Describing alcohol consumption and alcohol related  
Do hazardous and harmful drinking and dependence on alcohol exist within a continuum?

Alcohol consumption, alcohol-related harm and alcohol dependence exist within a continuum. Alcohol consumption ranges from not drinking alcohol, through low risk drinking, hazardous drinking, harmful drinking to alcohol dependence. In the same way, the harm done by alcohol ranges from no harm through mild harm, substantial and severe harm. Alcohol consumption and the harm done by alcohol are not fixed entities and individuals can move back and forth along the continuum, including in and out of alcohol dependence during their lives. An American study found that of people with alcohol dependence prior to the last year, 18% were found to be abstainers during the last year, 18% were low­risk drinkers, 12% were asymptomatic risk drinkers who demonstrated a pattern of drinking that put them at risk of relapse, 27% were classified as being in partial remission, and 25% were still classified as dependent (Dawson et al. 2005). Only one quarter of all these people had ever received treatment for alcohol dependence.


The aetiology and the course of harmful drinking and alcohol dependence are to a large extent explained by behavioural, environmental and life course factors (McLellan et al. 2000; Bacon 1973; Öjesjö 1981; Edwards 1989; Moos et al. 1990); they can be described as environmentally responsive (Curran et al. 1987; Pattison et al. 1977; Humphreys et al. 2002) clinical disorders; they are readily responsive to environmental policy factors, such as the price of alcohol and regulations on the availability of alcohol (Bruun et al. 1975; Edwards et al. 1994; Babor et al. 2003); they are also readily responsive to treatment (Klingemann et al. 1992; Blomqvist 1998), whose impact is likely to be enhanced in the presence of effective environmental policies.

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Last modified: 03/05/2006 | Published on: 29/06/2005 Top

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