PATTERNS IN THE INSTITUTIONAL ENCOUNTERS OF PROBLEM DRINKERS IN A COMMUNITY HUMAN-SERVICES NETWORK

It is useful to view the social handling of alcohol problems in US com munities from the perspective of a whole network of human service syst ems that share in the burden of identifying and responding to problem drinkers. This analysis examines the management of alcohol problems in different community service systems by mapping patterns in the instit utional encounters of problem drinkers across alcohol treatment, drug treatment, mental health treatment, social welfare and criminal justic e systems in a single US community. Findings highlight the prominence of large bureaucratic systems for social welfare and criminal justice as sources of referrals for smaller service systems offering treatment for alcohol problems. However, large proportions of problem-drinking service recipients in the community remain exclusive clients of the we lfare and criminal justice systems,making no contact with therapeutica lly orientated service settings. Compared with problem drinkers who ob tain treatment services, problem drinkers on the case-loads of crimina l justice and welfare agencies tend to be younger, of higher socio-eco nomic status, ave more likely robe male, and tend to drink less heavil y and to experience fewer symptoms of alcohol dependence. Given the di stinctive characteristics of problem drinkers found exclusively in cri minal justice and welfare settings, it may be advisable for communitie s to introduce early Intervention programs in these systems that targe t services to this particular subgroup of problem drinkers.