High-risk social drinkers and heavy drinkers display similar rates of alcohol consumption

Abstract

Alcohol consumption is often assessed over weeks to months, but few attempts have been made to characterize alcohol consumption rates at the level of an individual drinking session. Here, we aimed to compare the rate of alcohol consumption in social drinkers at high risk for alcohol use disorder (AUD) and heavy drinkers. One hundred and sixty social drinkers and 48 heavy drinkers participated in an alcohol self-administration study. Social drinkers were classified as low risk or high risk for AUD based on sex, impulsivity, and family history of alcoholism. Participants received a priming dose of intravenous alcohol to assess alcohol-induced craving and completed a 125-minute intravenous alcohol self-administration session to assess rate of achieving a binge-level exposure (blood alcohol concentration greater than or equal to 80 mg%). There were no differences between rates of binging in high-risk and heavy drinkers (hazard ratio = 0.87; 95% CI, 0.48-1.56). Heavy drinkers reported higher levels of craving than high-risk and low-risk drinkers at baseline. However, following a priming dose of alcohol, there were no longer differences in craving between high-risk and heavy drinkers. These results indicate that high-risk social drinkers demonstrate binging behavior that is similar to heavy drinkers, which may be driven by alcohol-induced craving. Prospective studies are needed to elucidate whether these patterns of craving and consumption in high-risk social drinkers are predictive of future AUD.

Keywords: addictive behavior; alcohol self-administration; alcoholism; binge drinking; craving; risk factors.

Figure 1.. Alcohol Self-Administration Patterns in Low-Risk, High-Risk, and Heavy Drinkers

(A) Cumulative probability of achieving a binge-level exposure (estimated blood alcohol concentration of 80mg%) during the alcohol self-administration session. Cumulative probability of achieving a binge-level exposure was similar in heavy drinkers and high-risk social drinkers. (B) Total alcohol consumption during the first 30 minutes of the alcohol self-administration session. High-risk social drinkers and heavy drinkers had similar increases in blood alcohol concentration. Lines represent mean blood alcohol concentration for the respective groups.

Figure 2.. Alcohol Craving in Low-Risk, High-Risk, and Heavy Drinkers

Self-reported alcohol craving was measured using the Alcohol Urge Questionnaire at the beginning of the alcohol self-administration session (baseline) and after the participants received a priming dose of alcohol (post-alcohol prime, at minute 20). High-risk social drinkers reported similar levels of craving to low-risk social drinkers at baseline. After receiving a priming dose of alcohol, they reported similar levels of craving to heavy drinkers. *p < 0.01.