Influence of self-titration on the relationship between ethanol dose and chronic tissue toxicities: theoretical considerations

Abstract

Ethanol "titration" is offered as a possible explanation for the poor correlation of typical quantity-frequency measures of alcohol consumption with the extent of neuropsychological and other performance deficits in detoxified alcoholics. This view asserts that there are large variations in the susceptibility of individuals to alcohol toxicities and that individual alcoholics may regulate their ethanol consumption in accordance with their individual susceptibility, such that usual doses and their effects fall within personally acceptable limits. Thus, the dose chosen for chronic administration is determined, in part, by the biological impact of the ethanol ingested during drinking episodes. Owing to individual differences in susceptibilities to toxic effects, this titration behavior may result in a situation in which two- or even threefold differences in alcohol intake are associated with the same levels of toxicity or performance deficits in a group of alcoholics. Under these conditions, a graded dose-response relationship cannot be expected.