The prevalence of alcohol use disorder rises in neighborhoods with large numbers of alcohol retailers, as well as among groups whose social norms accept or encourage drunkenness, according to recent findings from a group of American researchers.
Alcohol consumption is largely a social activity and commonly occurs in specific social contexts or settings. In a study published in March 2015 in the journal Drug and Alcohol Dependence, researchers from two U.S. universities explored the impact that two social factors—the number of alcohol-selling locations in a given neighborhood and the social acceptability of getting drunk—have on the odds that a person will develop a diagnosable case of the American Psychiatric Association-recognized illness known as alcohol use disorder.
Alcohol Use Disorder
A person with alcohol use disorder has mild, moderate or severe indications of problematic drinking associated with non-dependent alcohol abuse, alcohol dependence (alcoholism) or overlapping alcohol abuse and alcohol dependence. Doctors use an 11-symptom checklist to diagnose the presence of the disorder. Specific symptoms on this checklist include loss of the ability to set and honor predetermined limits on drinking participation, a recurring craving to drink while not actively consuming alcohol, devotion of a disproportionate amount of time or resources to drinking-related activities, repeated alcohol consumption in clearly risky physical circumstances, reduced participation in previously favored activities as a consequence of drinking, increasing tolerance to alcohol’s intoxicating effects and the onset of an unpleasant and potentially dangerous withdrawal syndrome when alcohol intake does not reach a minimum established level.
Since 2013, doctors in the U.S. have officially diagnosed all serious alcohol-related problems as indications of alcohol use disorder, whether specific problems in an individual fall into the alcoholism category or the non-dependent alcohol abuse category. This fact reflects the scientifically established intertwined nature of alcoholism and alcohol abuse. Importantly, doctors no longer have to choose between an alcoholism diagnosis and an alcohol abuse diagnosis when working with their patients. In practical terms, this means that there is typically a smaller chance that serious alcohol problems will go unnoticed or unreported in a medical setting.
Drinking and Social Norms
Since the human species is inherently socially oriented, social norms can have a major impact on the behaviors undertaken by any given person or group. For thousands of years, human societies have consumed alcohol in a largely social context. This means that, in addition to consumption in the home, drinking commonly occurs in social environments such as parties, bars, nightclubs, concerts and sporting events. All groups have social norms that govern acceptable behavior in settings associated with alcohol intake. In some cases, prevailing norms may discourage open displays of intoxication; however, prevailing norms may also allow or actively encourage intoxication.
Impact of Alcohol Availability and Drinking Norms
In the study published in Drug and Alcohol Dependence, researchers from the University of California, Berkeley and Boston University used data gathered from 4,000 residents of New York City to help determine the impact that neighborhood availability of alcohol and social norms regarding drunkenness have on the likelihood that a person will develop alcohol use disorder. The researchers wanted to know if either of these factors has an independent influence on alcohol use disorder rates; they also wanted to know if neighborhood alcohol availability and drunkenness-related social norms have a combined influence on rates for the disorder.
The researchers found that 1.78 percent of the study participants qualified for an alcohol use disorder diagnosis. They concluded that living in a neighborhood with an unusually high number of alcohol-selling locations increases the chances of developing the disorder by a small but notable 0.88 percent. In addition, the researchers concluded that exposure to social norms that accept or encourage drunkenness increases the chances of developing alcohol use disorder by 2.05 percent. However, they did not identify any combined risk associated with living in a neighborhood with large numbers of alcohol-selling locations and belonging to a social group that accepts or encourages drunkenness.
Despite the lack of a combined effect of neighborhood alcohol availability and drunkenness norms on the risks for alcohol use disorder, the study’s authors believe that alcohol-related public health efforts that address both of these issues will likely produce benefits that are superior to the benefits provided by efforts that address only one of them.