Drinking and problem drinking in US women. Patterns and recent trends.

General population surveys suggest that the percentage of US women who drink declined slightly during the 1980s. Comparisons of 1981 and 1991 national surveys using the same drinking measures show that fewer women drank heavily in 1991, and women drinkers drank less frequently and had fewer episodes of heavy drinking, although younger drinkers reported more frequent intoxication. Longitudinal analyses of 5-year changes in drinking behavior indicate that movement both into and out of problem drinking is greatest among women aged 21 to 34. Subgroups of women with elevated rates of heavy drinking and/or adverse drinking consequences include younger women; women lacking social roles or occupying unwanted social statuses; women in nontraditional jobs; cohabiting women; and ethnic minority women experiencing rapid acculturation. Risks of heavy and/or problem drinking are also greater among women with a heavy-drinking husband or partner; depression; sexual dysfunction; or violent victimization in childhood or adulthood. Future research should focus on (1) the causes and consequences of recent declines in women's drinking; (2) antecedents and consequences of specific patterns of multiple substance use in women; (3) social and relational contexts of women's drinking, including occupational influences, drinking behavior of significant others, sexual dysfunction, and relationship violence; (4) longitudinal predictors of both problem drinking onset and "spontaneous" remission of women's alcohol problems; and (5) childhood sexual abuse as a potentially powerful risk factor for later alcohol abuse in women.