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REDUCING RISKS FOR Mental Disorders: FRONTIERS FOR PREVENTIVE INTERVENTION RESEARCH
to 30 percent of alcoholics have panic disorder, and about 20 percent of persons with anxiety disorders abuse alcohol (DHHS, 1991). ECA data also indicate that persons dependent on alcohol are more likely to abuse drugs. The increased odds ratios are as follows: cocaine (35 times); sedatives (17 times); opioids (13 times); hallucinogens (12 times); stimulants (11 times); and marijuana or related drugs (6 times). Surveys of both clinical and nonclinical populations indicate that at least 90 percent of alcohol-dependent persons are also nicotine dependent (DHHS, 1991).
Despite the national downward trend in alcohol consumption, projections for 1995 suggest that 11.2 million adults will exhibit symptoms of alcohol dependence, while the number of alcohol abusers will remain at current levels (DHHS, 1990). More men than women are heavy drinkers. For both men and women, drinking problems are especially common among younger age groups. In a 1984 national survey, for example, the proportion of male drinkers reporting at least a moderate level of drinking problems was highest among those aged 18 to 29 for both dependence symptoms (14 percent) and drinking-related consequences (20 percent). The proportions dropped with increasing age, reaching respective lows of 5 and 7 percent among men aged 60 and older. Among female drinkers, the proportion reporting at least a moderate level of dependence symptoms remained stable at 5 to 6 percent from age 18 to age 49 and then dropped to 1 percent. For drinking-related consequences, the proportion reporting at least a moderate level of problems was relatively high in the 18-to-29 age group (12 percent), but dropped to 6 percent for women in their thirties and forties and was negligible for those aged 60 and older (Hilton, 1987).
There are characteristics other than gender and age that are related to patterns of alcohol consumption; one of these is homelessness. People who are homeless have higher levels of alcohol abuse and dependence than the general population, with prevalence estimates ranging from 20 to 45 percent and estimates of lifetime prevalence as high as 63 percent (DHHS, 1990). Unlike the pattern in the general population, the incidence of problem drinking among the homeless appears to be highest in the middle years, and is substantially lower among both the young and the old. This finding lends some support to the thesis that many homeless people continue to drink heavily as a means of coping with the physical and emotional stresses associated with homelessness, although it is probably also true that alcoholism itself puts middle-aged alcoholics at relatively high risk for becoming homeless.
Overall drinking levels are lower among African-Americans than among the majority white population, but there are notable differences within age-group categories and African-Americans suffer to a greater