Discriminative control of alcoholics' drinking by the drinking situation

Implicit in what has come to be called the loss of control concept is the notion that the environment, or the context within which drinking occurs, exerts little influence on the quantity of alcohol consumed by an alcoholic. In contrast, recent formulations of the alcohol dependence syndrome have argued that dependence arises from an interaction among personality, pharmacological and contextual variables. The present study investigated the relationship between contextual factors and alcohol consumption in 231 men and 90 women alcoholics. Self-report questionnaire data were obtained describing social pressures to drink more or less than usual, and the usual quantity of drinking in a variety of situations (e.g., at home alone, in bars or in family settings). The findings indicate clear differences in the quantities that alcoholics drink when alone, with friends or with family. Even the dependent drinker is apparently able to discriminate the relative quantity of drinking that will be socially sanctioned in a given situation and modify consumption accordingly. In situations in which constraints are absent or minimal (e.g., alone), drinking tends to be greater than in situations in which social controls are more pronounced (e.g., with friends and family).