To examine the adverse consequences of risky drinking,* researchers assessed baseline drinking among 22,122 adult national survey participants who had consumed at least 1 drink in the year preceding the baseline interview and measured the 3-year incidence of selected outcomes.

• At baseline, 60% of subjects reported no risky drinking. Seventeen percent reported risky drinking <1 time per month; 9%, 1 to 3 times per month; 8%, 1 to 2 times per week; 3%, 3 to 4 times per week; and 3%, daily or near daily.
• The risk for adverse consequences increased as the frequency of risky drinking increased. In adjusted analyses, participants who reported risky drinking 1 to 2 times per week were more  likely than those who reported no risky drinking to have incident alcohol  abuse (odds ratio [OR], 3.3); alcohol dependence (OR, 2.7); drug use (OR, 1.6);  drug dependence (OR, 2.3); tobacco use (OR, 2.7); nicotine dependence (OR, 1.8);  and any liver disease (OR, 2.8). They were also more likely to divorce or separate (OR, 1.3) and lose their driver's licenses (OR, 1.8).
• In similar analyses, the risk for adverse consequences was generally higher in subjects who reported risky drinking on a daily or near-daily basis.

Comments by Tom Delaney, MSW, MPA
This paper is useful for counselors in 2 ways: First, it discusses criteria for risky drinking, which can be used in current practice. Second, it alerts practitioners to the need for more precise tools to identify at-risk drinking. These findings show the advantages of measuring multiple outcomes. Although a relationship between risky drinking and health, social, and legal problems is shown, as noted by the authors, causality could be either way.