PRC Projects

Center Grant

Social Ecological Contexts of Heavy Drinking and Alcohol Use Disorders
Principal Investigator: Paul Gruenewald
Co-Investigator: Raul Caetano

In this component, we are interested in finding out the aspects of our community environments that promote or deter heavy drinking and that are associated with alcohol problems that would lead to a diagnose alcohol use disorders.

People are often surprised to find out that many heavy drinkers, those who drink on average six or more drinks on each occasion of use, are not diagnosed with alcohol use disorders. These heavier drinkers report that they do not have significant problems related to 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 drink on average 3 or fewer drinks on each occasion of use, are diagnosed with alcohol use disorders.  These lighter drinkers report that they do have problems related to their drinking and find it difficult to stop when they need to.

So, there is a puzzle here:  What could cause this disconnect between drinking, problems with alcohol, and diagnoses of alcohol use disorders?  Shouldn’t people with these disorders be heavy drinkers?  Why are any light drinkers diagnosed as alcohol dependent?  We believe the answers to these questions can be found in a study of drinkers’ community environments.  The ways in which drinkers use alcohol in different contexts in their communities determines many of the drinking problems they experience and the difficulties they confront when they try to stop.  By drinking contexts, we mean things like are they drinking in bars or at home or in friends’ homes?  When they are drinking, are the people around them drinking heavily?

To help answer these questions, we are surveying about 3000 adult drinkers in California and asking them for detailed information about their drinking environments, the places and situations in which they drink, problems related drinking in those contexts, and experiences that lead to symptoms of alcohol use disorders.  We will use data from this survey to identify a group of 250 drinkers who report symptoms of alcohol use disorders.  We will match each of these drinkers to two other drinkers who don’t have these symptoms, but who drink just as much as they do. Then, we will follow both groups over the next two years to see how changes in their drinking environments and contexts affect problems related to alcohol.

At the end of the study, we will know more about relationships between community environments and drinking and problems among drinkers with and without alcohol use disorders.  We will also be able to estimate the effects that community environments and the presence of people who are heavy drinkers or who have alcohol use disorders have on alcohol problems across communities in California.