This competing continuation application for a National Alcohol Research Center proposes a program of epidemiological and social research on the patterning and determinants of drinking practices and problems in both general and clinical populations. The 14 major research components include (1) a core component for the Center. A program of national alcohol survey research includes (2) planned analyses of the 1990 national survey, including a series of trend comparisons with earlier national drinking surveys, and analysis of the structure of alcohol dependence in the general population; and (3) a 1994/95 national alcohol survey, including descriptive and trend analyses, social psychological analysis of the relation between expectancies and reasons for drinking, and study of the interrelations of attitudes to drinking, to responding to alcohol problems, and to alcohol policies. A program of longitudinal research on national samples includes (4) a follow-up study of changes in drinking among White, Black and Hispanic respondents; (5) a mortality analysis of the same sample; and (6) a study of incidence and remission of heavy drinking and other risk-taking behaviors in a national sample of adolescents and young adults. Studies of alcohol's role in serious events include (7) analyses of alcohol's role in criminal behavior and in victimization in general populations and in a sample of arrestees; and (8) studies of alcohol's role in injuries seen in emergency rooms, including a comparison between data from California and Mississippi. (9) A study of the structure alcohol dependence in clinical populations compares patterns among White, Black and Hispanic men. Several studies relate to a continuing program of studies that use a county as a Community Epidemiology Laboratory. These studies include: (10) a study of alcohol use and problem among clients of homelessness services; (11) a study of systems of care for cases with alcohol problems which analyzes information and opinions from professionals and other service providers; (12) a study of the clients of private alcohol treatment, in a large health maintenance organization (HMO), comparable with earlier studies of clients of public alcohol treatment; (13) a study of drinking practices and problems in clients of the urgent care services of the HMO, comparable with data from public primary care clinics; and (14) a series of analyses across both proposed and existing CEL data-sets, including studies of clients of 8 health and social service systems and of general population samples, which probe processes of community response to and triage of problematic drinking.
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