The Feasibility, Tolerability, and Safety of Administering a Very High Alcohol Dose to Drinkers with Alcohol Use Disorder

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.

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

Models of addiction are based on neurobiological, behavioral, and pharmacological studies in animals, but translational support from human studies is limited. Studies are lacking in examining acute responses to alcohol in drinkers with alcohol use disorder (AUD), particularly in terms of relevant intoxicating doses and measurement of stimulating and rewarding effects throughout the breath alcohol concentration (BrAC) time curve. Participants were N = 60 AUD drinkers enrolled in the Chicago Social Drinking Project and examined in three random-order and blinded sessions for subjective and physiological responses to a beverage containing 0.0 g/kg, 0.8 g/kg, and 1.2 g/kg alcohol. BrAC in the alcohol sessions at 60 min was 0.09 g/dL and 0.13 g/dL, respectively. Both doses of alcohol produced significant biphasic effects on subjective measures of stimulation, euphoria, reward (liking and wanting), sedation, and neuroendocrine and cardiovascular factors. Increased pleasurable effects of alcohol were pronounced during the rising limb-to-peak BrAC and sedating effects emerged during the declining limb. Alcohol dose-dependently increased feel drug ratings and rewarding effects at peak BrAC or early declining limb, and physiological responses at the rising limb. Thus, rather than the notion of an overall tolerance, results show an alcohol response phenotype characterized by sensitivity to alcohol's stimulating, rewarding and physiological effects. The results of this study may aid in the conceptualization of alcohol addiction as a disorder characterized by the persistence of enhanced hedonic alcohol responses rather than chronic tolerance and reward deficiency.