Alcohol and the disruption of cognitive processes

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

BACKGROUND

Behavioral tolerance to alcohol underscores the widely accepted notion that individuals who regularly drink alcohol become less sensitive to its impairing effects. However, previous research assessing alcohol-induced impairment in humans has primarily focused on social drinkers. This has limited our understanding of the nature and extent of behavioral tolerance among heavier drinkers, such as those with alcohol use disorder (AUD).

METHODS

Data from three cohorts of the Chicago Social Drinking Project were evaluated to examine the acute effects of alcohol on psychomotor performance across the breath alcohol curve in light drinkers (LDs; n = 86), heavy drinkers (HDs; n = 208), and individuals with AUD (AUDs; n = 103). Before and at several intervals after ingesting either alcohol (0.8 g/kg, peak BrAC = 0.09 g/dL) or placebo in two random-order laboratory sessions, participants completed a test of fine motor coordination (Grooved Pegboard), a test of perceptual-motor processing (Digit Symbol Substitution Task), and a self-reported survey of perceived impairment. Sixty individuals with AUD completed a third session with a very high dose of alcohol (1.2 g/kg, peak BrAC = 0.13 g/dL).

RESULTS

The AUD and HD groups, relative to the LD group, perceived less impairment and demonstrated greater behavioral tolerance to an intoxicating dose of alcohol, exhibited by reduced peak impairment and a quicker return to baseline performance on psychomotor measures. Among individuals with AUD who consumed the very high dose, impairment was more than double that following the usual high dose, and it exceeded the impairment among LDs following the usual high dose.

CONCLUSIONS

In this sample of young adult drinkers, relative to the LD group, those with heavier drinking patterns (AUD and HD groups) showed greater behavioral tolerance to 0.8 g/kg alcohol, a dose typically associated with a binge drinking episode. However, when challenged with a very high alcohol dose commensurate with high-intensity drinking, individuals with AUD showed substantial psychomotor impairment.

Alcohol dependence and driving: knowledge of DVLA regulations

Aims and Methods The UK's Driver Vehicle Licensing Authority (DVLA) requires individuals to report if they have a medical condition such as alcohol dependence. General Medical Council guidance indicates that medical practitioners should ensure patients are aware of their impairment and requirement to notify the DVLA. Results In a survey of 246 people with known alcohol dependence, none were aware of advice on driving given by medical practitioners and none had self-reported. In addition, 362 doctors, either attending a college symposium or visiting a college website, were asked about their knowledge of DVLA regulations regarding alcohol dependence: 73% of those attending the symposium and 63% of those visiting the website answered incorrectly. In Scotland, over 20 000 people have alcohol dependence (over 1 million people with alcohol abuse), yet only 2548 people with alcohol problems self-reported to the DVLA in 2011. Clinical implications If the DVLA regulations were implemented, it could make an enormous difference to the behaviours of the driving public.

The impact of intermediate-term alcohol abstinence on memory retrieval and suppression

Background: The nature of episodic memory deficit in intermediate-term abstinence from alcohol in alcohol dependence (AD) is not yet clarified. Deficits in inhibitory control are commonly reported in substance use disorders. However, much less is known about cognitive control suppressing interference from memory. The Think/No-think (TNT) paradigm is a well established method to investigate inhibition of associative memory retrieval.

Methods: Thirty-six unmedicated patients with AD and 36 healthy controls (HCs) performed the TNT task. Thirty image–word pairs were trained up to a predefined accuracy level. Cued recall was examined in three conditions: Think (T) for items instructed to-be-remembered, No-think (NT) assessing the ability to suppress retrieval and Baseline (B) for general relational memory. Premorbid IQ, clinical variables and impulsivity measures were quantified.

Results: AD patients had a significantly increased demand for training. Baseline memory abilities and effect of practice on retrieval were not markedly different between the groups. We found a significant main effect of group (HC vs. AD) × condition (B, T, and NT) and a significant difference in mean NT–B scores for the two groups.

Discussion: AD and HC groups did not differ essentially in their baseline memory abilities. Also, the instruction to focus on retrieval improved episodic memory performance in both groups. Crucially, control participants were able to suppress relational words in the NT condition supporting the critical effect of cognitive control processes over inhibition of retrieval. In contrast to this, the ability of AD patients to suppress retrieval was found to be impaired.

Alcohol disrupts the effects of priming on the perception of ambiguous figures

Inhibitory mechanisms are thought to underpin the well-documented impairing effects of alcohol on attention. Here, we use a novel priming paradigm to investigate the effects of alcohol on inhibitory mechanisms in attention. Participants were assigned to an alcohol (N=15), or placebo (N=15) group. The dose of alcohol was 0.8 g/kg for males and 0.75 g/kg for females. Participants were asked to report figure reversals during presentation of the face-vase ambiguous figure. Prior to this, they were shown a prime that was either semantically relevant to the face-vase stimulus or was neutral. Semantic priming decreased the number of figure reversals in the first half of the test session in the placebo group but not in the alcohol group. The placebo group was also more likely than the alcohol group to report the first interpretation of the figure to be the same as the semantic prime. Prior presentation of a semantic prime had a stabilising effect on reversal rate, suggesting that the primed interpretation inhibited the alternate interpretation. The absence of an effect in the alcohol group is consistent with an alcohol-related impairment of this inhibition.

A selective review of simulated driving studies: Combining naturalistic and hybrid paradigms, analysis approaches, and future directions

Naturalistic paradigms such as movie watching or simulated driving that mimic closely real-world complex activities are becoming more widely used in functional magnetic resonance imaging (fMRI) studies both because of their ability to robustly stimulate brain connectivity and the availability of analysis methods which are able to capitalize on connectivity within and among intrinsic brain networks identified both during a task and in resting fMRI data. In this paper we review over a decade of work from our group and others on the use of simulated driving paradigms to study both the healthy brain as well as the effects of acute alcohol administration on functional connectivity during such paradigms. We briefly review our initial work focused on the configuration of the driving simulator and the analysis strategies. We then describe in more detail several recent studies from our group including a hybrid study examining distracted driving and compare resulting data with those from a separate visual oddball task (Fig. 6). The analysis of these data was performed primarily using a combination of group independent component analysis (ICA) and the general linear model (GLM) and in the various studies we highlight novel findings which result from an analysis of either 1) within-network connectivity, 2) inter-network connectivity, also called functional network connectivity, or 3) the degree to which the modulation of the various intrinsic networks were associated with the alcohol administration and the task context. Despite the fact that the behavioral effects of alcohol intoxication are relatively well known, there is still much to discover on how acute alcohol exposure modulates brain function in a selective manner, associated with behavioral alterations. Through the above studies, we have learned more regarding the impact of acute alcohol intoxication on organization of the brain's intrinsic connectivity networks during performance of a complex, real-world cognitive operation. Lessons learned from the above studies have broader applicability to designing ecologically valid, complex, functional MRI cognitive paradigms and incorporating pharmacologic challenges into such studies. Overall, the use of hybrid driving studies is a particularly promising area of neuroscience investigation.

The effect of alcohol and repetition at encoding on implicit and explicit false memories

RATIONALE

Alcohol impairs explicit memory, whilst leaving implicit memory relatively intact. Less is known about its effects on false memories.

AIM

The present study examines the effects of alcohol on explicit and implicit false memories using study list repetition as a tool for modulating learning at encoding.

METHODS

Thirty-two participants were given either an alcohol (0.6 g/kg) or placebo beverage before undergoing an encoding phase consisting of 10 lists of nine associated words (veridical items). Each list was associated to a word, which was not presented at encoding (semantically associated non-studied lure; critical item), serving as the measure for false memory. Half of the lists were presented once, and half were repeated three times. The next day, participants underwent an implicit (stem completion and post hoc awareness measurements), and an explicit (free recall) task.

RESULTS

Alcohol decreased veridical and false explicit memory for singularly presented lists compared to placebo; no group difference existed for repeated lists. Implicit veridical memory was not affected by alcohol. Awareness memory measures demonstrated in placebo participants an increased ability with repetition in rejecting false memories. The reverse was found in intoxicated participants who with repetition accepted more false memories.

CONCLUSION

Alcohol appears to decrease semantic activation leading to a decline in false memories. Increased learning with repetition, which increases the rejection of false memories under placebo, is reversed under alcohol leading to a decrease in rejection of false memories. The latter effect of alcohol may be due to its ability to impair monitoring processes established at encoding.

Acute alcohol effects on repetition priming and word recognition memory with equivalent memory cues

Acute alcohol intoxication effects on memory were examined using a recollection-based word recognition memory task and a repetition priming task of memory for the same information without explicit reference to the study context. Memory cues were equivalent across tasks; encoding was manipulated by varying the frequency of occurrence (FOC) of words in the study lists. Twenty-two female and male social drinkers (age 21-24 years) completed equivalent versions of the memory tasks in two counterbalanced sessions (alcohol challenge, no-alcohol). Alcohol and the FOC manipulation affected recollection-based memory processing, but not repetition priming. Results supported alcohol's dissociative effects on memory systems.

Using Virtual Reality to Study Alcohol Intoxication Effects on the Neural Correlates of Simulated Driving

The use of virtual reality in the form of simulated tasks can provide a realistic environment in which to study complex naturalistic behaviors. Many of the behavioral effects of alcohol intoxication are well known, but there is relatively little imaging evidence examining how alcohol exposure might transiently modulate brain function, especially in the context of task performance. In this review, we provide a brief synopsis of previous work using functional magnetic resonance imaging (fMRI) to study the neural correlates of alcohol intoxication. We describe in detail two studies from our published work, the first involving a visual perception paradigm, and the second involving virtual reality through a naturalistic behavior; simulated driving. Participants received single-blind individualized doses of beverage alcohol designed to produce blood alcohol content (BAC) of 0.04 and 0.08 or placebo. Subjects were fMRI scanned after training to asymptote performance. In both studies we found specific circuits that were differentially modulated by alcohol, we revealed both global and local effects of alcohol, and we examined relationships between behavior, brain function, and alcohol blood levels.

Alcohol-induced impairment and enhancement of memory: A test of the interference theory

Many studies have found cognitive deficits related to alcohol consumption. However, few studies have studied cognitive performance when alcohol was administered after the to-be-remembered information was presented with memory testing occurring when participants are once again sober. The present study examined effects of alcohol on cognitive performance using a prose recall task during acute intoxication and a post-trial recall task for prose passages that had been presented before intoxication. Fifty-one men were given either 2.0 g/kg of 100 proof (50% absolute ethanol) vodka or a placebo. In the present study, evidence was found of acute alcohol impairment in prose memory, along with alcohol facilitation of memory on a post-trial task.

Alcohol intoxication effects on visual perception: an fMRI study

We examined the effects of two doses of alcohol (EtOH) on functional magnetic resonance imaging (fMRI) activation during a visual perception task. The Motor-Free Visual Perception Test-Revised (MVPT-R) provides measures of overall visual perceptual processing ability. It incorporates different cognitive elements including visual discrimination, spatial relationships, and mental rotation. We used the MVPT-R to study brain activation patterns in healthy controls (1) sober, and (2) at two doses of alcohol intoxication with event-related fMRI. The fMRI data were analyzed using a general linear model approach based upon a model of the time course and a hemodynamic response estimate. Additionally, a correlation analysis was performed to examine dose-dependent amplitude changes. With regard to alcohol-free task-related brain activation, we replicate our previous finding in which SPM group analysis revealed robust activation in visual and visual association areas, frontal eye field (FEF)/dorsolateral prefrontal cortex (DLPFC), and the supplemental motor area (SMA). Consistent with a previous study of EtOH and visual stimulation, EtOH resulted in a dose-dependent decrease in activation amplitude over much of the visual perception network and in a decrease in the maximum contrast-to-noise ratio (in the lingual gyrus). Despite only modest behavior changes (in the expected direction), significant dose-dependent activation increases were observed in insula, DLPFC, and precentral regions, whereas dose-dependent activation decreases were observed in anterior and posterior cingulate, precuneus, and middle frontal areas. Some areas (FEF/DLPFC/SMA) became more diffusely activated (i.e., increased in spatial extent) at the higher dose. Alcohol, thus, appears to have both global and local effects upon the neural correlates of the MVPT-R task, some of which are dose dependent.

Ethanol improves short-term social memory in rats. Involvement of opioid and muscarinic receptors

Some human and animal studies have demonstrated enhancement of memory processes when ethanol was administered immediately after training and subjects were later tested in the drug-free state. The aim of this study was to evaluate the effect of acute ethanol administration (0.5, 1.0 and 2.0 g/kg) by intraperitoneal (i.p.) and oral route on short-term memory, using the social recognition test in rats. The actions of scopolamine (0.06 and 0.5 mg/kg, i.p.) and naloxone (1.0 mg/kg, i.p.) and their interaction with ethanol in relation to short-term memory were also studied. The doses of ethanol used did not show any sedative effect, which was assessed by measuring locomotor activity. The results indicate that acute low doses of ethanol (0.5 and 1.0 g/kg, i.p.) improve the short-term olfactory memory in rats in a specific and time-dependent manner, and that this action is, at least in part, related to opioid, but not to muscarinic receptors. In addition, these findings confirm that the social recognition test in rats is a useful and reliable model to investigate short-term memory affected by ethanol.

Effects of posttraining ethanol on an appetitive task

The present study examined the effects of posttraining ethanol administration upon retention of an appetitive task using a variety of retention behaviors associated with the task. Male C57BL/6J mice were individually trained to find a cheese pellet placed in the corner of an open field. Five behavioral measures were used including locomotor activity counts, rearings, grooming episodes, approaches to the cheese pellet, and latency to consume the cheese pellet. Immediately after training, mice were injected intraperitoneally with saline or 2.0 g/kg of ethanol and then returned to their home cage in which four "intruder" mice were added for 2 h after training. On subsequent testing days (1, 6, 14, and 51 days posttraining), mice were returned to the original training environment and the five behaviors were measured. Both saline- and ethanol-treated mice habituated to the initially novel test environment at similar rates as indicated by decreased exploratory behavior (locomotor activity and rearings). In contrast, a divergence in the latency to consume the cheese pellet was observed: Saline-treated mice behaved as though the cheese was rewarding (decreased latency to eat the pellet), while the ethanol group behaved as though the cheese was aversive (increased latency to eat the pellet). Taken with previous studies, these results demonstrate that posttraining ethanol can have strikingly different effects on retention depending on the task, the measure of retention used, and the underlying neural structures involved.

Executive cognitive functioning in alcohol use disorders

Executive cognitive functioning (ECF) has been identified as an important determinant in the etiology of alcoholism. ECF represents a "higher-order" cognitive construct involved in the self-regulation of goal-directed behavior. The prefrontal cortex and its subcortical connections represent the primary neurological substrate that subserves ECF. Both alcoholics and individuals at high risk for alcoholism exhibit a mild dysfunction in ECF. However, this deficit appears to be significantly stronger in alcoholics with a comorbid diagnosis of an antisocial personality disorder. Individuals with other disorders that are also highly comorbid with alcoholism, such as attention deficit hyperactivity disorder and conduct disorder, also demonstrate deficits in ECF. As such, compromised ECF may not be specific to alcoholism, but instead, might be a potential underlying etiologic substrate for a number of disorders of behavioral excess-disinhibition. Subsequent to reviewing the literature implicating ECF deficits in alcoholism and comorbid disorders, the authors present a heuristic cognitive-neurobehavioral model of alcoholism implicating the frontostriatal system. Finally, recommendations for the prevention and treatment of alcoholism, based on this model, are discussed.

The development, validation, and applications of a computerized measurement of cognitive impairment from the content analysis of verbal behavior

This is a report of the development, validation, and computerized applications of a method of measuring cognitive and intellectual impairment through the content analysis of verbal behavior. The content analysis procedure utilized is based on the method developed by Gottschalk and Gleser for the measurement of the magnitude of many other psychological states and traits, in addition to cognitive dysfunction. Verbal behavior studies are reviewed that examine the cognitive effects of age, certain psychoactive drugs, alcohol, total body irradiation, sensory overload, and dementia. Finally, the availability of a recently developed artificial intelligence software program is reported that will reliably, rapidly, and objectively score speech samples (on Gottschalk-Gleser Scales) transcribed according to specific directions from IBM-compatible computer diskettes.

Alcoholic blackouts: legal implications

Alcoholic blackouts are defined as the temporary, complete inability to form long-term memory as the result of a high blood alcohol level. This means that a neuron-to-neuron system has been blocked. Since that is the case, such central nervous dysfunction should have legal implications, both from the blackout itself and also from the fact that this degree of neural interference in one system is at least suggestive that other dysfunction may be present. The subject of blackouts is updated with recent developments in neuroscience. The legal significance of the blackout is examined in enough depth to allow for further discussion and exploration.

Gender differences in retrieval from long-term memory following acute intoxication with ethanol

The present study investigated the effects of ethanol on retrieval from long-term memory by using a set of cognitive decision tasks. Male and female subjects were administered either 0.0 or 1.0 milliliter of ethanol per kilogram of body weight, and then asked to make physical, lexical, and semantic decisions about pairs of words. In general, intoxicated subjects responded significantly slower than sober subjects on all decision types. In addition, female subjects demonstrated greater performance deficits than males when intoxicated. The results suggested that the reduction in speed was not due to a simple slowing of motor responses. Rather the ethanol induced memory deficits may result from the slowing of cognitive operations that impair the efficiency of working memory. Several reasons were proposed for the observed difference in reaction to intoxication between male and female subjects, including neuroendocrine processes and cognitive differences.

The effect of ethanol and sex on radial arm maze performance in rats

A daily dose of 1.5 g/kg of ethanol interfered with radial arm maze performance in rats. Ethanol inhibited the acquisition of a new win-shift response to obtain a food reward, especially when a previously learned response was present. This effect was greater in females than in males. Ethanol appears to suppress flexibility in the development of optimal performance of goal-directed behavior.

The effects of tolerance on state-dependent learning in social drinkers

Sixty drinkers were assigned to three experimental groups which manipulated pre and post drug state. Subjects on learning trials were exposed to 30 slides, composed of geometrical shapes and alcohol-related self-statements. On the day following learning, subjects were required to try and recognise the 30 original slides out of 60 test slides. Signal detection method was used to analyse differences between the groups. Results showed that medium drinkers who consumed an experimental dose similar to their usual dose showed state dependency over both stimuli. Light drinkers showed an impairment on all alcohol-related conditions but alcohol on learning primed the recognition of alcohol-associated stimuli. Heavy drinkers, who drank a dose that was lower than their usual dose, showed little effect. The findings thus showed the importance of controlling for the level of tolerance and the type of stimuli presented in the State Dependent Learning experiments.

Chronic alcoholism in males: cognitive deficit as a function of age of onset, age, and duration

Performance on a cognitive rule-learning task was studied in detoxified alcoholics having early/late onset and short-/long-term drinking histories, and in matched nonalcoholic controls. There were pronounced cognitive deficits in early onset and long-term alcoholics. Impairment was severest in the early onset group, even though they were on the average 15 years younger than the late onset group. Early onset alcoholics were relatively more impaired on both the abstract and the verbal Shipley measures. This group also manifested a relative deficit in ability to show positive transfer across problems. Chronicity of alcoholism also interfered with acquisition of an abstract relationship between concrete stimulus attributes. Age negatively influenced ability to perform abstractions, but not commonly tested verbal skills. The findings suggest that an early onset of alcoholism, regardless of duration of problem drinking, is particularly predictive of cognitive impairment.

The effects of alcohol on prose memory

The present study examined the effects of acute alcoholic intoxication on prose memory. Intoxicated and sober subjects listened to six narrative passages at different presentation rates. Immediately after listening to a tape-recorded version of each story, subjects orally recalled it. The results demonstrated that sober subjects recalled more than intoxicated subjects, but subjects from both groups favored the main ideas in their recalls. However, at the fastest presentation rate, intoxicated subjects showed some diminished sensitivity to the semantic structure of prose. It was suggested that alcohol induced deficits in prose memory may result from a general slowing in the rate with which text is encoded into working memory.

The impact of fathers' drinking on cognitive loss among social drinkers

This chapter examines cognitive loss in social drinkers. The question of concern is whether the relationship between increased levels of alcohol consumption and reduced sober cognitive performance is misspecified. In particular, does reduced abstraction performance in social drinkers result from parental heavy drinking rather than, as we have proposed, from social drinkers' current use of alcohol. Because offspring of alcoholics may be at high risk for cognitive deficits even in childhood, these deficits may be transmitted in alcoholic families. Thus, the relationship between increased drinking and sober cognitive loss might be eliminated if parental drinking is controlled. We report here, however, that the effects of current alcohol use on abstraction performance in a representative sample of employed men and women cannot be accounted for by fathers' drinking. Our findings indicate the need for further research on both the cognitive effects of parental drinking and current alcohol use.

Alcohol and proactive interference: a test of response eccentricity theory of alcohol's psychological effects

A theory is offered which proposes that alcohol induces eccentricity in the neurophysiological mechanism by which responses are selected for emission by the nervous system. Hence, in a specific stimulus situation, normally high probability responses decrease in frequency, while lower probability responses increase in frequency. From this postulate, the prediction is derived that in a verbal paired-associate learning task administered over two days, alcohol will decrease proactive interference from first-day learning (high probability associate) and result in enhanced acquisition of second day items. This paper reports two experimental tests of the prediction, each of which employs four subject groups tested over two days. Experiment 1 (n = 24) provides tentative support while ruling out some potential confounds. With these confounds eliminated, Experiment 2 (n = 40) confirms the prediction in a more direct test. A variety of possible alternative explanations for the counter-intuitive finding of improved cognitive performance under alcohol are evaluated against the theory proposed, as are other recent theories which address the variable behavioral effects of alcohol. Finally, the new data gathered on the effects of imagery instructions on proactive interference are considered.

Interaction of apomorphine and amantadine with ethanol in men

Male moderate drinkers (n = 12) drank ethanol (0.8 g/kg) and then ingested one of the following: apomorphine (5 mg), amantadine (200 mg), or placebo. Subjects were tested on a battery of physiological and behavioral measures using a double-blind, within-subjects, crossover design. Postethanol ingestion of apomorphine significantly increased ethanol's effect on 3 out of the 8 measures employed (divided attention, objective and subjective inebriation ratings) without significantly altering blood ethanol concentrations or the rate of blood ethanol decline. There was no indication that apomorphine antagonized ethanol's effects. In contrast to reports indicating that amantadine antagonized ethanol depression in rodents, amantadine did not significantly alter the degree of ethanol intoxication in humans. The increase in intoxication induced by apomorphine supports suggestions that dopaminergic systems may be involved in mediating ethanol intoxication and that the sobering effect of catecholamine-augmenting drugs results from noradrenergic, rather than combined noradrenergic and dopaminergic, stimulation. Further studies are necessary to elucidate the role of pre- and postsynaptic dopaminergic receptors in mediating these effects.

Objective psychological measurement and alcoholism: survey of the literature 1974

This survey is the third in a series examining objective psychological test data or behavioral measurements on alcoholics published in the United States during a specific year. The 131 articles published in 1974 are divided into two broad categories, treatment orientation and behavior and attitudes of alcoholics. Findings are further divided into subcategories, briefly described, and cross indexed. The resume and conclusion section includes references to current findings.

Neuropsychologic decrements as a function of alcohol intake in male students

Drinking history and sober neuropsychologic performance were examined in 45 male university students between the ages of 21 and 30 yr. Sober performance on the Shipley-Hartford Institute of Living Scale was significantly and inversely related to the amount of alcohol consumed per drinking event. Neither frequency of drinking nor lifetime alcohol consumption were significantly related to cognitive performance in controlled multiple regression equations. These findings emphasize the need for more information about the effects of social drinking on health.

Retrograde enhancement of human memory with alcohol

In two experiments with normal male subjects, the ingestion of alcohol (1 ml/kg) immediately after learning significantly improved subsequent remembering. By comparison, marijuana (15 mg) had no significant post-acquisition effect. Facilitation of visual and verbal memory with alcohol under these conditions has implications for the interference and consolidation views of memory.

Memory facilitation by post-training injection of ethanol

Immediate post-training IP injection of ethanol (0.75--4.5 g/kg) significantly enhanced retention of a one-trial passive avoidance task in mice compared to saline controls. Ethanol (4.5 g/kg) in the absence of footshock did not affect test performance. The memory facilitation may reflect ethanol's effects on neurotransmitter, macromolecular, or hormonal systems, or a reduction in interference.

Effects of alcohol on moral functioning in male social drinkers

The present study investigated the effect of alcohol consumption on both moral reasoning and moral values, cognitive variables which are likely to mediate moral behavior. Fifty-five male social drinkers (Mean age = 19.75 years) participated in a one-way pretest-posttest design incorporating two experimental (alcohol) and three control groups. Results showed that alcohol did not affect moral stage reasoning on the Defining Issues Test. However, the endorsement of meaningless items was significantly, but differentially, affected by the alcohol doses administered. No group differences were found in regard to moral values. These findings are related to previous research on alcohol and cognitive processes.

Pharmacotherapy of drug abusers: adjunctive psychopharmacologic management of nonopiate mixed substance abusers in an outpatient setting

Conventional practice in treating nonopiate mixed substance abusers have avoided the use of pharmaceuticals because of the strong drug orientation of this patient population. The author's impressions are that this is a maladaptive treatment polarization, and that psychopharmacotherapy of this group of patients is not only sometimes useful but necessary for some individuals. Diagnostic syndromata and problems specific to this patient population are delineated along with our experience in pharmacotherapy.

Reversal of ethanol intoxication in humans: an assessment of the efficacy of L-dopa, aminophylline, and ephedrine

The effect of postethanol treatment with L-Dopa, aminophylline and/or ephedrine was investigated. In one experiment, healthy, male, moderate drinkers ingested ethanol (0.8 g/kg) and then either L-Dopa (1.5 g), or placebo. In a second experiment, subjects ingested ethanol followed by aminophylline (200 mg), ephedrine (50 mg), aminophylline (200 mg) plus ephedrine (50 mg), or placebo. Double-blind, within-subjects, crossover designs were employed. Treatment with L-Dopa significantly reduced ethanol's effect on the electroencephalogram, motor coordination, and divided attention performance (t-test for paired data). Treatment with aminophylline and/or ephedrine also significantly reduced ethanol's effects on the electroencephalogram and motor coordination. The ethanol-antagonism may result from central noradrenergic stimulation.

Cognitive deficits in chronic alcoholics

The degree of cognitive deficit in chronic alcoholic males at onset of inpatient treatment and degree of recovery at discharge, plus a possible relationship between the latter and post-hospital drinking behaviors were assessed. 330 patients were classified as abstaining, improved, unimproved, or unclassified on the basis of their drinking behaviors during the first 3 mo. following discharge. The Hooper Visual Organization Test and the Shipley-Hartford were administered at admission and discharge as measures of cognitive impairment. All four groups showed significant improvement on the Hooper as well as on their Shipley Conceptual Quotient scores at discharge, but only the abstainers showed a significant gain in vocabulary scores. The results suggest a cognitive deficit consistent with mild organicity.

Drinking practices and cognitive functioning

The relationships between drinking practices and cognitive functioning were examined in a non-patient sample. Neither the amount of alcohol consumed over a lifetime nor current frequency of drinking occasions was significantly (ps greater than .05) correlated with cognitive test scores. However, the quantity of alcohol consumed per drinking occasion was inversely related to performance on tests of abstraction, adaptive abilities and concept formation. The results suggest that social drinking may have deleterious effects on cognitive processes.

Reversal of ethanol intoxications in humans: an assessment of the efficacy of propranolol

The effect of post-ethanol ingestion of a single dose of propranolol on acute intoxication was studied in 13 healthy male volunteers. A within subjects, double-blind, crossover design was employed. Each subject participated in two experimental sessions. In each session, subjects took a battery of tests under three conditions: Sober, Alcohol (0.8 g/kg) and Alcohol (1.1 g/kg) + Pill, in that order. The pill contained propranolol (40 mg) in one session and placebo in the other. Ethanol significantly reduced motor coordination, memory and divided attention performance and altered mood scores. Propranolol significantly increased ethanol's effects on divided attention, inebriation ratings and the electroencephalogram without significantly altering blood alcohol concentrations. There was no indication that propranolol antagonized any of ethanol's effects. These results agree with studies indicating that ethanol's effects are increased by a reduction in the functional capacity of central catecholamine systems. It is suggested that central catecholamine-stimulating drugs may reverse some of ethanol's effects.