New research finds that problem drinkers may reduce the amount of alcohol they consume over a period of years — but not to the level of the average adult.
Since heavy drinkers usually are unable to become “normal” drinkers on their own, the takeaway message for clinicians and family members is to help connect a problem drinker to professional support.
In the current study, simply telling someone that they had a drinking problem did not seem to be helpful. But being specific about how to get help — for example, Alcoholics Anonymous or a community support group — was beneficial.
Using a telephone screening program, researchers identified 672 problem and dependent drinkers who had not been in an alcohol treatment program for at least 12 months.
Although no standard definition for “problem drinking” yet exists, the researchers suggested that a problem drinker meet at least two of the following three criteria in the past year: (a) at least one alcohol-related social consequence (from a list of eight), (b) at least one symptom of alcohol dependence (from a list of nine), and (c) at least ﬁve drinks in a single day at least once a month (men) or at least three drinks in a single day weekly (women).
In a national, representative survey in 2004 – 2005, the average number of drinks per month amongst adults was 24 for men and 10 for women. The average number of drinks per month for problem and dependent drinkers in this study was 118 for men and 61 for women.
Eleven years later, both men and women in the study had reduced their average number of drinks per month by approximately half (62 drinks per month for men and 31 drinks per month for women).
However, even after this reduction, male and female problem drinkers still consumed 160 percent and 223 percent more alcohol, respectively, than the average adult without a drinking problem. If, however, abstainers are removed from the national survey data used in comparison, average consumption drops to 104 percent and 125 percent more than average, for men and women respectively.
The researchers point out that the greatest reductions in alcohol consumption occurred within one to two years after the initial screening and then slowed, suggesting that problem drinkers and heavy drinkers may never lower their consumption to the level of the general population.
“Most heavy drinkers maintain a steady level of heavy alcohol consumption over time,” said lead researcher Kevin L. Delucchi, Ph.D., professor of biostatistics in psychiatry at the University of California San Francisco.
“It’s pretty toxic, but somehow they manage to keep drinking at a fairly sustained level. Our people were functional, for the most part. They had addresses, a lot of them had insurance at baseline, and they’re not at the ‘bottom of the barrel'” contrary to stereotypes.
The researchers say their study is one of the first to examine heavy alcohol use in the general population. Most studies have focused on the most severe drinkers — those who were already in a treatment program, said Delucchi.
“Not everyone who has an alcohol problem is in treatment or is in a program,” said Delucchi. “People are out there on their own.”
The researchers also examined which factors appeared to be linked with continued heavy drinking. Participants who received help from Alcoholics Anonymous or community social service agencies were likely to drink less.
However, those who had heavy-drinking friends in their social network, received general suggestions that they do something about their drinking, and went to a formal treatment program were actually likely to drink more.
Delucchi said they were unable to determine why formal treatment appeared to be linked with continued elevated drinking, although the researchers theorize that perhaps those who sought this type of treatment were likely to have experienced the greatest level of alcohol-related problems and, therefore, were more likely to have sought such treatment.
The study may be found in the November issue of the Journal of Studies on Alcohol and Drugs.