Quantitative dimensions of alcohol use for hospitalized problem drinkers

Estimates of lifetime drinking quantities were obtained from two samples of hospitalized drinkers by personal interview. Estimates had high reliability and may significantly correlate with actual amounts. Group parameters for two samples were similar. Individuals show considerable differences from each other on all measures. Drinking quantities often remain stable from year to year, and the changes that do occur include both increases and decreases, usually by small amounts. There are occasional sharp increases in some subjects. The upper limits of drinking may be as high as three quarts of 1200 proof per day for a person over 200 lbs. There is great quantitative diversity among those labeled "alcoholic." It is more useful to view drinking within a quantitative continuum, and discard the presently accepted dichotomy which arbitrarily divides drinkers into the two classes of normal and abnormal. Drinking quantities would be associated with probable social and physical damage along the drinking continuum. It would not be necessary to view those at the extreme of the continuum as qualitatively different from other drinkers, but as quantitatively different. The relationship between quantity and the adverse consequences of drinking are not simple. The harm that any quantity of alcohol can cause may depend also on other factors. Drinking may be viewed as a learned behavior that is a response to on-going events within the person's environment, rather than a symptom of an underlying disease process. It is regulated like other conditioned behaviors by the effects which it produces. The occurrence of this persistent non-adaptive behavior can be explained by the principals of learning theory, making it unnecessary to suppose an underlying disease process to account for such behavior.