Haven’t lost the positive feeling: a dose-response, oral alcohol challenge study in drinkers with alcohol use disorder

Assessing real‐time positive subjective effects of alcohol using high‐resolution ecological momentary assessment in risky versus light drinkers

“…The increases among risky drinkers in liking alcohol's effects over time with consistently elevated alcohol wanting also lend support for earlier stages of incentive‐sensitization processes, when both hedonic and motivational drug effects predominate (Robinson & Berridge, 1993). Notably, neither the results of the current study nor those of prior oral alcohol laboratory studies (King et al, 2011, 2016, 2021, 2022) support the low level of response theory (Schuckit, 1994) that purports that low alcohol sensitivity spurs a desire to achieve intoxication. A low level of response to alcohol sedation was observed in risky drinkers and likely indicated tolerance to those effects.…”

“…This is important as the natural environment is not as well‐controlled as the laboratory. The present findings, in line with those of controlled human laboratory alcohol challenge studies (King et al, 2011, 2016, 2021, 2022), suggest persistence of the reward‐dominant initial “binge‐intoxication” stage of the allostasis model of addiction (Koob, 2003) in MS‐AUD. The increases among risky drinkers in liking alcohol's effects over time with consistently elevated alcohol wanting also lend support for earlier stages of incentive‐sensitization processes, when both hedonic and motivational drug effects predominate (Robinson & Berridge, 1993).…”

“…Considering the results of the present study with both oral (King et al, 2011, 2016, 2021, 2022) and intravenous (Bujarski et al, 2017) laboratory findings together, we propose that heightened pleasurable effects and motivational salience of alcohol in risky drinkers fueled their excessive drinking during the alcohol drinking episode, but were minimal‐to‐absent in LD, which may have served as a protective effect against binge drinking. While the slopes of the positive alcohol effects observed in risky drinkers (Figures 2 and 3) suggest some degree of acute tolerance in the positive‐like effects over time (Plawecki et al, 2019), there was no evidence for a “satiation” of responses, as both HD and MS‐AUD continued to drink through the 3‐h interval, with 49% and 66% of participants in those groups continuing to drink afterward, respectively.…”

“…The latter two groups are considered risky drinkers (McKnight‐Eily et al, 2017). These subgroup criteria are similar to those of prior studies (Bujarski et al, 2017; Fridberg et al, 2021; King et al, 2011, 2022) and combining drinking behavior and AUD symptom criteria ensured no overlap across subgroups.…”

Holding your liquor: Comparison of alcohol‐induced psychomotor impairment in drinkers with and without alcohol use disorder

“…Participants completed the Grooved Pegboard and Digit Symbol Substitution Test before and after ingesting a high alcohol dose (0.8 g/kg) or placebo in each of two random‐order laboratory sessions (Brumback et al, 2007, 2017). In addition, a subset of drinkers with AUD completed the same laboratory session with a very high alcohol dose (1.2 g/kg) shown to be safe in this subpopulation (King, Vena, Howe, et al, 2022; Vena et al, 2020). This dose was undertaken to examine responses to alcohol consumption that more closely align with high‐intensity drinking often reported in persons with AUD.…”