Low social control—in particular, greater density of off-premise alcohol outlets—appears to exacerbate associations between family history of alcohol problems and high-risk drinking by adults. Sex- and racial/ethnic-specific differences did appear, suggesting that risk factors for AUD do not increase liability for alcohol use for all groups equally. Clinicians should consider not only family history but also area-level factors as they gather information and prepare treatment plans for their clients. Policymakers should consider benefits of decreasing alcohol availability, especially for people from high-risk families, to reduce high-risk drinking and associated problems. Retirement of outlet licenses for businesses lost during the recession due to the coronavirus 2019 (COVID-19) pandemic may provide a legislative opportunity to decrease alcohol availability.
