Adolescent Women Induce Lower Blood Alcohol Levels Than Men in a Laboratory Alcohol Self‐Administration Experiment

Abstract

Background Adolescence is a critical period for the development of alcohol use disorders; drinking habits are rather unstable and genetic influences, such as male sex and a positive Family History of alcoholism (FH), are often masked by environmental factors such as peer pressure. Methods We investigated how sex and FH modulate alcohol use in a sample of 18-19-year-olds from the Dresden Longitudinal Study on Alcohol use in Young Adults (D-LAYA). Adolescents reported their real-life drinking in a TimeLine Follow-Back (TLFB) interview. They subsequently completed a training and an experimental session of free-access intravenous Alcohol Self-Administration (i.v. ASA) using the computer-assisted alcohol infusion system in order to control for environmental cues as well as for biological differences in alcohol pharmacokinetics. During i.v. ASA, we assessed subjective alcohol effects at eight time points. Results Women reported significantly less real-life drinking than men and achieved significantly lower mean arterial Blood Alcohol Concentrations (aBACs) in the laboratory. At the same time, women reported greater sedation relative to men and rated negative effects as high as did men. A positive FH was associated with lower real-life drinking in men but not in women. In the laboratory, FH was not linked to i.v. ASA. Greater real-life drinking was significantly positively associated with higher mean aBACs in the laboratory, and all i.v. ASA indices were highly correlated across the two sessions. Conclusions We conclude that adolescent women chose lower aBACs because they experienced adverse alcohol effects, namely sedation and negative effects, at lower aBACs than men. A positive FH was not apparent as risk factor for drinking in our young sample. The i.v. ASA method demonstrated good external validity as well as test-retest reliability, the latter indicating that a separate training session is not required when employing the i.v. ASA paradigm.

Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption

“…Our study extends these intravenous alcohol self-administration results by showing that participants with a greater percentage of biological relatives with alcohol problems were at greater risk. Our study also found higher rates of alcohol consumption in males compared to females, which is consistent with a recent study of intravenous alcohol self-administration in adolescents (9). Delay discounting has previously been observed as a predictor of laboratory alcohol consumption (8), and we confirmed that here.…”

“…Intravenous alcohol self-administration also differs in many ways from real-world alcohol consumption. However, recent results suggest that intravenous self-administration is reflective of external consumption patterns when comparing across drinkers of varying severity (9; 39). A few individuals in our sample were in their forties and an even younger sample would have been ideal to assess the effects of these risk factors, although the vast majority of our sample (86.1%) was at or below the age of 30.…”

“…This method has shown good test-retest reliability and external validity (8; 9) and has been employed in pharmacological (10) and genetic studies (11). Intravenous alcohol self-administration has several advantages over oral self-administration.…”

The OPRM1 A118G polymorphism: converging evidence against associations with alcohol sensitivity and consumption

“…Laboratory paradigm. Participants completed an intravenous alcohol self-administration session, a paradigm which has shown good test-retest reliability and external validity in prior studies [29,30]. This paradigm eliminates the large variability in blood alcohol concentration (BAC) associated with oral alcohol intake [31,32] by bypassing gastrointestinal absorption and first-pass metabolism and using an algorithm that adjusts for age, sex, height, and weight to account for differences in alcohol distribution and elimination [33].…”

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

“…Intravenous self‐administration also eliminates cues such as smell, taste, and appearance, so consumption should be primarily driven by the pharmacodynamic effects of alcohol, such as dopamine release in the nucleus accumbens . This paradigm has been used to test the effects of medications on self‐administration, to show that males consume more than females, and to examine genetic effects on alcohol consumption and sensitivity . There is evidence that phenotypes elucidated in the laboratory have important clinical implications.…”