How is Excessive Drinking Maintained? Untreated Heavy Drinkers' Experiences of the Personal Benefits and Drawbacks of their Drinking

Abstract

The present paper reports results from a larger study of 500 heavy drinkers (men drinking more than 50units of alcohol per week, women more than 35 units), untreated for their drinking within the last ten years, recruited by advertising and snowballing in the English West Midlands. Data on participants' perceived benefits and drawbacks of their own drinking were obtained by I) a computer-administered set of ratings of benefits and drawbacks in thirteen life domains, and 2) open-ended interviewing with a subsample of 50 participants leading to qualitative analysis of post-interview reports and transcripts. The main fmdings were: perceived benefits outweighed drawbacks in both forced-choice ratings and open-ended interview; there was a small but significant correlation between drinking large quantities in a day and perceived drawbacks; social benefits and drawbacks were dominant in open-ended interview; enhancement and coping benefits were linked by the concept of "relaxation" and were difficult to distinguish; becoming argumentative and aggressive with friends and family was the dominant drawback in open-ended interview; in the health domain, toxic and short-term drawbacks were more salient than longer-term illness effects. These findings suggest a model of the perceived benefits and drawbacks of heavy drinking which challenges both conventional health promotion efforts and motivational balance models of alcohol consumption.

From Use to Abuse: When Everyday Consumption Behaviours Morph into Addictive Consumptive Behaviours

“…Orford et al (2002) observed that the perceived benefits of drinking outweighed the drawbacks for heavy drinkers. This finding suggests an opportunity to better understand how to creatively communicate the benefits of the potential addictive behaviour while more heavily weighting the harm.…”

Addiction: A Disease of Volition Caused by a Cognitive Impairment

“…Left with only reasons to act and unable to access reasons not to act, the addict once again resumes the addictive behaviour, with negative consequences. Orford did show that "toxic and short-term drawbacks of heavy drinking were more salient than longerterm illness effects" (9). This suggests that a more recent or readily accessible memory of negative consequences decreases the cognitive impairment, which impedes the return to addictive behaviour.…”

“…The confusion and use of multiple terminologies with no common etiology of addiction are such that William Miller warned in 1993 that the current disease models were inadequate to explain or resolve the wide spectrum of alcoholrelated problems (8). In 2002, Orford reported that, among a group of heavy drinkers, the perceived benefits outweighed the drawbacks "which challenges both conventional health promotion efforts and motivational models of alcohol consumption" (9). In 2002, the endogenous cannabinoid system was shown to have a central function in the extinction of aversive memories (10).…”

Pub and community: The views of Birmingham untreated heavy drinkers

“…We think the answer to that question may be strongly affirmative. The present results add the element of place to our earlier analysis which highlighted the importance of socialising as a principal benefit of drinking for heavy drinkers (Orford et al, 2002). Personal motives and alcohol expectancies combine with the positive functions of drinking places to provide a powerful person-place complex against which forces for 'moderate' or 'sensible' drinking must compete.…”

“…Nearly all of the sample drank in a pub from time to time. Analysis of the benefits and drawbacks of their drinking described by members of the sample, also at Wave 1, suggested that the positive function of drinking in aiding socialising was predominant (Orford, Dalton, Hartney, Ferrins-Brown, Kerr, & Maslin, 2002). Since cohort members were first interviewed we have tried to build up as full a picture as possible of their lives as heavy drinkers, through a combination of structured and semi-structured interviewing carried out every 2 years.…”