Rita Augustin

A COMPARISON OF DRINKING PATTERNS AND ALCOHOL-USE- RELATED PROBLEMS IN THE UNITED STATES AND GERMANY, 1995

Distinct drinking habits are seen in the United States and Germany. Using 1995 national surveys, we examined alcohol consumption patterns, demographic correlates, and relationships between consumption and problems. Although differing in design (Germany: mail survey; United States: face-to-face interviews), both surveys shared measures that permitted comparisons. Drinking volume and pattern were assessed and the CAGE screening test for alcohol-use-related problems was used. Germany has larger prevalence of current drinking, higher levels of consumption, and more heavy drinkers. However, at matched volume levels, more Americans reported alcohol-use-related problems. Sociodemographic correlates of heavier consumption also varied between countries. Results support the role of cultural traditions in the expression and recognition of alcohol-use-related problems.

Changes in Prevalence of Problem Opiate Use in Germany between 1990 and 2000

Objectives: Estimates of opiate use are calculated for the years 1990/1991, 1995 and 2000 in order to explore the development of problem opiate use in Germany in the preceding decade. Methods: The estimates stem from multiplier methods which extrapolate from a sample (benchmark) of known drug users to the total population by multiplying the benchmark by an appropriate factor that accounts for the unknown population. Data came from the German treatment monitoring system, police and mortality statistics. Results: The population estimates for 2000 resulted in 166,300–197,500 problem opiate users based on treatment data, 153,000–190,000 heroin users from police data, and 126,900–169,200 (current) injectors from mortality data. Recalculated estimates for 1990/1991 and 1995 derived from the same data sources were found to be somewhat lower. Discussion: The reported estimates between 1990 and 2000 point at a moderate increase of problem opiate users in the 1990s. The population estimates based on the multiplier method using three different data sources may be considered consistent for the highly overlapping target groups of (current) injectors, problem heroin and problem opiate users. Nevertheless, some of the applied multipliers are based on small-scale studies, raising the question of representativeness. National prevalence estimates may be improved by using other techniques such as multivariate indicator, capture-recapture, or dynamic models.

Drug Use Patterns and Drug-Related Disorders of Cocaine Users in a Sample of the General Population in Germany

Aims: The prevalence of cocaine use is still very low in Germany, but rates have been increasing over the past few decades. Patterns of drug consumption and related adverse consequences in individuals who have used cocaine were investigated in order to distinguish different types of cocaine users. Methods: Data come from two national representative surveys on substance abuse in the German general population conducted in 1997 and 2000 using self- administered questionnaires. Overall response rates were 65 and 51%, respectively. The two samples were pooled (n = 16,159) and latent cluster analysis was conducted using a sub-sample of 272 lifetime cocaine users. Results: Three clusters were derived: the majority belonged to the group of mainly unproblematic users (UPG, 80%), the second group comprised non-amphetamine poly-problem drug users (NAPPG, 12%), and a small group was composed of poly-problem drug users (PPG, 8%). Comparisons of sociodemographic characteristics, consumption patterns and age of onset for licit and illicit drug use revealed significant differences between the groups. Conclusions: The majority of cocaine users in the general population are experimental or occasional users of licit and illicit drugs. Rather than being a major drug, cocaine is one of many other licit and illicit drugs. Cocaine use as part of predominantly poly-drug use behaviour is strongly associated with substance-related disorders.

Soziale Ungleichheiten bei Alkoholkonsum und Alkoholmissbrauch in der Allgemeinbevölkerung Deutschlands

This paper investigates social inequalities in drinking behaviour in a sample of the German general population aged 25 to 59 years. The prevalence of several indicators of alcohol use and misuse were examined by socio-economic status (SES). Odds ratios were calculated to examine the relative effect of socio-economic status on the various alcohol misuse indicators. Abstinence showed a clear negative gradient with social status. When age was controlled, no differences were found in the prevalence of hazardous drinking. In comparison with men of high SES, men of middle SES had increased odds of consuming five or more drinks per day at least weekly and of a positive score on the AUDIT hazardous use measure, while men of lower SES had higher odds for dependence symptoms. Women of middle SES had significantly lower odds for reporting items of the CAGE alcohol screening instrument and DSM-IV alcohol abuse criteria in comparison to women of high SES. Thus, women of lower and higher SES resemble each other in drinking behaviour. For men, no identifiable pattern was found. The lack of clear social inequalities among the consuming German general population may be due to the widespread integration of alcohol drinking in everyday life.AbstractAnhand verschiedener Indikatoren zu Alkoholgebrauch und -missbrauch werden soziale Ungleichheiten in einer Stichprobe 25-59-Jähriger aus der deutschen Allgemeinbevölkerung untersucht. Der relative Effekt der Schichtzugehörigkeit aufdie verschiedenen Indikatoren wurde mit Hilfe von Odds Ratios analysiert. Bei der Abstinenz zeigt sich ein klarer negativer Gradient. Kontrolliert man nach Alter, so ergeben sich keine signifikanten Unterschiede bei der Prävalenz riskanten Trinkens. Im Vergleich zu Männern aus der Oberschicht hatten Männer aus der Mittelschicht signifikant höhere Odds für den Konsum von 5 oder mehr Gläsern alkoholischer Getränke an mindestens einem Tag pro Woche und für den AUDIT, einen Indikator für riskanten Alkoholkonsum. Männer aus der Unterschicht hatten signifikant höhere Odds für eine DSM-Abhängigkeitsdiagnose. Frauen aus der Mittelschicht hatten signifikant niedrigere Odds, für einen positiven CAGE-Wert oder eine DSM-Missbrauchsdiagnose als Frauen aus der Oberschicht. Das Trinkverhalten von Frauen aus der Unterschicht und denen aus der Oberschicht ähnelt sich. Bei den Männern zeigt sich dagegen kein klares Muster. Die weite Verbreitung desAlkoholkonsums in der deutschen Allgemeinbevölkerung mag ein Grundfür das Fehlen klarer sozialer Unterschiede sein.Anhand verschiedener Indikatoren zu Alkoholgebrauch und -missbrauch werden soziale Ungleichheiten in einer Stichprobe 25-59-Jahriger aus der deutschen Allgemeinbevolkerung untersucht. Der relative Effekt der Schichtzugehorigkeit aufdie verschiedenen Indikatoren wurde mit Hilfe von Odds Ratios analysiert. Bei der Abstinenz zeigt sich ein klarer negativer Gradient. Kontrolliert man nach Alter, so ergeben sich keine signifikanten Unterschiede bei der Pravalenz riskanten Trinkens. Im Vergleich zu Mannern aus der Oberschicht hatten Manner aus der Mittelschicht signifikant hohere Odds fur den Konsum von 5 oder mehr Glasern alkoholischer Getranke an mindestens einem Tag pro Woche und fur den AUDIT, einen Indikator fur riskanten Alkoholkonsum. Manner aus der Unterschicht hatten signifikant hohere Odds fur eine DSM-Abhangigkeitsdiagnose. Frauen aus der Mittelschicht hatten signifikant niedrigere Odds, fur einen positiven CAGE-Wert oder eine DSM-Missbrauchsdiagnose als Frauen aus der Oberschicht. Das Trinkverhalten von Frauen aus der Unterschicht und denen aus der Oberschicht ahnelt sich. Bei den Mannern zeigt sich dagegen kein klares Muster. Die weite Verbreitung desAlkoholkonsums in der deutschen Allgemeinbevolkerung mag ein Grundfur das Fehlen klarer sozialer Unterschiede sein.