This study proposes a tenth National Alcohol Survey (N=10,000) using Random Digit Dialing telephone interviews which will range in length from 15 minutes (among abstainers) to 60 minutes (for a subsample of drinkers and of heavier drinkers). Telephone interviewing will allow economical oversampling of minorities (2,000 Blacks and 2,000 Hispanics), and will permit inclusion of Alaska and Hawaii for the first time in the NAS series. A response rate of at least 70% is specified. Questions used in prior in- person NAS and telephone warning label national surveys will be pre-tested using telephone interviews; items include alcohol consumption and reasons for abstaining from or limiting drinking, opinions on alcohol policy, alcohol-related problems, alcohol dependence comorbidity, service utilization, and risk-taking behavior. These data will provide a detailed epidemiological profile of consumption patterns, problems, norms, attitudes and service utilization at the end of the millennium. They augment the surveillance data required to assess attainment of policy goals for Health People 2000 and will enable trend analyses of alcohol use and problems over the past 20 years. We expect to find indications that the period of declining aggregate national consumption is coming to an end -- although drinking patterns are unlikely to change uniformly across all subgroups. We hypothesize that use of alcohol-specific treatment services will reflect the uneven distribution of service availability, as well as referral patterns of community agencies (including court-mandated treatment) and factors at the individual level such as insurance coverage. We expect to find sustained support for alcohol policies needed to achieve athe goals for the year 2000 regarding reduction of alcohol-related motor vehicle accidents, reduction o alcohol-related injuries leading to emergency room visits, and increased availability of treatment for women and minorities. We further expect self-reported behavior to indicate achievement of goals in these areas as well (e.g., fewer respondents reporting driving while intoxicated or not knowing where to go for help with their drinking problem). Hypotheses regarding regional patterns in use of alcohol-related health services will have practical applications for contemporary health reform efforts that increasingly emphasize decentralization of services. The proposed risk function analysis will provide information relevant for national recommendations regarding """"""""safe"""""""" drinking levels. In an effort to inform the debate over the """"""""prevention paradox"""""""" and to provide information on the public health burdens accruing from various types of alcohol consumption, we will assess the parametric relationship between several alcohol consumption measures and the prevalence and seriousness of alcohol problems.
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