RESEARCH

Social Ecological Contexts of Heavy Drinking and Alcohol Use Disorders

Component Director: Paul J. Gruenwald, Ph.D.

Co-Investigator: Raul Caetano, M.D., M.P.H., Ph.D.

Introduction

In this component we are interested in finding out what aspects of our community environments promote heavy drinking and those alcohol-related problems that lead to a diagnosis of alcohol use disorders (AUD).

People are often surprised to find out that many heavy drinkers, those who drink six or more drinks on each occasion of use, are not diagnosed with AUD.  These heavier drinkers report that they do not have significant problems with their drinking and do not find it difficult to stop when they need to.  People are often also surprised to find out that many light drinkers, those who may drink three or fewer drinks on each occasion, are diagnosed with AUD.  These lighter drinkers report significant problems and have difficulty stopping when they need to.

So, there is a puzzle here:  Why are some lighter drinkers diagnosed with AUD while some heavier drinkers are not?  We believe the answer to this question can be obtained through a study of drinkers’ community environments.  The ways in which drinkers use alcohol in different contexts, for example when they drink at home or at a bar or restaurant, affect their use, the problems they experience when they drink, and the difficulties they confront when they try to stop.  We think these conditions also affect the incidence of AUD.

Research Goals and Activities

We are surveying about 3000 adult drinkers in California to ask about their drinking environments, the places and situations in which they drink (e.g., drinking alone or with others), problems related to their drinking in those contexts, and experiences that lead to symptoms of AUD.  We will identify a group of 250 drinkers who report symptoms of AUD and match each of these drinkers to two other drinkers who do not have symptoms of AUD but drink as much as they do.  We will follow both groups over the next two years to see how changes in their drinking environments and contexts are related to their drinking, problems, and AUD.

At the end of the study we will know much more about community environments and drinking contexts that are correlated with problems that lead to AUD and identify those that are etiologically significant to these diagnoses.  We will be able to estimate effects that community environments have on heavy drinking and rates of AUD as well as the contribution of drinkers who are diagnosed with AUD to community alcohol problems.