Session: Extreme Alcohol Use: Prevalence, Patterns, Predictors, and Consequences (Society for Prevention Research 21st Annual Meeting)

High levels of alcohol use are associated with acute consequences including accidents, injuries, suicides, homicides, and drowning, as well as with long-term consequences like addiction and changes to the brain. There is also increasing recognition in the public health literature that patterns of alcohol use – and not just total volume consumed – are important determinants of acute and chronic effects on health and well-being (e.g., Rehm et al., 2003). At both the individual and country levels, patterns of typical consumption predict alcohol-related mortality.

This symposium brings together three studies with complementary strengths to focus on the prevalence, patterns, predictors, and consequences of very heavy alcohol use. Whereas traditional indicators have typically defined heavy episodic alcohol use have as consuming 5 or more drinks (or 4+/5+ for women/men) on a single occasion, paper 1 introduces the significance of extreme binge drinking and reports estimated national prevalence rates of this behavior (operationalized as 10+ drinks and 15+ drinks in a row) among high school seniors. Paper 2 approaches the assessment of extreme alcohol use among college students broadly, focusing on numerous alternate indicators of extreme drinking behaviors (e.g., pregaming, drinking games, estimated blood alcohol content > .16). Paper 3 summarizes the long-term consequences of excessive drinking by examining national historic data; clusters of counties characterized by unusually high rates of mortality due to excessive alcohol consumption are identified.

Important cross-cutting themes and questions include: (a) a focus on identifying subgroups at greatest risk for experiencing catastrophic alcohol-related consequences, at either the individual or county level; (b) using alternate methods to identify epidemiologically and etiologically-relevant patterns, including latent class analysis and spatial analysis; (c) identifying predictors and outcomes of differential patterns; and (d) exploring whether patterns are stable or dynamic across historical time.

Collectively, the talks in this symposium offer new insight by highlighting the importance of assessing extreme alcohol use and the need for screening and intervention efforts at the community-level in sub-populations of greatest risk. The discussant of this symposium has extensive expertise in the dynamic processes involved in alcohol treatment and relapse. The discussion will focus on the potential that research focused on extreme alcohol use holds for informing intervention programs with maximum public health impact.