Notes on the New Epidemiology of Alcoholism in the USA

Abstract

The definition of alcohol problem intervention in the US has undergone a major transformation over the past 15 years. The structure of this transformation has been based on the promulgation and diffusion of the notion that alcohol problems are distributed throughout the social class structure rather than concentrated among the disaffiliated on Skid Row. The effective development of this new epidemiology as “fact” required several other elements vital to the mainstreaming of alcoholism intervention into the American health care system: health insurance coverage, private systems for care and a source of clients from the population of employed persons. The interdependence among these events is analyzed, indicating the success of each has been dependent on the social accomplishment of the others.