Increase In Alcohol-related Problems Research Articles

Alcohol during the pandemic: Steady for women, down for men

A new RAND study found that alcohol consumption during the COVID‐19 pandemic declined among men, while it remained steady among women. In general, alcohol‐related problems increased during the pandemic, by 49% for women and 69% for men, but the reasons for the problems remain unclear. The findings were published online last week by the journal Drug and Alcohol Dependence. “Both men and women report increases in negative consequences from their drinking as the pandemic goes on,” said Joan Tucker, lead author of the study and a senior behavioral scientist at RAND, a nonprofit research organization. “For men, this finding is particularly striking in that the increase in alcohol‐related problems during the pandemic was occurring even as there was a steady decline in the amount they were drinking.” An earlier RAND survey found that among women there was a pronounced increase in frequency of drinking days and binge drinking days from pre‐pandemic to early pandemic. This study surveyed 1,118 people in the RAND American Life Panel about their alcohol consumption during three time periods — May to July 2020, October to November 2020 and during March 2021. The study found that feelings of loneliness and motivations for using alcohol during the pandemic may play a role in alcohol consumption patterns. For both men and women, stronger coping and social motives for drinking early in the pandemic were associated with an initial higher level of alcohol use, and stronger coping motives were associated with an initial higher level of alcohol problems.

Exploiting motherhood: Do mummy drinking sites offer real support or are they mainly alcohol marketing?

Even as women's roles have expanded substantially beyond traditional sex stereotypes, women are still commonly portrayed as uncomplaining caregivers, long-suffering intimate partners and in control of family matters, all while maintaining a sexualised femininity. Nowhere are these stereotypes and expectations more apparent than for mothers. However, some social media are exploiting mothers by inappropriately offering alcohol consumption as a solution to the challenges of parenting. This is a very timely topic, given the impacts of COVID-19 on family and home life, and potential for an increase in alcohol-related problems and health harms. We address these issues and offer alternatives to alcohol consumption as an easy solution to countering challenges of parenthood.

Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: a narrative review.

To summarise publications reporting on alcohol consumption and alcohol-related problems during the Coronavirus disease 2019 (COVID-19) pandemic in a narrative review. ProQuest, Web of Science and Google Scholar were searched for articles published in 2020. This search used two terms: 'alcohol' and 'COVID'. Reference lists of articles were reviewed to identify additional articles. There is growing concern around an increase in alcohol intake and alcohol-related harms. These concerns are related to the impact of excessive alcohol consumption in a person with COVID-19 and/or with alcohol use disorder, as well as with a potential increase in the prevalence of harmful drinking, alcohol use disorder, withdrawal symptoms, intimate partner violence, harm to children, suicide, mental health problems and non-communicable diseases. The need for assessing alcohol use and providing adequate advice during the pandemic have been highlighted. The time for action is now, and all necessary measures to prevent an increase in alcohol-related problems should be adopted. At the same time, healthcare services should also prepare for such potential increase, while adapting to the exceptional circumstances presented by the pandemic, such as physical distancing.

Disrupting the Behavioral Health Consequences of Racial Discrimination: A Longitudinal Investigation of Racial Identity Profiles and Alcohol-Related Problems.

Researchers have documented the negative associations between racial discrimination and alcohol use for young Black people, yet fewer researchers have examined these associations longitudinally and with racial identity as a protective factor. We use data from the Flint Adolescent Study (465 Black/African Americans) to investigate the relationship between discrimination and alcohol-related problems over time, and how that relationship differs with varying trajectories of racial identity (i.e., private and public regard). Among those reporting persistently moderate levels of private regard and high levels of public regard in late adolescence through emerging adulthood, increases in racial discrimination were associated with increases in alcohol-related problems over time. Findings suggest that regard for one's racial group may function protectively in the health strategies employed in response to discriminatory events. More longitudinal research is needed to delineate how varying racial pride operates with regard to long-term discrimination and behavioral health.

Work stressors, sleep quality, and alcohol-related problems across deployment: A parallel process latent growth modeling approach among Navy members.

This study examined how work stressors were associated with sleep quality and alcohol-related problems among U.S. Navy members over the course of deployment. Participants were 101 U.S. Navy members assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Approximately 6weeks prior to deployment, 6weeks after deployment, and 6months reintegration, participants completed measures that assessed work stressors, sleep quality, and alcohol-related problems. A piecewise latent growth model was conducted in which the structural paths assessed if work stressors influenced sleep quality or its growth over time, and in turn if sleep quality influenced alcohol-related problems intercepts or growth over time. A significant indirect effect was found such that increases in work stressors from pre- to postdeployment predicted decreases in sleep quality, which in turn were associated with increases in alcohol-related problems from pre- to postdeployment. These effects were maintained from postdeployment through the 6-month reintegration. Findings suggest that work stressors may have important implications for sleep quality and alcohol-related problems. Positive methods of addressing stress and techniques to improve sleep quality are needed as both may be associated with alcohol-related problems among current Navy members.

Overturn of the proposed alcohol advertising ban in Lithuania

In response to the dramatic increase in alcohol-related problems in Lithuania, policy measures, including alcohol advertising and availability restrictions combined with taxation increase, were implemented in 2007-08. Simultaneously, a full alcohol advertising ban was adopted to take effect from 1 January 2012. Therefore, the alcohol industry responded with extensive lobbying aiming to revoke this ban, and ultimately they succeeded at the end of December 2011. To document and analyse actions of stakeholders and events during the alcohol advertising ban cancellation process in Lithuania. Policy analysis includes a development of event time-line, description of key stakeholders' actions and a review of policy context. The alcohol industry in Lithuania used similar tactics as the tobacco industry globally, such as creating strong and diverse opposing groups. The industry successfully exerted pressure to change alcohol control legislation, while non-governmental organizations had the important role of a watchdog, blunting industry's efforts. Unequal power distribution made it difficult to withstand combined local and international lobbying to cancel the ban. Given the global nature of the alcohol industry, there is a need for international regulation to limit the influence of vested interests on national lawmaking.

Changes in Alcohol Availability, Price and Alcohol-related Problems and the Collectivity of Drinking Cultures: What Happened in Southern and Northern Sweden?

Aims: The aims of this study were to study whether alcohol-related self-reported problems follow the same pattern of changes in alcohol consumption in southern Sweden, assumed to be affected by a decrease in Danish spirits tax and by an increase in Swedish travellers’ import quotas, and to study whether the results obtained for southern and northern Sweden follow the predictions of Skog's theory of collectivity of drinking cultures. Methods: Analysis was carried out on a sample from the Swedish general population from southern and northern Sweden separately. Two indices such as impaired self-control/dependent behaviour and extrinsic problems for alcohol-related problems were computed and analysed in terms of sex, age, income and alcohol consumption level. Results: Although there were no huge changes in the number of persons reporting alcohol-related problems, the general trend in data for various subpopulations was a decrease in the southern site and an increase in the northern site. In the northern site, the increase in alcohol consumption among men also showed an increase in alcohol-related problems. However, various population subgroups changed in different directions and did not move in concert over the population distribution. Conclusions: Analysis confirmed that alcohol-related problems, according to the two indices used, followed a similar pattern to alcohol consumption, but less divergent. A version of Skog's theory applied on alcohol-related problems could not confirm that alcohol-related problems did not change collectively within the population.

Local action to prevent alcohol problems: Is the UK Community Alcohol Prevention Programme the best solution?

Increasing evidence indicates that the UK has a serious alcohol problem. This crosses many patterns of drinking and all ages, whereas the public debate about alcohol tends to focus almost exclusively on binge drinking and on young people's alcohol-related anti-social behaviour. This paper addresses the interventions and policy developments currently implemented in the UK to reduce alcohol-related anti-social behaviour. There are two main approaches: a national (England) change in the licensing laws; and local harm reduction projects seeking to effect change independently of central Government initiatives. This paper describes the critique currently mounted against the expected efficacy of new licensing laws and describes the theoretical and practical developments of some local prevention initiatives that are part of the United Kingdom Alcohol Prevention Programme (UKCAPP), funded by the Alcohol Education and Research Council (AERC). Although it is too early to draw conclusions as to the effects of either of these developments, initial reports suggest that changes in the licensing regime have not yet created the increase in alcohol-related problems some commentators have argued would occur; and the local prevention initiatives have led to the formation of extremely strong community partnerships, with a range of innovative and integrated actions to tackle alcohol-related anti-social behaviour. Fundamental criticisms of both the new licensing laws and the National Alcohol Strategy remain, however. Even if the above interventions lead to reductions in alcohol-related anti-social behaviour, it is not clear how they might deal with the rising levels of alcohol-related health harms reported within the UK. Nevertheless, the community partnership approach may be the best possibility for dealing with at least some of the alcohol-related problems caused by the rise in availability and accessibility of alcohol within the UK.

A COMMENT ON ALLOWING SATURDAY SALES IN THE SWEDISH RETAIL MONOPOLY

The paper ‘Saturday opening of alcohol retail shops in Sweden: an experiment in two phases’, written by Norström & Skog (2005), found a modest but statistically significant increase in alcohol off-premise sales in Systembolaget, the state retail monopoly, during a pilot experiment (Phase I) and an equivalent increase in all of Sweden (Phase II). This is not an unexpected finding, as any increase in alcohol availability typically stimulates increased sales. They found no associated country-wide drinking and driving arrests in Phase II. This indicator is biased, of course, by the actual operations of the police, not necessarily reflecting overall drinking and driving. There was no change in assault indicators, often linked with heavy drinking. With no increases in alcohol-related problems, these results can be taken by some as evidence that increasing off-premise alcohol sale does not increase drinking or alcohol problems. There are several problems with this simple conclusion. During the years of these analyses, limits on European Union (EU) traveler alcohol imports into Sweden were significantly increased. As a result of Swedish membership in the EU (comparing 1996 to 2003), spirits consumption (litres per capita, 15 years and older) has remained relatively constant, while spirits sales at Systembolaget actually declined from 1.4 to 1.1 litres. National wine and beer consumption has increased over 70%, while Systembolaget sales have increased by about 50% for wine and 75% for beer. Restaurant spirits and wine sales have increased substantially (beer about the same) during the same period. Registered alcohol consumption (Systembolaget plus licensed private outlets) accounted for almost 80% of total estimated consumption in 1995 but less than 70% in 2002, Within this context, it is unrealistic to expect that Systembolaget sales would keep pace with total consumption. It has become more convenient for Swedes to purchase lower-cost alcohol in other EU countries. Thus Swedes have apparently taken advantage of the higher traveler import allowances to bring in low-cost alcohol from such EU countries as Denmark and Germany. This means that less alcohol consumed is actually sold in Swedish monopoly stores. Prior to the changes associated with EU membership, there were only two available practical sources of alcohol for Swedes, i.e. state monopoly stores and privately licensed restaurants which actually purchased their spirits and wine supplies only from Systembolaget. If Saturday opening for Systembolaget stores had occurred in the pre-EU phase in Sweden, where there were both higher prices on alcohol and rather restricted private import allowances, we could expect Systembolaget sales to have increased much more than the 3.7% found in this study. In short, this natural experiment of allowing Saturday sales for Systembolaget stores has been conducted in a time of substantial changes in other aspects of the retail alcohol market when, in additional to higher traveler import allowances, restaurants could obtain their alcohol supplies from private domestic sources and imported alcohol could be sold to restaurants and promoted by a number of private alcohol importers. In short, this is a study of an important change in days of sale which is largely overshadowed by concurrent other changes in alcohol purchase and increase in assault indicators consumption patterns of Swedes. Even if there had been reported changes in alcohol-related problems, it would have been difficult for the authors to attribute these changes solely to these modest increases in Systembolaget sales.

Disaster preparedness and management in the Caribbean: the need for psychological support

Over the last 10 years, the world has seen a number of mass casualty disasters. Within that period, the Caribbean has had its own share of such disasters. These include the eruption of the Soufriere Hills volcano, Montserrat, in 1995, the passage of Hurricane Ivan through Grenada, Jamaica and the Cayman Islands in September 2004 and floods in Guyana in 2005. The 2005 hurricane season is predicted to be a busy one with 12 to 15 tropical storms with nine likely to become hurricanes. Of those, three to five could become major hurricanes (1). In Jamaica, there are yearly floods and frequent fires which destroy multi-family dwellings, often in inner city communities. Disasters leave in their wake much devastation and loss: death, physical destruction and dislocation. This is often associated with long-term adverse economic impact on both the individual and the community. What is not often recognized or responded to is the psychological impact of these disasters. The emotional turmoil, trauma and hopelessness that often accompany these events are not as visible as the physical needs. Further, the psychological trauma does not always present soon after the event and the recovery from them often takes far longer (2). Research on mental health outcomes following mass trauma is relatively new to the Caribbean. Data are being analyzed with respect to post-traumatic stress disorder (PTSD) in children following Hurricane Ivan in 2004 in Jamaica (A Pottinger: personal communication). Further, a 2003 study has cited what appeared to be a significant increase in anxiety and depressive symptoms among the elderly population in Montserrat following the volcanic eruptions (3). Studies elsewhere have suggested that children and the elderly may be at particular risk (4, 5). For the elderly, a decline in their physical health was noted for persons who resided near to disaster sites, although a short-term improvement in cognitive functioning was also found (4). The psychosocial impact of other disasters studied in the Caribbean and Central America include Hurricane Mitch on Honduras in 1998. The Pan American Health Organization (PAHO) found that 19.5% of the affected population in Honduras suffered from a severe depressive episode and 10.6% with PTSD. When the criteria of duration and disability were excluded from PTSD, the proportion of PTSD symptoms related to the hurricane was much higher (23.0%) (6). In addition to psychological responses associated with trauma, an increase in alcohol-related problems have been found particularly among those who lived in shelters following the disaster (6). Research in the Caribbean and Central America has also indicated an increase in violence in the community. In the aftermath of the disaster in Montserrat, an apparent increase in attendance at the Casualty Department of the hospital for violence-related injuries was noted for two years following the disaster (3). A similar finding was also reported by PAHO following Hurricane Mitch (6). Psychological support programmes designed to eliminate or reduce the risk of long-term emotional distress related to disasters are beginning to emerge in the Caribbean. In 2000, a counselling programme was developed in Montserrat for those at risk in the population after the volcanic eruption (3). In Jamaica, the Disaster Mental Health Unit (DMHU) of the Jamaica Red Cross was established in 2001 (7). It is the only such unit in the English-speaking Caribbean. The current team of 20 volunteer mental health professionals worked with affected individuals in Jamaica, Grenada and Grand Cayman following Hurricane Ivan in 2004 (8). The unit has been instrumental in training the Red Cross staff and volunteers in all three island states in psychological first aid and selfcare. The DMHU of the Jamaica Red Cross has also embarked on a nation-wide training of community workers that has included promoting interventions that focus on resilience-building, encouraging community solidarity and integrating mental health skills within general services (8). The following are some recommendations as the Caribbean approaches the 2005 Hurricane season: 1. There is a need to raise awareness among the public about typical emotional responses during and after a disaster, such as, flashbacks, insomnia, disturbance of appetite and heightened irritability, as well as when it is necessary to seek professional help. 2. Health professionals need to be sensitized to the presentation of emotional, behavioural and somatic symptoms such as anxiety, depression, domestic and From: Counselling Services, University Health Centre and Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies, Kingston 7, Jamaica.

Regulating unregulated markets.

Ongoing political and economic changes in the ex-socialist countries have proved to be very expensive socially. The sudden transition from a centrally planned to a market economy had led to an increase of social problems. One commonly observed danger is the rapid increase in alcohol consumption. The rates of total alcohol consumption are particularly high in those countries where spirit consumption dominates. Considerable pressure is being applied to liberate the alcohol market from all restrictions. Inadequate legislation in the new economic situation, modifications in value systems, and the general rejection of all legislative solutions developed under the previous regime have created a climate conducive to the development of an unregulated alcohol market. State administrations have lost control of the alcohol market. Previous data on consumption have ceased to be reliable sources of information. The dynamic increase in alcohol-related problems is dangerous for public health. If this situation is to be corrected, the first step must be regulation of the alcohol market.

Regulating unregulated markets

Ongoing political and economic changes in the ex‐socialist countries have proved to be very expensive socially. The sudden transition from a centrally planned to a market economy had led to an increase of social problems. One commonly observed danger is the rapid increase in alcohol consumption. The rates of total alcohol consumption are particularly high in those countries where spirit consumption dominates. Considerable pressure is being applied to liberate the alcohol market from all restrictions. Inadequate legislation in the new economic situation, modifications in value systems, and the general rejection of all legislative solutions developed under the previous regime have created a climate conducive to the development of an unregulated alcohol market. State administrations have lost control of the alcohol market. Previous data on consumption have ceased to be reliable sources of information. The dynamic increase in alcohol‐related problems is dangerous for public health. If this situation is to be corrected, the first step must be regulation of the alcohol market.

Predictors of Increases in Alcohol-Related Problems among Black and White Adults: Results from the 1984 and 1992 National Alcohol Surveys

We examined increases in self-reported alcohol-related problems among black and white adult drinkers using data from the 1984 and 1992 National Alcohol Surveys. The objectives of the study were to determine whether alcohol consumption, drinking norm, or socioeconomic status were related to increases in alcohol-related problems. Two types of self-reported alcohol-related problems were analyzed using regression methods: drinking consequences and alcohol dependence symptoms.Results indicated that increases in alcohol consumption were associated with increased drinking consequences for white men, but increased consumption had little affect for black men. Changes in drinking norms regarding non-social drinking were associated with increases in drinking consequences among black men, such norms showed little affect on drinking consequences for white men. Despite substantial increases in alcohol consumption among black women from 1984 to 1992, there were no significant racial/ethnic differences in drinking consequences or alcohol dependence symptoms among women. Changes in socioeconomic status were however related to increases in drinking consequences and alcohol dependence symptoms in women, but not in men.Findings suggest that liberal drinking norms may have greater long term consequences for black than white men. Socioeconomic status, on the other hand, may have greater explanatory power in predicting increases in alcohol-related problems in women than in men.

The end of U.S. prohibition: a case study of Mississippi

Natural experiments involving changes in alcoholic beverage availability are valuable opportunities to examine the corresponding associated changes in alcohol consumption and alcohol-related problems. Usually one is able to examine the relationship between changes in availability and consumption (all other things being equal), changes in consumption and problems and/or changes in availability and problems (see Giesbrecht et al., 1982; Smart, 1979; Makela, 1974; Blose and Holder, 1987; and Holder and Blose, 1987). Mississippi was the last state in the United States to repeal prohibition, in 1966, and provides a good opportunity for a case study of the effects of changes in the legal availability of alcoholic beverages on consumption. The hypotheses addressed in this paper are that increased legal availability of alcoholic beverages following repeal of a state's prohibition would result in increased consumption, which would, in turn, result in an increase in alcohol-related problems. Both anecdotal data of alcohol consumption during prohibition and per capita sales of distilled spirits following prohibition for Mississippi in comparison with surrounding states are used to analyze changes in consumption before and after prohibition. Rates from 1950 to 1985 for total alcohol-related mortality (deaths from liver cirrhosis, alcoholism and alcohol poisonings), suicide and homicide mortality, and traffic and non-traffic mortality are used to analyze changes in alcoholrelated mortality for the state. Mississippi has maintained a remarkably homogeneous population over time. The white population is primarily of British, Scots-Irish and Northern European ancestry, with most being at least second generation Mississippians. Mississippi's black population was in the majority until 1940, when a large outmigration occurred to Northern cities. By 1980, only 35% of the state's population was black, and almost all were nativeborn Mississippians. Mississippi's population has remained relatively stable, with a high birth rate offsetting emigration of both blacks and whites. Mississippi is largely a rural state; more than half of the land area is in commercial forests. It was not until 1965, the year before Mississippi repealed state prohibition, that industrial income surpassed agricultural income. The state has historically been politically and religiously conservative, with Baptists and United Methodists predominating. The Mississippi Gulf Coast area has remained more heterogeneous, including a number of Catholics of French and Spanish ancestry. Mississippi has continued to have the highest illiteracy and infant mortality rates and the lowest per capita income of any state in the Union (Encyclopedia Britannica, 1985). Alcohol control before and during national prohibition Mississippi's long history of alcohol control policy began in 1850, when the legislature passed a measure by which communities could vote to permit or ban alcohol sales. In 1886, a local option law was passed that provided for the holding of local option elections throughout the entire state. The first public prohibition meeting in Mississippi was held in 1881, although statewide constitutional prohibition was not voted on until 1904. Although the measure received a majority vote at the time (66 to 43), the bill was lost because it failed to receive the two-thirds majority required. In January 1908 statewide prohibition was successfully passed, 10 years before Mississippi adopted the resolution providing for ratification of the prohibitory amendment to the U.S. Federal Constitution. Mississippi was the first state in the Union to ratify federal prohibition. A bone dry law was put on the state statute books: No whiskey for any purpose could be shipped into the State and no person could have, control or possess any whiskey whatsoever (Standard Encyclopedia of the Alcohol Problem, p. 1786, 1928). Exceptions were made for wine for sacramental purposes and grain or pure alcohol for medicinal purposes. …

Alcohol and sexual victimization: a longitudinal study of Norwegian girls

In a study of sexual victimization and alcohol consumption, a population sample of Norwegian adolescents from the Oslo area was followed-up through five data collections over a 6-year time span. By means of generalized structural equation modeling, alcohol-related predictors and consequences of sexual assaults were investigated; 17% of the girls reported that they had been sexually assaulted at some time: 7% in childhood, 6% in early adolescence (13-16 years) and 4% in late adolescence (17-19 years). Only 1% of the boys reported having been sexually victimized. Female childhood sex victims reported increased alcohol consumption from their mid-teens, with dramatic increase in alcohol-related problems (using DSM-III-R criteria) at the end of their teens. However, the analyses showed that alcohol consumption was not influenced by childhood sexual abuse when parental use of tobacco and alcohol and normative standards imparted to their children were taken into consideration as confounding variables. There was, on the other hand, a strong effect on alcohol problems. Thus, the victims of childhood sexual abuse seem to be at high risk for alcohol abuse and dependency. Further, early alcohol debut and high alcohol consumption combined with permissive parental norms increased the risk of sexual assault in early adolescence. The girls who were assaulted in early adolescence also reported a high number of sexual partners and early intercourse debut. There was no increase in subsequent alcohol consumption after assaults in this group. Late adolescent victims did not report increased alcohol consumption either prior to or after the assault.

Increases in alcohol-related problems for men on a college campus between 1980 and 1992.

A questionnaire concerning alcohol and drug use was mailed to a random sample of male students at the University of California at San Diego in 1980, and similar procedures were used in 1992. Both mailings yielded response rates of approximately 70% (1980: N = 1,024; 1992: N = 721). The data revealed that while the rates of illicit substance use and associated problems decreased significantly between the two time points, the quantity of alcohol consumed per occasion and the prevalence of alcohol-related problems significantly increased during those 12 years. These increases suggest a need for an expanded emphasis on alcohol education at colleges and universities.

The liver and alcohol

Barely one quarter of the world's population consumes some four-fifths of the available alcohol. With the inexorable rise in world production it is not surprising that some communities are facing an explosive increase in alcohol-related problems. Yet, as Kreitman has pointed out [1], a great number of alcohol problems derive not from the hard core of very excessive and addicted consumers, with their very high risks, but from among the large 'middle-ground' of so-called moderate consumers, This fact serves to highlight the paradox for the hepatologist which, despite colossal endeavour, is still unanswered - namely: why do only a proportion of drinkers suffer from alcoholic liver disease (ALD)_ Although overall the level of consumption of alcohol in communities is determinative and risks rise with increasing daily consumption [2], factors other than alcohol itself are also clearly involved [3]. These factors doubtless include endogenous determinants (predisposition) and exogenous determinants (such as other hepatotoxins and possibly viral infections) [4].

Reduction of community alcohol problems: computer simulation experiments in three counties.

A series of alcohol abuse prevention strategies was evaluated using computer simulation for three counties in the United States: Wake County, North Carolina, Washington County, Vermont and Alameda County, California. A system dynamics model composed of a network of interacting variables was developed for the pattern of alcoholic beverage consumption in a community. The relationship of community drinking patterns to various stimulus factors was specified in the model based on available empirical research. Stimulus factors included disposable income, alcoholic beverage prices, advertising exposure, minimum drinking age and changes in cultural norms. After a generic model was developed and validated on the national level, a computer-based system dynamics model was developed for each county, and a series of experiments was conducted to project the potential impact of specific prevention strategies. The project concluded that prevention efforts can both lower current levels of alcohol abuse and reduce projected increases in alcohol-related problems. Without such efforts, already high levels of alcohol-related family disruptions in the three counties could be expected to rise an additional 6% and drinking-related work problems 1-5%, over the next 10 years after controlling for population growth. Of the strategies tested, indexing the price of alcoholic beverages to the consumer price index in conjunction with the implementation of a community educational program with well-defined target audiences has the best potential for significant problem reduction in all three counties.

Perceived differences of standards for alcohol use among American youth.

Students perceive the greatest degree of similarity of standards for beer use with their close friends. An increase in liberality of personal standards and the perception of liberality as well as any dissimilarity of standards among close friends are associated with an increase in alcohol-related problems.

Utilization of emergency departments for psychiatric treatment.

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.