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Heavy drinkers consume less over time, but not at 'normal' levels

October 2010--Problem drinkers in the general population may reduce the amount of alcohol they consume over a period of years but not to the level of the average adult, according to a new study in the November issue of the Journal of Studies on Alcohol and Drugs.

Given that heavy drinkers often don't become "normal" drinkers on their own, the takeaway message for clinicians and family members is to help connect a problem drinker to a community social service agency or Alcoholics Anonymous.

Simply telling someone that they had a drinking problem did not seem to be helpful in this study, but being specific about how to get help did.

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.

Eleven years later, men in the study had reduced their average number of drinks per month by 51%, and women had reduced their average number of drinks by 57%.

However, even after this reduction, male and female problem drinkers still consumed 160% and 223% more alcohol, respectively, than the average adult without a drinking problem.

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,' which is interesting."

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.