Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

324 IV. SPECIAL POPULATIONSamounts consumed. Black men were significantly less permissive in attitudestoward alcohol use in particular situations, such as driving a car or spendingtime with small children in a parental role. Further analyses showed that thehigher rates of alcohol-related problems were not fully accounted for by socialand demographic differences between black and white men.An earlier study by Herd (1990), reporting on data from a 1984 nationalsurvey, showed similar findings of greater alcohol-related problems among blackmen than among white men in the past year. The exception was drunk driving,in which white men scored higher. Black men scored higher on symptoms ofphysical dependence and health problems. Here, the rates of frequent heavydrinking were lower, not higher, for black men. Limited financial resources andaccess to health care likely also contributed to the higher prevalence ofalcohol-related health problems in black men. African Americans may be athigher risk for hepatic damage and cirrhosis from drinking (Singh & Hoyert,2000; Stewart, 2002). Herd (1994) suggested that this finding may represent alonger duration of heavy use, as opposed to more discrete phases of heavy alcoholuse seen in some white men. The body, it is hypothesized, is less resilient toalcohol toxicity at older ages.Jones-Webb, Hsiao, and Hannan (1995) found that lower socioeconomicclass seems to have a more profound influence on alcohol-related problems forblack men than for white men, as did other researchers (Barr, Farrell, Barnes, &Welte, 1993; Herd, 1994; Jones, 1989). Black men of lower socioeconomic statusmay experience more overt forms of discrimination and may be more likelyto reside in communities in which there is more police surveillance. Groupnorms may be predictive of problematic alcohol use in African Americans(Jones-Webb, Snowden, Herd, Short, & Hannan, 1997). Greater ethnic identitymay be protective against problematic drinking (Herd & Grube, 1996).Lower neighborhood cohesion has been associated with adolescent drug andalcohol problems.Polymorphism of the ADH2*3 alcohol dehydrogenase metabolic enzymemay play a role in alcohol expectations in African Americans (Ehlers, Carr,Betancourt, & Montane-Jaime, 2003). Lower P3 amplitudes during eventrelatedpotentials have also been reported in alcoholic African Americans(Ehlers et al., 2003). The association of alcohol use and hypertension may beparticularly problematic in African American men (Russell, Cooper, Frone, &Peirce, 1999). The association between hypertension and illicit drug use hasalso been reported (Kim, Dennison, Hill, Bone, & Levine, 2000). Ziedonis,Rayford, Bryant, and Rounsaville (1994) have reported on differential rates oflifetime psychiatric comorbidity in black and white cocaine addicts, withwhites having significantly higher rates of lifetime depression, alcohol dependence,and attention deficit and conduct disorder. African Americans oftenexhibit significant general coping skills but fewer treatment resources comparedto whites (Conigliaro et al., 2000; Walton, Blow, & Booth, 2001). There is