Indexing reasons for heavy drinking using the Alcohol Consumption Questionnaire in a sample of American Indian adults

To better quantify reasons for high levels of drinking observed among American Indians (AIs) who drink, we measured drinking behaviors in a sample of AI adults using the Alcohol Consumption Questionnaire (ACQ).

The sample consisted of 549 AI adults (54.8% female; average age = 31.7 years [standard deviation = 13.7]) living on reservations. Logistic regression models assessed associations of mean scale scores with lifetime alcohol use disorders (AUDs), adjusting for key demographics.

Respondents were stratified by the amount of alcohol needed to feel they had "enough" (level of alcohol satiety). Approximately one quarter (23.3%) of respondents reported satiety at less than binge drinking (<4 drinks for women, <5 drinks for men), 30.9% by heavy binge drinking (4-7 women, 5-9 men), 30.9% by high-intensity binge drinking (8-15 women, 10-19 men), and 14.9% were only satiated by extreme binge drinking (16+ women, 20+ men). Respondents satiated by extreme binge drinking also reported that their satisfying level of alcohol use was associated with losing their ability to walk and talk and with experiencing blackouts. The overall ACQ score and the subscale indexing consumption were significantly associated with AUD, with odds ratios ranging from 5.53 for mild AUD to 33.37 for severe AUD (each versus no AUD; all P-values < .001).

Extreme levels of binge drinking may be associated with extreme expectations about an individual's "satisfying" level of alcohol exposure. The ACQ measure effectively indexes consumptive behaviors and provides an additional diagnostic tool that may help target prevention and/or treatments for AUD.