Regular Heavy Drinkers Research Articles

Drinking in second generation black and asian communities in the english midlands

Previous research has suggested low levels of drinking and high rates of abstinence amongst members of ethnic minority groups in Britain, but it was not clear that those conclusions applied equally to those born or educated in Britain. Using quota sampling and street interviewing methods, a sample of 1684 second or subsequent generation men and women from Black (African), African-Caribbean, and Black (British), Indian Hindu, Indian Sikh, Bengali, and Pakistani communities in two Midlands cities completed a brief structured interview during February and March 1999. Results differed markedly by ethnic group, and sometimes by sex. Most Black men and women and most Sikh men were drinkers, and rates of heavy drinking in those groups were comparable to those found in national general population samples. The drinking of substantial minorities in those groups gives cause for concern on account, for example, of regular heavy drinking and associated behaviour carrying social or health risks. Hindu, Pakistani and Bengali men and women, and Sikh women, on the other hand, reported high levels of abstinence, with much smaller proportions of the total (but similar proportions of drinkers) drinking heavily and giving cause for concern. Both men's and women's drinking (ethnic groups combined) was correlated with a lower self-rated identity with religion, and in addition women's drinking was correlated with a range of other social and cultural variables (more qualified, employed, single, smaller household, fewer friends from own ethnic group). Large proportions of South Asian men and women drinkers believed their parents did not know about their drinking, and preferred that parents should not know. GPs and health centres were widely recognised as sources of external advice for drinking problems. Community centres and leaders and places of worship were very little mentioned as sources of such help, and in nearly all groups there was a high level of reluctance to seek help outside the family or friendship network. It is concluded that, whilst many second and subsequent generation South Asian people in Britain remain protected from indigenous patterns of drinking by cultural and religious norms, that is no longer the case for Sikh men nor for Black men and women, nor for small minorities of other South Asian groups who drink.

Intoxicated weekends: young adults’ work hard–play hard lifestyles, public health and public disorder

Going out at the weekends binge drinking is a leisure priority of the majority of young English adults. This going-out sector is described via a cohort (n = 465) of 22 year olds who have been tracked by the North West Longitudinal Study (1991–2001) since they were 13. This cohort is made up of conventional, educated and employed young people. However, over half are regular heavy drinkers and occasional recreational drug users. They often mix alcohol and illicit drugs on nights out. Their motives for intoxicated weekends relate to maintaining successful work hard–play hard lifestyles. Most nights out are perceived as functional and enjoyable but some go wrong leading to arguments, fights and assaults (the public disorder agenda) and impaired judgement, illness and accidents (the public health agenda).These negative outcomes are probably inevitable given the scale and functions of nights out. Better management of nightlife requires an integrative strategy which recognizes the added value of focusing on the care and welfare of the overall going-out population rather than targeting ‘trouble makers’ and reacting to ad hoc disorder and mishap.

A cognitive model of binge drinking: The influence of alcohol expectancies and drinking refusal self-efficacy

While binge drinking—episodic or irregular consumption of excessive amounts of alcohol—is recognised as a serious problem affecting our youth, to date there has been a lack of psychological theory and thus theoretically driven research into this problem. The current paper develops a cognitive model using the key constructs of alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE) to explain the acquisition and maintenance of binge drinking. It is suggested that the four combinations of the AE and DRSE can explain the four drinking styles. These are normal/social drinkers, binge drinkers, regular heavy drinkers, and problem drinkers or alcoholics. Since AE and DRSE are cognitive constructs and therefore modifiable, the cognitive model can thus facilitate the design of intervention and prevention strategies for binge drinking.

Alcohol use and cardiovascular disease preventive services.

Moderate drinking is associated with decreased cardiovascular mortality. Biological effects may mediate this association, but differences in utilization of preventive services may be important. Cross-sectional analysis of adults participating in the Third National Health and Nutrition Examination Survey with data on alcohol use and prior use of services for the detection and treatment of hypertension and hypercholesterolaemia. Regression models were analysed to provide age-, sex- and race-adjusted risk estimates for outcomes related to these services for several patterns of alcohol use relative to regular light drinkers. Hypertension was more common in most alcohol use strata compared with regular light drinkers (adjusted prevalence ratios 1.22 for lifelong abstainers, 1.33 for nonlifelong abstainers, 1.35 for infrequent moderate drinkers, 2.01 for frequent moderate drinkers, 1.73 for infrequent heavy drinkers and 1.98 for regular heavy drinkers, P-values < 0.05). Having had blood pressure measured was similar in all drinking strata. The prevalence of hypercholesterolaemia was similar in drinking strata, but most drinking patterns were associated with lower use of services to detect high cholesterol (prevalence ratios 0.7 for lifelong abstainers, 0.8 for nonlifelong abstainers, infrequent moderate and regular moderate drinkers, 0.6 for infrequent heavy drinkers, and 0.7 for regular heavy drinkers, P-values < 0.05). The utilization of cardiovascular disease preventive services may contribute to the beneficial association of moderate drinking with cardiovascular mortality. Additional research is needed to estimate the influence of differences in health services utilization on the association of alcohol use with cardiovascular disease outcomes.

Prospective study of moderate alcohol consumption and risk of hypertension in young women.

Heavy alcohol consumption is associated with an increased risk of hypertension. However, the effect of moderate alcohol consumption; the specific effects of wine, beer, and liquor; and the pattern of drinking in relation to risk of hypertension among young women are unclear. We prospectively examined the association between alcohol consumption and subsequent risk of hypertension among 70 891 women 25 to 42 years of age. During the 8 years of follow-up, 4188 cases (5.9%) of incident hypertension were reported. After adjustment for multiple covariates, the association between alcohol consumption and risk of hypertension followed a J-shaped curve. Compared with nondrinkers, the risk of developing hypertension according to average number of drinks consumed per day was as follows: 0.25 or less, 0.96 (95% confidence interval [CI], 0.89-1.03); 0.26 to 0.50, 0.86 (95% CI, 0.75-0.98); 0.51 to 1.00, 0.92 (95% CI, 0.82-1.04); 1.01 to 1.50, 1.00 (95% CI, 0.80-1.24); 1.51 to 2.00, 1.20 (95% CI, 0.92-1.58); and more than 2.0 drinks, 1.31 (95% CI, 1.02-1.68). Exclusion of past drinkers yielded similar results. Among women in the highest category of alcohol consumption, there was a suggestion that the increased risk of hypertension was present regardless of the specific beverage consumed (beer, wine, or liquor). Episodic drinking, defined as consumption of more than 10.5 drinks over 3 or fewer days per week, was not associated with increased risk of hypertension (relative risk, 0.80; 95% CI, 0.51-1.23). The association between alcohol consumption and risk of chronic hypertension in young women follows a J-shaped curve, with light drinkers demonstrating a modest decrease in risk and more regular heavy drinkers demonstrating an increase in risk.

Injury and alcohol: a hospital emergency department study

AbstractA pilot survey was undertaken of injury presentations to a public hospital emergency department to determine patterns of alcohol use in this population. Of the 402 injury presentations in the study period, a total of 236 injury cases were interviewed, of whom 45% (n = 107) and 29% (n = 69) had consumed alcohol 24 and 6 hours prior to injury. Mean age for all injury presentations was 35.1 years, and 32.6 years for alcohol injury cases. For both injury groups, males were significantly younger than females. Recent alcohol ingestion was three times more common among male than female injury presentations, but with females drinking at significantly lower levels. Of males who had consumed alcohol 6 hours prior to injury, nearly 70% were drinking at NHMRC harmful levels and 61% had drunk more than eight standard drinks. Overall, alcohol‐involved injury cases commonly occurred among low‐income, single males around 30 years of age who were regular heavy drinkers who were drinking heavily in licensed premises prior to their injury, and who sustained injury through intentional harm. In addition, one in five of the alcohol‐involved injury cases were aged 15–18 years, i.e. below the legal age of purchase. The high proportion of hazardous and harmful drinkers among those who had consumed alcohol within the last 6 hours, and the injury sample overall, highlights the need for further research to explore the relationship between the occurrence of injury and the drinking patterns and environments associated with injury. Further research is also required to assess the efficacy of early and brief interventions for alcohol and drug use within the emergency ward setting. This information would enable appropriate public health interventions to be initiated.

The relation between alcohol and cardiovascular disease in Eastern Europe: explaining the paradox

BACKGROUNDRecent evidence from Eastern Europe of a positive association between alcohol and cardiovascular disease has challenged the prevailing view that drinking is cardioprotective. Consuming amounts of alcohol comparable to those...

A cluster analysis of alcohol-related attitudes and behaviors in the general population.

Alcohol use typologies have previously focused on chronic alcohol abusers and alcohol-dependent populations. This empirical typology was created to profile lifestyle patterns associated with nonclinical patterns of alcohol use. This study used two surveys sent to a commercial mailback panel, sampled to construct a study population demographically representative of the general U.S. population (N = 2,910). A K-means cluster analysis of alcohol use predictor variables and alcohol use generated the typology. The results suggest five distinct psychobehavioral clusters, referred to by the modal patterns of alcohol use for each cluster: nondrinkers, light drinkers, moderate drinkers, episodic drinkers and regular heavy drinkers. These clusters were found to have predictive validity using related health behaviors, psychosocial variables, personality self-descriptors, and media use as criteria. In particular, moderate drinkers had double the income of any other cluster and showed consistently healthy exercise, cigarette use, and diet patterns as well as a relatively high ranking of health as a personal value. Episodic drinkers had the highest levels of sensation-seeking and drug use and were not health oriented in values and behaviors, although their total weekly consumption was only marginally greater than the moderate drinkers. The profile of the moderate drinker cluster is consistent with concerns about lifestyle confounds in the relationship between moderate alcohol consumption and cardiovascular health. The episodic drinker profile is consistent with relatively high risk behaviors; this cluster may be a good target for harm-reduction education and intervention efforts.

Alcohol intake and other skin disorders

The classical cutaneous stigmata of alcoholism have been well recognized for over a century. Most stigmata are in fact manifestations of the end stage of cirrhosis, rather than of alcohol itself, and as such are discussed in more detail in chapter 18. Over the past decade alcohol has become recognized as a causal or aggravating factor in a wide variety of skin diseases, particularly those of inflammatory origin. The exacerbation of psoriasis by alcohol has received greatest attention of late (see chapter 12), but many other chronic dermatoses may also be associated with excess drinking.1–3 However, these are not always widely appreciated and can be easily overlooked. A careful history is often required to elucidate the patient’s alcohol consumption, as these patients are often regular heavy drinkers (alcohol misusers) rather than alcoholic, and in particular will not exhibit any features of dependency. In fact, they may be quite surprised when it is suggested that drinking could have a pivotal role in their skin disease, as they would not personally consider themselves to be “at risk” or drinking to excess. Having a high level of awareness of the role of alcohol in skin disease is important for the clinician, as clues are rarely gleaned from standard screening tests, biochemical and hematological parameters being usually normal in these patients.3

Alcohol Consumption and Stroke: Benefits and Risks

The complex relationship between alcohol consumption and stroke includes both benefits and risks. Regular light‐to‐moderate consumption of alcohol seems to decrease the risk for ischemic stroke by reducing atherothrombotic events, but the undertying mechanism is still unclear. Recent and current (but not previous) heavy drinking increases the risk for both hemorrhagic and ischemic strokes. Young and middle‐aged men are stricken more often than women or elderly persons, probably because they are more often current heavy drinkers. Alcoholic cardiomyopathy is a cause of cardioembolic brain infarction. Cardiac arrhythmias caused by regular heavy drinking or binge drinking can precipitate thrombus formation and propagate already existing thrombi from the heart. The maintenance of high blood pressure by heavy drinking may promote cerebral arterial degeneration, but the effect of drinking habits on aneurysm formation is not known. Acute increases in systolic blood pressure and/or alterations in cerebral arterial tone could serve as mechanisms triggering hemorrhagic strokes during alcoholic intoxication. We lack studies to show that prevention of heavy drinking can efficiently influence the occurrence of strokes.

Alcohol consumption and stroke: benefits and risks.

The complex relationship between alcohol consumption and stroke includes both benefits and risks. Regular light-to-moderate consumption of alcohol seems to decrease the risk for ischemic stroke by reducing atherothrombotic events, but the underlying mechanism is still unclear. Recent and current (but not previous) heavy drinking increases the risk for both hemorrhagic and ischemic strokes. Young and middle-aged men are stricken more often than women or elderly persons, probably because they are more often current heavy drinkers. Alcoholic cardiomyopathy is a cause of cardioembolic brain infarction. Cardiac arrhythmias caused by regular heavy drinking or binge drinking can precipitate thrombus formation and propagate already existing thrombi from the heart. The maintenance of high blood pressure by heavy drinking may promote cerebral arterial degeneration, but the effect of drinking habits on aneurysm formation is not known. Acute increases in systolic blood pressure and/or alterations in cerebral arterial tone could serve as mechanisms triggering hemorrhagic strokes during alcoholic intoxication. We lack studies to show that prevention of heavy drinking can efficiently influence the occurrence of strokes.

Seasonal variation in alcohol use.

The objective of this article is to describe and quantify seasonality in a number of indicators on alcohol use. The data analyzed cover a period between 1988 and 1994, and are collected by a telephone survey of persons living in Glasgow and Edinburgh, Scotland. The analysis is on data from 29,256 respondents. Cosinor analysis is the analytical instrument applied; a dummy variable is incorporated in the analysis to model the December peak in alcohol use. Annual seasonality in alcohol use excluding drinking behavior in December, is highest in the summer. Seasonality with regard to changes in the proportion of respondents who report drinking alcohol in the previous month, or in the proportion of less regular heavy drinkers, is, although statistically significant, not very pronounced. With regard to drinking five or more drinks on 11 or more occasions in the past month the level of seasonality is very pronounced. The December peak in alcohol use powerfully influences the proportion of respondents who report drinking alcohol in the previous month, and the proportion of irregular and regular heavy drinkers. The data support previous advice that health promotion and health policy activities in relation to alcohol use should take place during the December festive period and, if one aims at heavy drinking, the summer.

Seasonal variation in survey and sales estimates of alcohol consumption.

Time variation of drinking is substantial and has an effect on aggregate estimates of consumption. In this article it is shown that because of a considerable seasonal variation in consumption (+/- 20%) a serious bias in annual consumption estimates can be expected in surveys with a limited time frame. The present study analyzes drinking data collected in the general population of the Netherlands from March 1985 through December 1985 (including Christmas and New Year's Eve). Since it was expected that sensitivity to temporal fluctuations might not be equal for different methods of measurement, several indices of consumption were compared. Although the assessed seasonal effect varies indeed across types of measurement, across male and female subsample and across types of alcoholic beverage, the general tendency is for consumption to be highest in the spring season and lowest in the autumn. Sales figures fluctuate accordingly. It is evident that the risk of biased estimates is larger the shorter the time frame of the survey. Seasonal variation was highest in the frequency domain. Furthermore, exclusion from the time frame of collective holidays, during which people drink more often and more per occasion (viz., Christmas), increases the risk of biased estimates. Even estimates of abstention, but also regular heavy drinking among women, appear to vary considerably over the three seasons in this study. The main conclusion is that results of comparisons of survey data on drinking, particularly those over time, are more or less invalid if the respective time frames of the surveys do not correspond.

Biological markers of alcoholism.

The roles of two categories of biological markers--those relating to alcohol consumption and those relating to the risk of developing alcohol related problems--are reviewed. Platelet Mono-amino oxidase levels are low in individuals with a strong inheritance of their drinking problem (Cloninger Type II alcoholics). Elevated gamma-glutamyl transpeptidase (GGT) levels identify regular heavy drinkers with a sensitivity between 40-60%. Mean corpuscular volume (MCV) has a high specificity (95%) and is useful in detecting regular heavy drinkers in the ambulatory care population if other causes of an elevated MCV can be included.

The effects of alcohol on learning as a function of drinking habits

Thirty-six subjects were categorized as light social drinkers (LSD) and 36 as heavy social drinkers (HSD) on the basis of both biological criteria, gamma-glutamyl transferase (GGT) and the mean corpuscular volume (MCV) and by self-reports of drinking habits. This study examined the effects of alcohol (0.7 ml/kg) and of noise (75 dB(A] on learning and performance, in choice RT and in immediate memory tasks. Each subject was tested in two consecutive sessions (the time factor) under one of the following experimental conditions: (a) silence + placebo; (b) silence + alcohol; (c) noise + placebo; and (d) noise + alcohol. On immediate memory, there was a strong effect of time which interacted with 'drinker' category, suggesting that HSD subjects learn less rapidly than LSD. Time interacted also with state (sober or intoxicated), showing that learning might be impaired even by a moderate dose of alcohol. On the reaction time task no main effects were found but the time X drinker category interaction was significant; in session 1 LSD's RT were shorter than those of HSD. It is suggested that regular heavy drinking might affect the learning abilities of those who are not yet labelled as alcoholics.

DIFFERENTIAL EFFECTS OF ETHANOL ON THE PLASMA GLUCOSE OF NON-ALCOHOLIC LIGHT AND HEAVY SOCIAL DRINKERS

Plasma glucose levels (PGL) in healthy non-alcoholic heavy drinkers of both sexes were significantly higher than in light drinkers following feeding or fasting. Female heavy drinkers showed significant glucose intolerance following a standard (75 g) glucose tolerance test. Acute alcohol consumption (0.4 g/kg orally) produced a larger fall in the PGL of heavy, compared with light, drinkers, although the rate of clearance of alcohol was similar in both groups. It is concluded that mild hyperglycaemia and glucose intolerance can occur in regular heavy drinkers who are otherwise clinically normal. It is suggested that previous drinking history is an important factor to be considered in assessing the metabolic response of non-alcoholics to acute alcohol consumption.

Alcohol and stroke.

Alcohol might contribute to stroke in several ways: induction of cardiac arrhythmias and cardiac wall motion abnormalities which predispose to cerebral embolism, induction of hypertension, enhancement of platelet aggregation and activation of the clotting cascade, and reduction of cerebral blood flow by stimulation of cerebral vascular smooth muscle contraction or by altering cerebral metabolism. While these pathophysiological mechanisms have gained enthusiastic experimental and theoretical support, the findings are preliminary and will require further large-scale clinical and epidemiological analyses to substantiate their roles as causal factors or potentiators of stroke. Documentation of measurable platelet and coagulation cascade abnormalities reported in healthy volunteers who have ingested alcohol will need to be confirmed on a broader scale in stroke patients with recent ethanol consumption. The risk of stroke in those with alcohol-induced atrial fibrillation and cardiomyopathy must be ascertained for the general population. While the experimental evidence is exciting and provocative, epidemiological evidence also suggests a link between alcohol consumption and stroke. Regular alcohol ingestion is associated with hypertension, fatal and nonfatal intracranial hemorrhage, cerebral infarction, and increased risk of death from stroke. Recent, less stringently controlled studies suggest that alcohol consumption is a risk factor for cerebral infarction in young adults with occasional ethanol intoxication and middle-aged women and young men with occasional alcohol intoxication and regular heavy drinking. Alcohol may also be a risk factor for subarachnoid hemorrhage.

Ethanol intoxication: a risk factor for ischemic brain infarction.

One hundred consecutive patients (67 men, 33 women) aged from 15-55 with acute ischemic brain infarction verified by computed tomography and/or angiography and/or brain scanning were studied. In 40 cases the onset of symptoms was preceded within 24 hours by ethanol intoxication. Ethanol intoxication preceding brain infarction was 4-7 times as common in men and 6-15 times as common in women as ethanol intoxication in the general Finnish population of the same age and sex. Nineteen of the patients were heavy drinkers. Heavy drinking was twice as common in men and 5 times as common in women as heavy drinking in the general Finnish population of the same age and sex. Both occasional ethanol intoxication and regular heavy drinking seem to carry an increased risk of ischemic brain infarction. The ethanol-induced risk was highest in middle-aged women and young men.

Alcohol and violent crime re-examined: self-reports from two sub-groups of Scottish male prisoners.

SummaryTo re‐examine the relationship between alcohol consumption and violent crime, 100 men from a Scottish prison were interviewed. Fifty respondents (the assailants) were convicted of violent offences and 50 (the control group) had been convicted of non‐violent offences.Assailants were more likely to have consumed alcohol at the time of the offence than the controls. The discrepancies which were found support previous findings that alcohol consumption at the time of the offence is associated with violent crime. The relationship cannot, however, be explained simply by the‘intoxicating effect’of alcohol. A pattern of regular heavy drinking was evident amongst both sub‐groups.

Nieprzystosowanie społeczne i środowiska rodzinne młodzieży systematycznie nadużywającej alkoholu

Nieprzystosowanie społeczne i środowiska rodzinne młodzieży systematycznie nadużywającej alkoholu