradition for asking about the negative social and health consequences of alcohol consumption in surveys, little is known about the dimensionality of these consequences. Analysing cross-sectional and longitudinal data from the Nordic Taxation Study collected for Sweden, Finland, and Denmark in two waves in 2003 and 2004 by means of an explorative principal component analysis for categorical data (CATPCA), it is tested whether consequences have a single underlying dimension across cultures. It further tests the reliability, replicability, concurrent and predictive validity of the consequence scales. A one-dimensional solution was commonly preferable. Whereas the two-dimensional solution was unable to distinguish clearly between different concepts of consequences, the one-dimensional solution resulted in interpretable, generally very stable scales within countries across different samples and time.
... Alcohol and drug use-related problems are associated with a current lack of religious affiliation and involvement (Larson and Wilson, 1980;Hilton, 1991). A national study in the United States concluded that persons for whom religion was important were less likely to have drinking problems (Midanik and Clark, 1995). ...
Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction because its perceived role in the promotion of meaningfulness in the recovery from addiction. Our review of the literature evaluates different domains relative to the relation between addiction, religion, and psychiatric treatment. Spirituality as a protective or precipitating factor for substance use and as a key component of recovery will be debated. Illustrations of its potential and limitations as a component of treatment will be presented. Types of investigation and integration of this dimension in an eventual therapeutic process strictly respecting the needs and specificities of each one will be discussed.
... Longitudinal research has demonstrated that the transition to and first year of marriage serves a buffering function, with respect to heavy drinking, alcohol problems, and AUDs (Bachman, Wadsworth, O'Malley, Johnston, & Schulenberg, 1997;Chilcoat & Breslau, 1996). Findings from national cross-sectional and longitudinal surveys indicate that married individuals drink less than those who are single, separated, or divorced, and that the presence of AUD symptoms was significantly lower among individuals who became or stayed married over time relative to those who remained single or became divorced (Chilcoat & Breslau, 1996;Hilton, 1991). Moreover, this decline in heavy drinking emerges in the year prior to marriage (Leonard & Mudar, 2000), suggesting that as these individuals anticipated the transition into a new social role, heavy drinking decreased. ...
How much and why individuals in romantic relationships drink alcohol may be a function of both personal and relational influences. The current research examined factors that predict vulnerability to health-related risky behavior (i.e., drinking to cope and drinking problems) in response to relationship difficulties. We consider the possibility that for individuals whose self-worth is contingently tied to the fluctuations of their relationship, feeling less satisfied may predict increased drinking problems; moreover, this may be mediated by drinking to cope. This study evaluated relationship-contingent self-esteem (RCSE) as a moderator of the association between relationship satisfaction and coping motives, which was expected to predict alcohol problems in couples. Both members in committed relationships (N = 78 dyads) reported relationship satisfaction, RCSE, drinking to cope motives, and alcohol problems in a cross-sectional survey. Actor-Partner Interdependence Model analyses revealed significant mediated moderation among men, such that higher RCSE interacted with lower relationship satisfaction to predict stronger coping motives, in turn predicting increased drinking problems. Implications and future directions are discussed.
... It may be that both women and men are affected unfavourably by the effects of alcohol. However, since men generally tend to drink more than women (Hilton, 1991), the magnitude of the decrease in longevity of men is greater than that in women, which results in a female advantage in the gender differential. It is also possible that men consume most of the per capita recorded alcohol consumption, since male drinking is more widely accepted. ...
We studied the gender gap in life expectancy (GGLE), which currently favours women on average by 5 years. Individual data from 54 societies were extracted from the 1999-2004 wave of the World Values Survey. The GGLE was not predicted by the socio-economic factors of gross domestic product (GDP) or Gini coefficient, but was increased by national level of alcohol consumption, and decreased by gender differences in national levels of life satisfaction. Different national-level phenomena appear to be responsible for male and female contributions to the GGLE. National levels of male longevity were responsive to GDP, Gini coefficient, social engagement, tobacco use and life satisfaction, whereas female longevity rates were responsive only to GDP and alcohol consumption, underscoring the greater sensitivity of male longevity to contextual features of the nations where they live.
... For alcohol and cannabis, by contrast, the rates of lifetime dependence among lifetime users are more than twice as high among men as among women, whereas among nonmedical users of psychotropics such as sedatives and tranquilizers, women are significantly more likely than men to develop dependence. The reasons for drug-specific sex differences in dependence among users may stem from greater use of alcohol by males than females (Hilton 1991, pp. 73-86) and the possibility that among psychotherapeutic users, females use more heavily than males. ...
... Lower rates of alcohol use disorders have been associated with private practices of prayer and scripture reading [63]. Consistently, research has demonstrated that alcohol-related negative consequences and alcohol use disorders among the highest-risk religious group, drinking members of conservative Protestant denominations [63,71], are still only 40% of those for drinkers without religious affiliation [53]. ...
This chapter aims to provide a broad overview of self-help approaches for addictions, with specific examples for specific substances. There are several reasons why an individual may choose self-help methods as an alternative to professional treatment, including but not limited to geographic barriers, cost, stigma, and shame associated with substance use. This chapter focuses on relevant literature related to self-help in substance use disorders, including reviews of natural recovery, maturation effects, and the Transtheoretical Model of Change. Techniques such as substance substitution, bibliotherapy, helplines, spirituality and meditation, and Internet resources are discussed as they relate to specific self-help approaches, applicability to various addictive substances, availability to self-administrators, and efficacy of different techniques. The existing literature on self-help strategies is relatively promising, suggesting that in addition to being of lower cost and widely available, self-help is also relatively effective. However, compared with the treatment literature, the literature concerning specific self-help strategies is considerably smaller and composed of fewer controlled studies. Thus, caveats regarding the appropriateness of self-help strategies exist and are reviewed.
... Among such affected social bonds are long-term relationships between spouses. In a survey exploring the demographic distribution of drinking patterns, 73% of married men and 63% of married women stated that they drink alcohol (1). Heavy alcohol use during a marriage has been associated with decreased marital satisfaction and increased rate of divorce (2)(3)(4)(5)(6). ...
... Among such affected social bonds are long-term relationships between spouses. In a survey exploring the demographic distribution of drinking patterns, 73% of married men and 63% of married women stated that they drink alcohol (1). Heavy alcohol use during a marriage has been associated with decreased marital satisfaction and increased rate of divorce (2)(3)(4)(5)(6). ...
Alcohol abuse can have devastating effects on social relationships. In particular, discrepant patterns of heavy alcohol consumption are associated with increased rates of separation and divorce. Previous studies have attempted to model these effects of alcohol using socially monogamous prairie voles. These studies showed that alcohol consumption can inhibit the formation of pair bonds in this species. While these findings indicated that alcohol’s effects on social attachments can involve biological mechanisms, the formation of pair bonds does not properly model long-term human attachments. To overcome this caveat, this study explored whether discordant or concordant alcohol consumption between individuals within established pairs affects maintenance of pair bonds in male prairie voles. Male and female prairie voles were allowed to form a pair bond for 1 week. Following this 1-week cohabitation period, males received access to 10% continuous ethanol; meanwhile, their female partners had access to either alcohol and water or just water. When there was a discrepancy in alcohol consumption, male prairie voles showed a decrease in partner preference (PP). Conversely, when concordant drinking occurred, males showed no inhibition in PP. Further analysis revealed a decrease in oxytocin immunoreactivity in the paraventricular nucleus of alcohol-exposed males that was independent of the drinking status of their female partners. On the other hand, only discordant alcohol consumption resulted in an increase of FosB immunoreactivity in the periaqueductal gray of male voles, a finding suggesting a potential involvement of this brain region in the effects of alcohol on maintenance of pair bonds. Our studies provide the first evidence that alcohol has effects on established pair bonds and that partner drinking status plays a large role in these effects.
... In Table 5 we extend the analysis of the problem score to the question of variations by age. Argentinian males show the pattern which is commonly found in studies in the U.S. (Hilton, 1991) and some other developed countries (though not all): the highest rate of alcohol-related problems in young adulthood, a substantial drop-off after that, and a further drop-off in older age. Costa Rican females also show this pattern, but elsewhere in the table the patterns are diverse. ...
... Would it be fair to expect this higher level of conceptual understanding from persons who are new in recovery? Studies indicate that, at the moment when addicts enter treatment, they tend to have a lower degree of active spiritual or religious involvement than the general population (Hilton, 1991;Larson & Wilson, 1980;Miller, 1998). ...
This study expands the role of transpersonal psychology in the treatment of addiction and offers a revised theoretical model that is, in effect, a spiritual alternative to the Twelve-step approach. First, the current transpersonal model of addiction is deconstructed based on three of its core suppositions: (a) that Twelve-step programs are spiritual rather than religious, (b) that they are philosophically congruent with transpersonal theory, and (c) that they are the most effective treatment for addiction. Next, aspects of two major theoretical trends in transpersonal studies, the integral and the participatory perspectives, are then implemented as foundational supports for extending the traditional transpersonal model of addiction beyond its current boundaries. Addiction research from different fields and disciplines is also referenced to ensure that the model is effective, appropriate, and relevant.
... An exception in the U.S. population is the Hispanic group, who also report hi-gher levels of consumption during middle age, especially among men (Caetano, 1991). Thus, higher levels of consumption in the U.S. population have been associated with a youthful lifestyle (Hilton, 1991). Among U.S. Hispanics, the freedom to drink is more associated with the maturity that comes during the middle age years (Caetano, 1989;Caetano & Kaskutas, 1995). ...
Este articulo describe los patrones de consumo de alcohol y los problemas asociados en Brasil. Los datos provienen de una muestra aleatoria multicluster de 2.346 brasilenos de 18 y mas anos de edad. La encuesta fue llevada a cabo en el periodo 2005-2006 y tuvo una tasa de respuesta del 66,4%. Alrededor del 35% de los hombres y 59% de las mujeres no habian bebido durante los ultimos 12 meses, mientras que el 39% de los hombres y el 13% de las mujeres consumian alcohol al menos una vez a la semana. Ademas, el 38% de los hombres y el 17% de las mujeres consumian “por lo general” 5 o mas bebidas, y el 40% de los hombres y el 18% de las mujeres informaron de un consumo intensivo (binge drinking) en los ultimos 12 meses. La prevalencia de los trastornos por consumo de alcohol (abuso y/o dependencia segun el DSM-IV) fue del 19% para los hombres y 4% para las mujeres. A pesar de que la abstinencia es en Brasil relativamente alta, el consumo excesivo de alcohol es frecuente y, por lo tanto, los problemas de alcohol y los trastornos por consumo de alcohol tambien lo son.
... Alcohol and drug use-related problems are associated with a current lack of religious affiliation and involvement (Larson and Wilson, 1980;Hilton, 1991). A national study in the United States concluded that persons for whom religion was important were less likely to have drinking problems (Midanik and Clark, 1995). ...
Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction because its perceived role in the promotion of meaningfulness in the recovery from addiction. Our review of the literature evaluates different domains relative to the relation between addiction, religion, and psychiatric treatment. Spirituality as a protective or precipitating factor for substance use and as a key component of recovery will be debated. Illustrations of its potential and limitations as a component of treatment will be presented. Types of investigation and integration of this dimension in an eventual therapeutic process strictly respecting the needs and specificities of each one will be discussed.
Objective: To examine the adverse consequences of drinking reported by a subsample of participants in the Australian arm of the GenACIS (Gender Alcohol and Culture: an International Study). Design and method: A random sample of adults (18+, N = 1,608) was interviewed by telephone for self-reported experience of adverse consequences of alcohol consumption. Results: Ten per cent reported experiencing either alcohol related life-area problems and/or physical/emotional/legal problems as a result of their drinking in the previous year. Around 4% reported getting into a fight after they had been drinking and 6% reported adverse effects of alcohol on their physical health. There were variations by age, and other correlates, such as drinking patterns, but not by gender. For example, while only 4% of the sample aged 35–44 reported being injured or injuring someone else, 17% of the sample aged under 25 reported being injured or injuring another. Conclusions: Young Victorians and those who reported riskier drinking were generally more likely to report experiencing adverse consequences than older Victorians and those who reported less risky drinking. This is important in the Australian context, with a focus on the harms associated with young people's drinking the subject of much recent public debate.
This chapter debunks the common myth about 12-step programs and discusses the research findings on them. It provides practical tips for facilitating involvement in 12-step programs. It also covers the role of religion and spirituality in addiction treatment and recovery. Practical tools about integrating religion and spirituality in recovery are presented.
Prenatal exposure to alcohol or other drugs can impair physical, intellectual, and behavioral development. An understanding of how these drugs act and interact with one another and with lifestyle factors is necessary to plan effective prevention and intervention efforts.
Previous research has consistently reported that alcohol consumption among the general population varies across cultural groups. However, studies investigating risk factors and drinking patterns of African-Americans and Caucasians with disabilities have been limited. The current study explored the factors of alcohol use among African-Americans and Caucasians with disabilities who were seeking rehabilitation services in three mid-western states of the USA. Multivariate data analysis revealed that African-Americans were more likely to use alcohol than their Caucasian counterparts when other demographic and disability variables were controlled. Additionally, separate multiple-regression models differentiated patterns between African-Americans and Caucasians in selected variables on alcohol use. Cultural issues and implications for rehabilitation services are discussed.
Substance use patterns and predictors of substance use by women aged 65 and over were examined using data from the Canadian National Alcohol and Other Drugs Survey (1989). Use patterns were consistent with findings from previous surveys: that older women drink less alcohol, smoke less and use less illicit drugs than other age-gender groups. Also consistent with previous surveys, older women reported the highest rate of psychoactive prescription drug use of all groups. Bivariate analyses indicated significant relationships between some social and demographic variables and substance use. Drinking was associated with being single, younger, not religious, in better health, and smoking. Smoking was associated with being younger, not religious, in poorer health, having less social support, drinking, and use of psychoactive prescription drugs. Use of psychoactive prescription drugs (especially sleeping pills) tended to be associated with being widowed, older, less educated, more religious, in poorer health, experiencing higher stress, having lower income and less social support, smoking, and use of other psychoactive prescription drugs. When data were analysed using principal component analysis, two very consistent dimensions of substance use emerged for older women: greater religiosity associated with less drinking and smoking, and a dimension involving use of all types of psychoactive prescription drugs. These findings are discussed in terms of projected use patterns for future older women and the need for a better understanding of the social context of older women's substance use that involves light to moderate alcohol use but a higher rate of use of psychoactive prescription drugs than other age-gender groups.
Little is known about the drinking habits of individuals who develop Alzheimer's disease. A pilot survey of 84 autopsy-confirmed Alzheimer cases was carried out to explore a possible role of alcohol consumption in the onset and duration of Alzheimer's disease. Information on the drinking habits of deceased patients for a 15-year period prior to the onset of the disease was obtained from a surrogate respondent (next of kin) and from the patients' medical records. Alzheimer patients' drinking patterns were comparable to those of the general population. Patients with a history of alcohol abuse did not develop Alzeimer's disease at an earlier age than abstainers or occasional, light or moderate drinkers. Although not statistically significant, duration of survival in Alzheimer's disease was a few years shorter in patients with a history of alcohol abuse.
Abusing alcohol at the work place in Malaysia is not common and most workers drink in public drinking places. Despite the harmful effects of alcohol, little is known on the prevalence, pattern, and effects of alcohol use in non-Muslim young adult workers. The aim of this study is to asses the influence of alcohol drinking pattern on the work performance in non-Muslim young adults. A sample of 50 non-Muslim workers with age range from 20 to 40 years was selected randomly from Kuala Lumpur. Questionnaires were administered focusing on their socioeconomic background, drinking pattern, the reason for drinking, the effect of drinking on their job performance and the job-related factors encouraging drinking. The results show that the majority of the workers are Buddhist, Chinese, single and holding a degree or diploma. Most of them are infrequent drinkers, drinking for 16 to 20 years, preferring beers or mixed drinks at pub or discos and after working hours. Most of them drink because it is required on the job, work stress and health benefits. Their work performance are mostly affected by drinking distilled spirits, level of education, fatigue or tiredness, poor concentration and motivation at work. Work stress does not seem to have significant influence on the
Despite evidence indicating that socioeconomic status is multidimensional, health behavior research frequently “controls for” education or income as monolithic indicators of SES. Education and income (as well as other SES indicators) tap different aspects of SES, are only moderately correlated, and can each independently influence behavior. The specific aims of this study were to: (1) describe and disaggregate the association between different indicators of socioeconomic status—educational attainment, employment status (as a proxy for occupational status), individual income, and household income—and multiple health behaviors; (2) examine the pattern of association between SES and health behaviors by gender; and (3) explore different hypotheses linking SES and health behaviors. In this study, like previous work, educational attainment had the most consistent relationship with different health behaviors, particularly among men. However an interesting pattern of associations between different dimensions of SES and different health behaviors emerged in multivariate analyses, as did several gender differences. Although fewer psychological resources (i.e. higher levels of depression and lower feelings of control) explained the SES disadvantage in terms of sedentary living, little evidence of mediation was found for other SES-health behavior linkages. Results from this study suggest that multiple aspects of socioeconomic disadvantage can undermine various behaviors related to health. Health interventions targeting lower status populations may need to incorporate specific strategies addressing different aspects of social class.
Misuse and abuse of legal and illegal drugs constitute a current and growing problem among older adults. This chapter reviews the prevalence, risks and protective factors, screening and diagnosis, and treatment of drug abuse in older adults. Despite a wealth of information on the epidemiology and treatment of alcohol abuse in older adults, few data are available on drug abuse in this population. Limited evidence suggests that although illegal drug use among older adults is relatively rare compared to younger adults and adolescents, there is a growing problem of prescription drug misuse and abuse, with nonmedical use of prescription drugs among all adults aged ≥50 years estimated to increase to 2.7 million by 2020. Factors associated with drug misuse and abuse in older adults include female sex, social isolation, history of a substance use or mental health disorder, and medical exposure to prescription drugs with abuse potential. The paucity of validated screening and assessment instruments impedes the identification and diagnoses of substance use disorders in the older population. Thus, special approaches may be necessary when treating substance use disorders in older adults with multiple comorbidities and/or functional impairment, with the least intensive approaches considered first. In conclusion, psychoactive medications with abuse potential are used by at least one in four older adults. The treatment of substance use disorders in older adults may involve family and caretakers, and should take into account the unique physical, emotional, and cognitive factors associated with aging. Further research should focus on epidemiologic, health services, and screening and treatment aspects of drug abuse in older adults. © 2012 Springer Science+Business Media, LLC. All rights reserved.
To examine differences in alcohol consumption among Hispanic national groups in the United States [Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans] and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period).
The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. Comprehensive data on alcohol consumption were collected. Analyses included bivariate and multivariate regression techniques.
Puerto Rican and Mexican American men reported higher drinking rates, weekly consumption, and binge drinking than D/SC and Cuban Americans. Women drank significantly less than men. Mexican American women reported the highest abstention rate (61%); Puerto Rican women drank more per week and binged more frequently compared with their counterparts in other groups. Puerto Rican origin, initiating drinking during high school years (<18), and male gender (US- or foreign-born) were significant predictors of weekly alcohol consumption. Being younger, being single, Puerto Rican or D/SC American origin, initiating drinking at <18 years, being a US- or foreign-born male and being a US-born female were significant predictors of binge drinking.
There are considerable differences in drinking behavior across Hispanic national groups as well as between men and women. Results underscore the need to recognize heterogeneity in drinking practices while designing effective prevention interventions in the community.
Purpose: This study employed a static group comparison design with 106 men in residential treatment to examine the relationship of race to treatment retention. Methods: A retrospective analysis of retention, by race, including survival analysis, was undertaken. Results: Findings from the study indicated that (a) Caucasian men complete treatment more frequently than African American men, (b) Race was not predictive of time in treatment, and (c) that race was a factor in the receipt of both criminal justice coercion and case-management both of which were strong predictors of time in treatment. Conclusions: Race serves as a factor in the receipt of services related to retention. Future research should focus on further exploration how race impacts retention, and the interaction of race with coercion and the receipt of case-management.
Lesbians reportedly use alcohol more frequently and in greater quantities than heterosexuals, conceivably placing them at greater risk for alcohol-related problems. Past theorists have suggested psychosocial variables such as stress or the centrality of the gay bar to account for these findings. Researchers have not examined lesbian drinking within its historical, social, and cultural contexts.
This paper reviews findings of a qualitative interview study examining sexual identity development and alcohol use patterns of 31 self-identified lesbian social drinkers. Findings reveal the importance of multiple contexts to understanding lesbian drinking. The author proposes a correspondence between identity development and alcohol use, as both are affected by the changing social conditions of different historic eras. The normalized presence of alcohol in lesbian contexts and norms related to its use present distinctive dilemmas for alcohol problem identification and treatment with this population. These findings have several implications for practice with lesbian clients.
As a large proportion of the American population grows into old age, it is important to understand how long-term illnesses are affecting us. Chronic disease refers to a health-related state, lasting a long time, often defined as three months or longer (Timmreck, 1988). Risk factors for chronic diseases are genetic, environmental, behavioral, and social. For the purposes of this chapter, we will refer to behavioral and social risk factors as lifestyle factors in comparison to genetic or environmental factors. Some environmental factors may be related to lifestyle factors such as occupation; however, we will address these as environmental factors. Over the past decade there has been an increase in stress, sedentary lifestyles, high-density-population living, poor diet, crime, drugs, gangs, poverty, and pollution, many of which lead to chronic diseases (Timmreck, 1988). Rural health has been examined by looking at farmers, nonmetropolitan health centers, populations not adjacent to a metro area, and populations with less than 20,000 residents.
Data on abstention from a 1979 general population survey in the U.S.A. were analyzed and compared to data from a similar 1964 survey. Trend comparisons for the 15 year interval revealed few changes in abstention rates among various demographic categories. There was no evidence that the difference between male and female abstention rates has narrowed, that a more abstemious older generation is being replaced by a less abstemious younger generation, that there has been a regional convergence of abstention rates, or that the influence of religion on abstention has declined. A cluster analysis of reasons for abstaining (among lifelong abstainers) identified four sets of reasons: moral objection to drinking, dislike of the consequences of drinking, ‘inconsequential’ reasons, and abstinent family background. Compared to drinkers, abstainers consistently and significantly tended to disapprove of drinking by others in a variety of situational contexts. Militancy on these issues was stronger among abstainers from dry regions and among abstainers who were fundamentalist Protestants. Militancy was not, however, related to age or education. Lifelong abstainers who cited moral reasons for abstaining were more militant than those who did not.
The objective of this paper is to describe drinking patterns, alcohol problems, attitudes toward drinking and drunkenness, and attitudes toward appropriate drinking among Mexican-Americans, Puerto Ricans, and Cuban-Americans. Subjects were selected through a multistage probability procedure from the United States Hispanic population 18 years of age and older living in households. Data were collected in face to face interviews conducted in the respondent's home. The response rate for the survey was 72%. The results indicate that Mexican-Americans drink more and have more problems. While 22% of Mexican-American men report at least one alcohol problem, only 8% of Puerto Ricans and 3% of Cuban-Americans do so. Mexican-Americans are also more accepting of drinking than Puerto Ricans and Cuban-Americans. This is especially so when drinking means drinking enough to feel the effects of alcohol. The generalizability of these findings is somewhat limited by the small number of Cuban-Americans and Puerto Ricans interviewed in the 1984 survey analyzed here. Thus, rather than providing a definitive description of alcohol use among Cuban-Americans and Puerto Ricans on the mainland, this paper should be seen as an enticement for further research. Future studies with United States Hispanics should therefore attempt to confirm the findings in larger and more stable samples of these two groups.
Findings on alcohol consumption and alcohol problems from a 1984 general population survey are presented and compared to previous survey findings. Eighteen percent of all men and 5% of all women were classified as frequent heavy drinkers; 6% of all men drinkers and 2% of all women drinkers reported that they got "drunk" as often as once per week or more. A system for measuring drinking problems, based largely on the work of Cahalan and Room, is presented and explained. As when interpreting any system of measuring drinking problems in a general population survey, readers must be aware that the resulting prevalence rates are strongly influenced by arbitrary decisions about where cutpoints should be drawn. With this caveat in mind, the results show that 9% of men drinkers and 4% of women drinkers reported problematic drinking behavior at what is defined as a moderate level of severity. Similarly, 14% of men drinkers and 6% of women drinkers reported adverse tangible consequences of drinking at a moderate level of severity. The age and sex distributions of drinking, heavy drinking, intoxication, and drinking problems were as expected, with greater proportions of men than women reporting these things and greater proportions of younger than older drinkers reporting them.
This paper reports on the relationship between drinking patterns and acculturation of Hispanics to U. S. society. Subjects comprise a national probability sample of members of this ethnic group. Acculturation is a composite measure which covers language used, media preference and other aspects of daily life. Acculturation is associated with decreased abstention among older men, and with a higher rate of frequent heavy drinking among younger men. More acculturated women have five times more chance of being drinkers than women in the low acculturation group. Women in the high acculturation group have 9 times more chances of being frequent high maximum or frequent heavy drinkers than women in the low acculturation group. Overall, the association between drinking patterns and acculturation is stronger and more consistent for women than for men.
1984 U.S. survey data on alcohol consumption are compared to similar data from a 1964 survey and to a series of surveys taken between 1971 and 1981. This creates a wider set of trend comparisons than was available in a previous analysis, but does so at the cost of compromising comparability. Although most results indicate stability in drinking patterns, some results suggest that the prevalence of heavy drinking has increased among men. Among men and women, increases are more apparent among those aged 21-34years than among other age groups.
Recent studies have noted significant regional changes in American patterns of alcohol use. The present paper discusses regional differences in drinking patterns, problems, attitudes, and contexts as these have emerged along with the ‘wettening’ of the previously drier Southern and Mountain states. Data come from a 1984 national survey. Results indicate the persistence of regional differences in abstention rates and in apparent consumption levels when calculated on a per-drinker basis. The higher per-drinker apparent consumption levels in the historically drier regions are accompanied by higher levels of problems in the categories of belligerence, accidents, and trouble-with-the-police. These differences in problem rates, however, are apparent only among men, indicating an interplay between gender and region. Attitude measures do not show notable regional differences, which indicates unresolved tensions, in the drier regions, between relatively high (per drinker) consumption and relatively conservative drinking attitudes. Contextual evidence indicates that the limitation of public drinking opportunities in the drier regions is accompanied by more drinking in the home.
The distribution of both heavy drinking and drinking problems are well known from several previous studies. Not surprisingly, drinking problems are more prevalent among the demographic groups where heavy drinking is also more prevalent. This well-known conjunction, however, does little to determine whether some groups are more likely than others to experience drinking problems when we control for the amount of alcohol consumed. Here, this question is punned through a multiple regression analysis in which the dependent variable is a score on a drinking problem scale and the independent variables are: the frequency of heavy drinking occasions, sex, age, marital status, region, urbanicity, income, and education. The results indicate that none of these demographic variables had a strong association with the reported problem level.
Data from a 1984 general population survey of drinking practices and problems in the United States are compared with those from identically worded items in a 1967 survey. Results indicate that beverage preference changed between 1967 and 1984. Americans consumed more wine and beer but fewer distilled spirits in 1984. However, the volume of drinks consumed did not change significantly. There were few significant differences in drinking patterns with the exception of a small increase in the percentage of men who were abstainers in 1984. Mixed findings were obtained with regard to drinking problems. Little difference was found over time in the proportion of respondents experiencing any of nine possible problem consequences, but there was an increase in the proportion who reported experiencing one of four possible dependence problems. Implications of this survey for the single distribution theory of consumption are discussed.
The Socio-Cultural Correlates of Drinking Patterns in Black and White Americans: results from a national study
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