Alcohol Abuse

It's just another Friday night, but this time it's the guy's night out. What do many teenage boys have on their mind? They want to go cruising down the highway at 80 miles per hour with the windows down. Find some beer, and some women that they can get drunk, have sex with and have something to tell about the next day. The sad thing is, that most of the time it is true. A survey was taken in Nebraska in September of 1995, which said 25.7% of adolescents aged 18 and younger said, they have used alcohol before having sex. That is just in Nebraska alone (Courtney, 288, 1995). It is also said that Fraternity and Sorority members drink more and drink more frequently than their peers and accept as normal high levels of alcohol consumption and associated problems. Fraternity-sponsored parties also may encourage heavy drinking. Studies have found that students who consider parties or athletics important and those who drink to get drunk appear most likely to binge drink or to drink heavily (Shalala, 1, 1995).
Although alcohol use by adolescents is frequent, alcoholism is very rare. Still, alcohol consumption by adolescents hinders normal development. Alcohol intake by children can result in learning impairment, hyperactivity, and personality and behavior problems, because today's society has accepted the casual use of alcohol (Effects, 1996, 1). Among men, research suggests that greater alcohol use is related to greater sexual aggression (Shalala, 1995, 2). Students living on campuses with higher proportions of binge drinkers experience more incidents of assault and unwanted sexual advances because of their peers' drinking than do students residing on campuses with lower proportions of binge drinkers (Shalala, 1995, 2). Some campuses sponsor alcohol awareness events and classroom lectures and distribute information about alcohol use. Although such education programs raise students' awareness of issues surrounding alcohol use, these programs appear to have minimal effect on drinking and on the rates of alcohol problems.
According to Donna E. Shalala, Secretary of Health and Human Services at The National Institute on Alcohol Abuse and Alcoholism, it seems that binge drinkers appear to engage in more unplanned sexual activity and to abandon safe sex techniques more often than students who do not binge drink (Shalala, 1995, 2). The purpose of this paper will prove whether or not Ms. Shalala is right or wrong.
The first study was done in 1992. The purpose of this study was to explore the relationship of alcohol use to unsafe sex in Latinas. The study was conducted using telephone interviews. The interviews were conducted with 523 currently sexually active Latinas aged 18-49 years old. The telephone survey employed a modified Mitofsky-Waksberg sampling technique to identify Latino households in nine states with concentrations of Latinos ranging from 5 to 39% in New York, New Jersey, Massachusetts, Connecticut, California, Arizona, Colorado, New Mexico, and Texas. Latinos in these states represent 77% of all United States Latinos (Marín, 1992, 1103).
The screening procedure involved identifying the ethnicity, gender, and age of household members. Potential respondents were asked "Do you or any of the members of your household consider yourselves to be Latinos or Hispanics?" An eligible respondent in the household was selected using the Kish method, which lists all adult household members and then uses one of 12 possible selection schemes to randomly select among those eligible (Marín, 1992, 1104). Interviewers were bilingual males and females. Experienced interviewers recruited respondents by telling them this was a national health survey and that the topic was AIDS. Interviewers received specific training on how to ask the highly personal questions used in this research (Marín, 1992, 1104).
A response rate in survey sampling can be defined as the ratio of the number of questionnaires completed of eligible elements to the number of eligible elements in the sample. Businesses, faxes, and non households were ineligible for reporting. After these were eliminated, age and gender of adults in the household was determined for 67.1% of eligible telephone numbers. Also 86.4% of those contacted who met the requirements for the study provided complete interviews. A response rate of 58% for the entire sample was obtained (Marín, 1992, 1104-5). The interviews were 100 open-ended calls, and two gender exclusive focus groups with Latinos and Latinas in San Francisco. Its purpose was to identify perceived consequences of condom use with secondary and primary partners, difficulties with condom use, and the average aspects of use. The final version of the interview took an average of 24 minutes to complete and explored a variety of topics related to condoms and sexual behavior. The questions mainly asked about alcohol use prior to sex, sexual comfort, self-effectiveness scale, secondary partner response to condom use, and acculturation (Marín, 1992, 1105).
Of the 624 Latinas aged 18-49 interviewed in this study, 523 (83.8%) were sexually active. These women provided responses to the question about alcohol use prior to sex. Fully 65% indicated that they never used alcohol prior to sex, 28% said they used alcohol less than half the time, and only 7.5% used alcohol half the time or more (Marín, 1992, 1106). The demographic characteristics of Latinas who use or do not use alcohol before sex are shown in the table below. There were a number of differences between the groups. Alcohol users were younger [t(519) = 2.3, p < .05], better educated [t(519) = 2.7, p < .01], more acculturated [t(519) = 2.3, p < .001], had fewer children [t(519) = 4.1, p < .001], and showed a trend toward being employed longer outside the home [t(519) = 1.7/ p < .10] (Marín, 1992, 1106). To clarify the effect of acculturation in this sample, depending on the level, the highly acculturated women were more likely to have two or more sexual partners, more likely to use alcohol before having sex, and more likely to use condoms with a secondary partners (Marín, 1992, 1106).
In this study, alcohol use prior to sex was associated with greater numbers of sexual partners., but also with more experience with condoms. Thus, alcohol use prior to sex may be a marker for the broader process of acculturation. Acculturation in Latinas has been associated with higher likelihood of multiple sexual partners and with greater use of alcohol, but also with higher likelihood of carrying condoms (Marín, 1992, 1109). In and exploratory analysis we found that among those 55 women who reported secondary partners, use of alcohol before sex was associated with greater condom use, even with the effects of acculturation (Marín, 1992, 1109). This study does agree with Mrs. Shalala's hypothesis.
The second study was conducted in 1993. It was conducted to examine the relationship between drug and alcohol use, personal network characteristics, and sexual risk behaviors. The study focused on social factors that may account for the relationship between substance use and sexual risk behaviors. In the study, social environment factors such as drinking with friends, drinking in bars, and patterns of purchasing alcohol with friends have been found to have a strong influence on alcohol consumption, both in term of frequency and quantity. Another factor the study wanted to examine was the relationship between use of different substances and sexual behavior.
To conduct this study, respondents were recruited from the AIDS Linked to Intravenous Experiences (ALIVE) study, a natural history study of HIV infection in IDUs in Baltimore. The primary means of recruitment for the ALIVE study were community outreach and word-of-mouth. ALIVE clinic participants who were 18 years or older and reported at their regular 6-month follow-up visit that they had injected drugs in the preceding 6 months and shared drugs were asked to participate in the Stop AIDS for Everybody (SAFE) study. All participants were administered a detailed survey on their background, drug, and sexual behaviors followed by a personal network interview. The personal network instrument asked participants to list, by giving the first name and the first letter of the last name or pseudonym, members of their personal network. They were first asked to list individuals that they had known for at least one month who they could go to for support in the domains of: intimate interactions, material assistance, socializing, physical assistance, positive feedback, and health information (Latkin, 1993, 161-3).
Out of 297 volunteers, seven failed to meet the eligibility requirement at rescreening. The 290 respondents were predominately of low income, African-American (96%), male (84%), and reported receiving public assistance (70%) (Latkin, 1993, 163). Within the last six months, 21% had been in jail and 40% had been homeless. The average age for men was 39 years and the range was 24 to 56 years; for women the average age was 37 years, the median was 35, and the range was 27 to 55 years. Daily use of alcohol was reported by 29% of the respondents. Individuals who reported daily alcohol use drank significantly more on the days they drank than those who reported drinking less than daily (mean of 11.1 vs. 5.2 drinks per day, t = 4.88, P <.01) (Latkin, 1993, 163). Most of the males (90%) and females (77%) reported that they were sexually active in the prior six months. The average number of partners for men was two and one for women. Over half the males (57%) reported more than one partner in the last six months, over two-fifths (40%) reported "one-night stands", and one-third (33%) reported "giving drugs or money for sex" (Latkin, 1993, 163-4). Fewer females reported multiple partners (28%) or casual partners (21%), though 26% reported receiving drugs or money for sex at least once in the last six months. The reported use of condoms was sporadic. More than one-third (38%) reported that they never used condoms and only 29% reported that they used condoms more than half of the times they had sex. These results indicate that among heavy drinkers, and those with larger, lower density personal networks have increased levels of sexual risk behaviors (Latkin, 1993, 166). In the end, this study said that people with drinking habits do have a tendency to have risky sexual behavior. This study also agrees with Mrs. Shalala's hypothesis.
The third study was conducted in 1995. It was conducted to see if alcohol-related blackouts, craving and risky sexual behavior are common among adolescents with alcohol use disorders and are an important focus for assessment and treatment efforts. The most recent diagnostic criteria for alcohol use disorders commonly used in the U.S. are contained in the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV) (Martin, 1995, 672). The DSM-IV framework provides a system of operationally defined symptoms, and standard definitions of problem areas and allow clear communication among and between clinicians and researchers in the field. To qualify for a DSM-IV alcohol dependence diagnosis, at least three of seven symptoms must be present within a 12-month period. The DSM-IV symptoms are: (D1) tolerance; (D2) withdrawal, or use of alcohol to avoid withdrawal; (D3) drinking "in larger amounts or for a longer period than was intended"; (D4) "a persistent desire or unsuccessful efforts to cut down or control" drinking; (D5) spending a great deal of time "obtaining, using, or recovering from" alcohol; (D6) "important social, occupational, or recreational activities given up or reduced" because of drinking; and (D7) "continued use despite knowledge of having had a recurrent or persistent physical or psychological problem that is likely to be caused or exacerbated by" alcohol (Martin, 1995, 673).
Subjects for this study were 181 adolescents (91 male, 90 female) who participated in the assessment protocol of the Pittsburgh Adolescent Alcohol Research Center (PAARC). Approximately 50% of the subjects were recruited from alcohol and substance abuse treatment programs and 50% from community advertisements. The kids who took part in this study participated in a day-long assessment protocol that characterized alcohol and drug use, substance use disorders, and areas such as health status, family interactions and comorbid psychopathology. Subjects were paid $100 in the form of gift certificates upon completion of the protocol (Martin, 1995, 674).
Subjects were aged 13-21 years; black subjects comprised 26.5% of the sample, the remainder were white. The sample had a range of 1-5 on the 5-point SES index of Hollingshed. Adolescents with alcohol dependence had an average of 5.3 (+-) 0.77 DSM-IV abuse and dependence symptoms, which is somewhat less than the average of 6.6 DSM-III symptoms reported for adults with dependence (Martin, 1995, 675). The highest item-total correlations were for D3 and D6. The lowest item-total correlations were for D7 and D2. The highest inter-item correlations were for D5 with D6 and D5 with D3. Overall, the dependency symptoms showed moderate to high covariation. In some of the results, risky sexual behavior for drinkers with no alcohol diagnosis was 5.8%, and it was 12.0% for the DSM-IV alcohol abuse diagnosis, and 16.1% for DSM-IV alcohol dependence diagnosis (Martin, 1995, 677). Patterns of alcohol abuse symptoms were very heterogeneous among adolescents with DSM-IV alcohol abuse (Martin, 1995, 678). This study also says that frequent alcohol use can be related to risky sexual behavior, and also agrees with Mrs. Shalala's hypothesis.
In conclusion, the first study said that alcohol use prior to sex appears to be an infrequent behavior of Latinas as a group due to cultural prohibitions about substance use. However, more frequent use of alcohol prior to sex for women with secondary partners was associated with more frequent condom use. Alcohol use in highly acculturated women may be a marker of more assertive behavior in general, including self-protective sexual behavior (Marín, 1992, 1109).
The second study concludes that there is a need for more intensive HIV prevention and alcohol and drug treatment programs for injecting drug users and their partners. Drinking once a day or more was associated with risky sexual practices independent of use of cocaine and heroin. Partners of these heavy drinking, IDUs are at triple jeopardy: their partners are injecting drugs, tend to have multiple high risk partners, and are less likely to use condoms. Consequently, these partners should be a high priority for targeted HIV prevention intervention (Latkin, 1994, 166).
The third study concludes that adolescent alcohol use disorders should focus on ways to produce more homogeneous subgroups, so that more can be learned about the etiology, prevention, and treatment of adolescent alcohol-related problems. This is necessary for future research advances on the etiology and treatment of these problems (Martin, 1995, 678).
So in the end, Mrs. Shalala's statement is correct, and that kids who drink, do in fact have more of a risky sex-life. The real issue here is not sex and alcohol, but today's society, and what they think and do about kids having sex, getting drunk, or both. Society as a whole should take action against these things. They should make laws stricter for kids, and adults who buy kids alcohol. They should have more sex education in high schools and colleges, and they need to tell things like they are, and not hide the fact that kids are having sex. All of us need to think of some ways we can educate these kids to prevent them from this type of behavior. What are a few things YOU can do to help these kids who go get drunk and screw all the women that will let them. Worst of all, he may get one of them pregnant. Then he has to deal with her, and a baby for the rest of his life. And you know something, he may not even know her.


Works Cited

Courtney, Kathie, and Ian M. Newman. "Sexual Behavior of Nebraska Adolescents." Nebraska Medical Journal. September 1995. 287-289.

Latkin, Carl et al. "The Relationships Between Sexual Behavior, Alcohol Use, and Personal Network Characteristics Among Injecting Drug Users in Baltimore, Maryland." Sexually Transmitted Diseases. May June 1994. 161-167.

Martin, Christopher S. et al. "Patterns of DSM-IV Alcohol Abuse and Dependence Symptoms in Adolescent Drinkers." Journal of Studies on Alcohol. November 1995. 672-680.

Marín, Barbara VanOss, and Elena Flores. "Acculturation, Sexual Behavior, and Alcohol Use among Latinas." The International Journal of the Addictions. 29(9) 1994: 1101-1114.

Shalala, Donna E. Alcohol Alert. No. 29 PH 357. July 1995.

"The Effects of Alcohol on Children and Teens"
http://www.inform.umd.edu:8080/EdRes/Colleges/BSOS/
Depts/Cesar/menet/alca4a4.mnu. Internet. 6 October 1996.