Acute consequences from high risk drinking in a period of increasing consumption in the US: Demographic factors and policy implications

Recent increases US per capita ethanol consumption appear driven by heavier drinking in those aged 18-24, following the nadir of the early 1990s. Data come from the cross-sectional 5-yearly National Alcohol Surveys (NASs) 1979 to 2005 series, especially the 1984 (n=5,221), 1995 (n=4,925), 2000 (n=7,216) and 2005 (n=6,919) surveys spanning the period of declining, then increasing consumption. Primary outcomes are alcohol-related acute consequences involving intoxication: drunk driving, arguments and fighting, crashes and legal trouble, and partner difficulties. Separately by gender, we contrast trends in consumption and problem indicators for young adults18-25 versus other adults over 25. Drunk driving, though higher in the young, falls systematically over the period 1984 to 2005 for both age groups. Other acute problems, also always higher for the young adults, are relatively stable in the younger group, while modest problem reductions mirror the declining drinking trends in the over-25 group. Multivariate models examine the basis for the decoupling of consumption patterns and problems in the younger drinkers. In those aged18-25, changing norms regarding acceptance of drunkenness and attitudes toward drinking track the drinking trends, are taken to indicate the drying then wettening social trends over the 20 years. Policies deterring drunk driving appear to result in reductions in drinking driving reports over time in both age groups. We evaluate the conjecture that alcohol problem reporting involves a social construction process, asking whether this helps explain the decoupling of rates of drinking-related aggression, partner trouble and legal problems from the heavy drinking changes among younger adults.