Patterns and Predictors of High-Intensity Drinking and Implications for Intervention

摘要

Efforts to intervene with subgroups at particularly high risk for alcohol use require information on factors that differentiate drinking intensity levels. This article summarizes existing research and provides new findings on sociodemographics and risk factors that differentiate high-intensity drinking (HID) to provide context for developing and delivering interventions for the highest-risk drinkers. Cross-sectional data were obtained in 2019 from participants who reported past 30-day alcohol use in 2018 as part of the nationally representative 12th grade Monitoring the Future study. Among past 2-week drinkers in 2019 (N = 601; modal age 19; 57.0 male; 67.4 non-Hispanic White), bivariate associations between drinking intensity (moderate drinking 1-4 drinks for women/1-5 drinks for men, binge-only drinking 4-7/5-9 drinks, and HID 8+/10+ drinks) and a range of sociodemographic characteristics, risk factors, and alcohol-related consequences were examined. Results showed binge-drinking norms, social and enhancement drinking motives, nicotine vaping, and use of limiting/stopping drinking and manner of drinking protective behavioral strategies differentiated all drinking intensity levels, lending support to HID and binge-only drinking having an overlapping risk profile. However, there were also risk factors uniquely associated with HID, including sex, college attendance, employment, HID norms, use of serious harm reduction protective behavioral strategies, family history of drinking problems, any cigarette or drug use other than marijuana, and depression symptoms. Therefore, risk factors differentiate young adult drinking intensity. These results can inform efforts to adapt interventions for young adults who report HID. Public Health Significance Statement This study indicates that young adults who report high-intensity drinking have higher social and enhancement drinking motives than young adults who engage in drinking at binge levels below high-intensity drinking thresholds. Young adults who report high-intensity drinking are more likely to have a family history of drinking problems and to report more depression symptoms than young adults who engage in drinking at binge or moderate-intensity levels. The results from the present study suggest that brief interventions targeting HID likely need to address unique risks, including other substance use, depression symptoms, fewer protective behavioral strategies, and negative alcohol consequences.