What if alcoholism had not been invented? The dynamics of American alcohol mythology.

This essay speculates on what might have been had alcoholism not been invented. The invention is viewed as a product of the ongoing myth-making process whereby society continuously defines and redefines alcohol, seeking to integrate it into the culture in ways that allow enjoyment of its pleasures with minimum pain. Had alcoholism not been invented, (a) the myth-making process might have yielded another simplistic explanation of drunkenness, but more likely alcohol would have remained the supposed cause; (b) the per capita alcohol consumption uptrend of some 50 years standing might not have reversed as it did in 1982; (c) chronic drunkards might still be denied life-saving hospitalization which gains them more time for the natural reform process to work for them; and (d) local communities nationwide might have taken common-sense actions to facilitate the natural rehabilitation process and provided more benefit to more alcoholics for less cost than treating alcoholism.

Privatization, price and cross-border liquor purchases.

Self-report survey data were used to investigate the effects of liquor sales privatization on cross-border liquor purchases. A state survey sample representing the Iowa age 18+ noninstitutionalized population was interviewed in April 1989, some 25 months after retail spirits sales were privatized. Despite a privatization induced 6.

Alcohol availability, drinking contexts and drinking problems: the Iowa experience.

Before/after survey data were used to investigate the effects that a wine and spirits privatization-induced increase in alcohol availability might have had on drinking contexts and, in turn, what effect any context changes might have had on specific drinking-related troubles. State surveys representing the aged 18+ noninstitutionalized population of Iowa were conducted in 1985, prior to the wine privatization; in 1986, after the wine privatization but before the spirits privatization; and in 1989, after both wine and spirits sales had been privatized. Despite substantial increases in the number of off-premise outlets for bottled wine and spirits following their privatizations, there was little or no change in the frequency of drinking in several different contexts or in the specific kinds of drinking-related problems studied.

Elderly versus younger problem drinker profiles: do they indicate a need for special programs for the elderly?

To address the question, "Do elderly problem drinkers differ from younger ones and therefore might they need special treatment programs?", the descriptive profiles of a representative sample of older and younger persons arrested for drinking and driving in Iowa were compared. Subjects were interviewed by telephone or mail using a structured, clinical interview schedule that was designed to obtain a comprehensive self-report picture of the role of alcohol in their lives. Younger persons (18-54 years old) were compared with two overlapping elderly age groups (55 and over and 65 and over).

Alcohol availability and consumption: Iowa sales data revisited.

Recent changes in Iowa liquor control laws ended the 51-year-old state alcohol monopoly distribution system and turned the sales of bottled wine and spirits over to the private sector. The resulting increase in the availability of these beverages provided a unique opportunity to study the relationship between increased wine and spirits availability and changes in their consumption. Time series analyses of monthly sales (apparent consumption) trends showed that the increased availability had no lasting impact on consumption.

Elderly vs. younger problem drinker 'treatment' and recovery experiences.

To address the question of whether or not elderly problem drinkers experience any treatment contact discrimination or recovery rate disadvantages, the programme utilization and recovery rate experiences of a representative sample of older and younger persons arrested for drinking and driving (OWI) in Iowa were compared. Subjects were interviewed by phone or mail shortly after their OWI arrest and then again approximately 12 months later. Younger persons (18-54 years old) were compared with elderly persons (55 and over and 65 and over).

Consequences of increasing alcohol availability: the Iowa experience revisited.

Before/after survey data were used to investigate the effect that a sudden and dramatic wine and spirits availability increase in Iowa might have had on heavy and problem drinker rates. Three state surveys representing the age 18+ non-institutionalized population of Iowa were conducted in 1985, 1986 and 1989. Neither previous sales analyses nor this survey data analysis support the Distribution of Consumption Prevention Model prediction that increased wine and spirits availability would produce significant and lasting consumption increases and, in turn, heavy drinker and problem drinker prevalence rate increases.

Self-report validity issues.

Two possible sources of the substantial gap usually found between survey self-reported alcohol consumption estimates for a population and estimates based on official alcohol sales records are investigated. A measure of atypical heavy drinking is added to ordinary consumption commonly measured in surveys, and consumption by an adolescent (age 14-17) sample is added to that of the adult sample. The relationship between respondents' purchases and consumption during a 30-day period is also investigated.

Drinking frequency changes in selected contexts by season in Iowa, 1979-1980.

A panel of individuals was interviewed at three points in time so that both individual and aggregate drinking behavior changes could be investigated during a period of increasing beverage alcohol sales (winter to summer) and a subsequent period of decreasing sales (summer to winter). The seasonal drinking frequency changes in different places, with different companions and in different situations, were generally consistent with the proposition that existing drinking behaviors are quite stable over time (the stability proposition), and also with the proposition that alcohol consumption increases occur without any substitution of new drinking behaviors for existing drinking behaviors (the addition proposition). There was, however, evidence that drinking contexts changed with age and that new drinking behaviors were substituted for old drinking behaviors in some of the subpopulations studied.

An experimental test of telephone aftercare contacts with alcoholics.

Alcoholics from two hospital-based treatment centers participated in an experimental test of the effects of extended aftercare on inpatient recovery rates. At discharge from inpatient treatment, subjects were randomly assigned either to an experimental group scheduled to be called by a center counselor every 2 weeks for 1 year or to a control group that experienced only the usual treatment. Follow-up interviews conducted approximately 12 months after hospital discharge found that the experimental group had no higher recovery rates than the control group.

Factors related to problem-drinking rates.

Intercorrelation and regression analyses of data obtained from a drinking-related behavior and attitude household survey (N = 1127) of adults (age 18+) in Iowa are reported. The consumption variables were based on the 30 days prior to interview and included total ounces of absolute alcohol consumed; number of days the subject drank beer, wine and distilled spirits separately; typical quantity of each beverage consumed on drinking days; and the number of days drank five or more drinks within a couple of hours. The drinking attitude variables included level of tolerance (approve, indifferent, disapprove) of others' (men, women, spouse, son and daughter) drinking, getting high and getting intoxicated; a balance score of the proportion of positive and negative definitions of alcoholic beverages endorsed; an level of concern (not worried, somewhat worried and very worried) for eight possible consequences of heavy drinking.

Seasonal changes in alcohol consumption and related problems in Iowa, 1979-1980.

What happens to heavy-drinking and problem-drinking rates when per-capita alcohol sales (apparent consumption) increase and decrease is examined. A panel of individuals were interviewed at three 6-month intervals: winter of 1979, summer of 1979 and winter of 1980. Respondents were questioned about their drinking-related behavior in the 30 days prior to each interview.

Changes in the climate of attitudes toward drinking in Iowa, 1961-1979.

The nature of the changes in attitudes toward alcohol use in Iowa may help explain why heavy-drinking and problem-drinking rates remained stable while consumption increased substantially there.

Maturational and generational changes in drinking behavior and attitudes in Iowa, 1961-1979.

Both maturational and generational changes in drinking-related behavior and attitudes occurred between 1961 and 1979 in Iowa. Their effects in general tended to be counterbalancing.

Alcohol consumption in Iowa 1961 and 1979. A comparison of sales and survey estimates.

Survey data reveal that an increase in per-capita alcohol consumption in Iowa from 1961 to 1979 is attributable mainly to an increase in the prevalence of drinkers and less so to an increase in the frequency of drinking occasions, and that there was little change in the quantity per drinking occasion. The extent, the direction and the sources of the consumption changes, however, varied widely across sociodemographic subpopulations.

On the validity of the research diagnostic criteria, the Feighner criteria, and the DSM-III for diagnosing alcoholics.

A 10-item Trouble-Due-To-Drinking Scale, similar to the Feighner Criteria, the Research Diagnostic Criteria (RDC), and the DSM-III Alcoholism Criteria, was tested for its ability to identify a population of clinic alcoholics (N = 2459) and a sample of nonclinic "designated" alcoholics (N = 169). The Trouble Scale identified only 27 per cent of the nonclinic cases with substantial sex, age, income, and educational biases. It identified 77 per cent of the clinic cases, with much less apparent bias.

On the validity of the Iowa Alcoholic Stages Index.

The Iowa Alcoholic Stages Index identified more later-stage than earlier-stage alcoholics in a clinic population and more earlier-stage than later-stage alcoholics in two samples of the general population in Iowa.