The Epidemiological Analyses of the NAS research component involves the current 2009/10 National Alcohol Survey (NAS), the future 2014/15 NAS and previous NAS surveys from 1979, 1984, 1990, 1995, 2000 and 2005. Our analyses capitalize on unique strengths of the NAS survey series including commensurate measurement of detailed alcohol consumption patterns, alcohol dependence and consequences, life-course heavy drinking patterns, prior problems and other risk factors. The NAS series includes an unusually broad range of personal characteristics and psychosocial risk factors, having many unique features including the availability of comparable US adult population surveys at approximately 5-year intervals over the past 30 years. From the 2000 on, the NAS Resouces Core will provide neighborhood and county-level geo-referencing that captures environmental measures of alcohol availability, local drinking culture and socioeconomic conditions which our aims exploit. Long-term trend analyses are specified to reveal recent changes in intake patterns and problems;additionally, we propose age-period-cohort (APC) models to better understand the underlying components of these trends. Attaching environmental variables to this representative US sample brings a fresh perspective to our analyses of individual-level data by locating respondents within a particular geographic setting characterized by socioeconomic, drinking culture and alcohol availability measures. Together with the life-course drinking and other risk factors, the inclusion of these environmental variables will add considerable depth to our plans to model problem outcomes, since these depend in many cases on an individual's past behavior and experiences, as well as the current social, cultural, economic and regulatory environment. Also, our analyses benefit greatly from more precise measures of current intake that, since 2000, adjust for drink size and strength. Using these key features of the NAS, a series of aims test hypotheses to advance the epidemiology and etiology of a broad range of alcohol-related problems including alcohol dependence, driving under the influence (DUI), accidents and injuries, and family, work, health and legal consequences of heavy drinking. Additional analyses will evaluate the determinants of externalities related to others'drinking including violence victimization, family problems and vandalism, and will investigate health care utilization by individuals with alcohol use disorders. Finally, detailed analyses of self-reported drunkenness and heavy drinking occasions will improve understanding of these important and inter-related measures and their relationship to outcomes such as impaired driving.

Public Health Relevance

Analyses of the National Alcohol Surveys will provide new findings of great public health significance on the eitiology of numerous alcohol-related problems including alcohol dependence, injuries, drunk driving and externality effects on others. Exploiting attached geo-referenced contextual data will reveal the roles of culture, socio-economic conditions and outlet density on alcohol problems. Age-period-cohort analyses will illuminate in depth how consumption patterns change over time plus their inter-relationships with drug use.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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Karriker-Jaffe, Katherine J; Witbrodt, Jane; Subbaraman, Meenakshi S et al. (2018) What Happens After Treatment? Long-Term Effects of Continued Substance Use, Psychiatric Problems and Help-Seeking on Social Status of Alcohol-Dependent Individuals. Alcohol Alcohol 53:394-402
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Karriker-Jaffe, Katherine J; Li, Libo; Greenfield, Thomas K (2018) Estimating mental health impacts of alcohol's harms from other drinkers: using propensity scoring methods with national cross-sectional data from the United States. Addiction 113:1826-1839
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