Alcohol-Induced Blackouts: A Review of Recent Clinical Research with Practical Implications and Recommendations for Future Studies

Abstract

Background Alcohol-induced blackouts, or memory loss for all or portions of events that occurred during a drinking episode, are reported by approximately 50% of drinkers and are associated with a wide range of negative consequences, including injury and death. As such, identifying the factors that contribute to and result from alcohol-induced blackouts is critical in developing effective prevention programs. Here, we provide an updated review (2010–2015) of clinical research focused on alcohol-induced blackouts, outline practical and clinical implications, and provide recommendations for future research. Methods A comprehensive, systematic literature review was conducted to examine all articles published between January 2010 through August 2015 that focused on examined vulnerabilities, consequences, and possible mechanisms for alcohol-induced blackouts. Results Twenty-sex studies reported on alcohol-induced blackouts. Fifteen studies examined prevalence and/or predictors of alcohol-induced blackouts. Six publications described consequences of alcohol-induced blackouts, and five studies explored potential cognitive and neurobiological mechanisms underlying alcohol-induced blackouts. Conclusions Recent research on alcohol-induced blackouts suggests that individual differences, not just alcohol consumption, increase the likelihood of experiencing an alcohol-induced blackout, and the consequences of alcohol-induced blackouts extend beyond the consequences related to the drinking episode to include psychiatric symptoms and neurobiological abnormalities. Prospective studies and a standardized assessment of alcohol-induced blackouts are needed to fully characterize factors associated with alcohol-induced blackouts and to improve prevention strategies.

Alcohol-related blackouts across 55 weeks of college: Effects of European-American ethnicity, female sex, and low level of response to alcohol

“…Alcohol-related blackouts are highly prevalent phenomena associated with potentially severe problems (Hingson et al, 2016; Wetherill and Fromme, 2016). Recently, the prevalence of ARBs has reached alarming rates, especially in females and individuals with early onset drinking (Marino and Fromme, 2015; Schuckit et al, 2015; White et al, 2015).…”

“…The sample is relatively large, and subjects were assessed prospectively eight times over 55 weeks during a life-period likely to involve heavy drinking (Schuckit et al, 2016a; Wetherill and Fromme, 2016). Several assessments were scheduled at periods when the rates of ARBs were likely to change, including following a heavy drinking campus festival, summer break, and after returning to school as sophomores (Schuckit et al, 2016a, 2016b).…”

“…The high blood alcohol concentrations (BACs) involved (Goodwin, 1995; Perry et al, 2006) and the compromised cognitive processes inherent in ARBs (Silveri et al, 2014) increase risks for additional serious consequences, including accidents, unwanted sex, and exposure to other forms of violence (Hingson et al, 2016, Mundt and Zakletskaia, 2012; White et al, 2004). In addition to BACs>.20g/dl needed for most blackouts, ARBs are also associated with European American [EA] ancestry, female sex, and several genetically-influenced phenotypes related to heavier drinking, including a low level of response (low LR) to alcohol, as described further below (Marino and Fromme, 2015, 2016; Schuckit et al, 2015, 2001; Wetherill and Fromme, 2016, 2009; White et al, 2015). However, the relationships among these characteristics and ARBs are complex and their potential interactions have not been adequately evaluated (Wetherill and Fromme, 2016).…”

“…In addition to BACs>.20g/dl needed for most blackouts, ARBs are also associated with European American [EA] ancestry, female sex, and several genetically-influenced phenotypes related to heavier drinking, including a low level of response (low LR) to alcohol, as described further below (Marino and Fromme, 2015, 2016; Schuckit et al, 2015, 2001; Wetherill and Fromme, 2016, 2009; White et al, 2015). However, the relationships among these characteristics and ARBs are complex and their potential interactions have not been adequately evaluated (Wetherill and Fromme, 2016). …”

“…A recent review highlighted the paucity of prospective studies evaluating how multiple risk factors interact in contributing to ARBs, while controlling for alcohol quantities (Wetherill and Fromme, 2016). In response, the present analyses extracted information from a 55-week prospective study that evaluated educational approaches to preventing heavy drinking on campus (Schuckit et al, 2016a).…”