Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption

Abstract

Objective Although several risk factors have been identified for alcohol use disorder, many individuals with these factors do not go on to develop the disorder. Identifying early phenotypic differences between vulnerable individuals and healthy controls could help identify those at higher risk. Binge drinking, defined as reaching a blood alcohol level of 80 mg%, carries a risk of negative legal and health outcomes and may be an early marker of vulnerability. Using a carefully controlled experimental paradigm, we tested the hypothesis that risk factors for alcohol use disorder, including family history of alcoholism, male sex, impulsivity, and low level of response to alcohol, would predict rate of binging during an individual alcohol consumption session. Method This cross-sectional study included 159 young social drinkers who completed a laboratory session in which they self-administered alcohol intravenously. Cox proportional hazards models were used to determine whether risk factors for alcohol use disorder were associated with the rate of achieving a binge-level exposure. Results A greater percentage of relatives with alcoholism (hazard ratio 1.04, 95% CI 1.02 to 1.07), male sex (hazard ratio 1.74, 95% CI 1.03 to 2.93), and higher impulsivity (hazard ratio 1.17, 95% CI 1.00 to 1.37), were associated with a higher rate of binging throughout the session. Participants with all 3 risk factors had the highest rate of binging throughout the session compared to the lowest risk group (hazard ratio 5.27, 95% CI 1.81 to 15.30). Conclusions Binge drinking may be an early indicator of vulnerability to alcohol use disorder and should be carefully assessed as part of a thorough clinical evaluation.

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

“…One hundred and sixty social drinkers and 48 heavy drinkers were recruited to participate in an alcohol self‐administration paradigm as part of three studies. The purpose of the first study was to examine determinants of intravenous alcohol self‐administration in social drinkers. The second and third studies sought to examine the effects of medications on intravenous alcohol self‐administration in heavy drinkers .…”

“…While epidemiological studies have elucidated how broad patterns of drinking such as weekly and annual consumption levels affect health, few attempts have been made to characterize interindividual differences in alcohol consumption patterns during a single occasion. Recent work has shown that healthy young adults with a greater number of risk factors for alcohol use disorder have markedly higher rates of binging during a 2‐hour alcohol self‐administration session . However, it is not clear how drinking patterns differ between high‐risk social drinkers and those who have already developed heavy drinking patterns.…”

“…High‐risk drinkers were determined based on three of the genetic and physiological risk factors for alcohol use disorder listed in DSM‐5: male sex, family history of alcoholism, and high levels of impulsivity . These risk factors have previously been shown to affect alcohol self‐administration in social drinkers . During the alcohol self‐administration session, we hypothesized that high‐risk social drinkers would exhibit greater craving and rates of binging than low‐risk social drinkers but lower craving and rates of binging than heavy drinkers.…”

Alcohol effects on globus pallidus connectivity: Role of impulsivity and binge drinking

“…Binge drinking is defined as drinking that results in blood alcohol concentration (BAC) levels at or above 0.08 g/dl (estimated as consuming at least 4 or 5 standard drinks in less than two hours for women and men, respectively). The mechanisms underlying binge drinking and related risky behaviors are unclear, but impulsivity or failure in inhibitory control during decision-making likely plays a role [5][6][7][8].…”

Alcohol Effects on Globus Pallidus Connectivity: Role of Impulsivity and Binge Drinking

“…Binge drinking is defined as drinking that results in blood alcohol concentration (BAC) levels at or above 0.08 g/dl (estimated as consuming at least 4 or 5 standard drinks in less than two hours for women and men, respectively). The mechanisms underlying binge drinking and related risky behaviors are unclear, but impulsivity or failure in inhibitory control during decision-making likely plays a role [5-8].…”