Introduction: Heavy drinkers, defined as men drinking at least 50 UK units a week and women drinking above 35 UK units a week, constitute 7% of men and 3% of women in the British population (Office for National Statistics, 2004). Most heavy drinkers never come into contact with alcohol treatment services and previous research suggests that up to three quarters of those who recover from an alcohol use disorder do so without treatment (Watson and Sher, 1998). The Birmingham Untreated Heavy Drinkers research (BUHD) project is a longitudinal study examining the ‘natural history’ of drinking in a sample of untreated heavy drinkers over a decade in their lives.
Aim: This paper uses both quantitative and qualitative data from the BUHD project to illustrate some of these main trends in alcohol consumption, and to explore the meanings of heavy drinking in relation to life events and to the social context of drinking.
Design: This is a longitudinal prospective study. Starting in 1997 with a sample of 500 people aged 25-55, the project interviewed participants at two-yearly intervals over a ten year period. 259 participants (52%) were interviewed at the final wave in 2007.
Findings: Whilst the sample has, on average, decreased drinking over the past decade, this broad trend masks diverse trajectories. Preliminary analysis shows three main clusters: (i) a relatively quick decline in consumption, (ii) a slower decline and (iii) a static, relatively high level of consumption. Further analysis using quantitative and qualitative data will attempt to unpack the main characteristics of members of each group, as well as their subjective reasons for change.
Conclusions: Despite the fact that a minority of heavy drinkers seek help for their drinking, there is a general trend in this longitudinal study towards decreased drinking over time. Nonetheless, a significant minority continue to drink at high levels and further understanding of who this group are, and the reasons for their continued heavy drinking, may enable targeting of this hard-to-access population.