Risky alcohol use affects 3 out of 10 adults in the U.S. and plays a role in over 60 chronic health conditions (NIAAA, 2005; DeAlba, Samet, Saitz, 2004).  A Healthy People 2010 priority goal focuses on reduction of alcohol use that exceeds low-risk drinking guidelines.

            Using a population based sample, this study examines the effects of at-risk alcohol use on patterns of healthcare use and health outcomes, and the effects of rural residence on these patterns and outcomes.  The Behavioral Model of Utilization served as a framework for understanding these complex relationships.  The National Health Interview Survey and the Medical Expenditures Panel Survey (Cohen, 1997) provided the data sources for this research.  These databases contain self-report measures and in-depth medical histories that allowed a detailed examination of healthcare use and outcomes over a 2 year period.  The research was part of a larger nationally funded research study investigating the effects of rural residence on treatment for psychiatric disorders.  This research provides information on the long-term use and outcomes of healthcare services by at-risk drinkers, especially among those living in rural areas.  As such, it has the potential to inform policy about the distribution of scarce specialty substance abuse treatment services.