Abstract
Heavy alcohol use is pervasive and one of our most significant global health burdens. Early theories posited that certain alcohol response phenotypes, notably low sensitivity to alcohol ('low-level response') imparts risk for alcohol use disorder (AUD). However, other theories, and newer measures of subjective alcohol responses, have challenged that contention and argued that high sensitivity to some alcohol effects are equally important for AUD risk. This study presents results of a unique longitudinal study in 294 young adult non-dependent drinkers examined with alcohol and placebo testing in the laboratory at initial enrolment and repeated 5 years later, with regular follow-up intervals assessing AUD (trial registration: http://clinicaltrials.gov/ct2/show/NCT00961792). Findings showed that alcohol sedation was negatively correlated with stimulation across the breath alcohol curve and at initial and re-examination testing. A higher rather than lower alcohol response phenotype was predictive of future AUD. The findings underscore a new understanding of factors increasing vulnerability to AUD.
Highlights
Participants were healthy young non-alcohol-dependent drinkers (42% female; mean age 25.4, s.d. = 2.9) who were at high or low risk for alcohol use disorder (AUD) based on their alcohol consumption patterns
Drinkers developing AUD were about five times more likely to be high rather than low alcohol responders (P
Lower alcohol sedation was consistently inversely associated with higher stimulation across the breath alcohol concentration (BrAC), for the whole sample and drinker subgroups, and persisted for 5 years
Summary
= 2.9) who were at high or low risk for AUD based on their alcohol consumption patterns. High-risk drinkers (n = 208) were defined as those who consumed ≥5 standard drinks (≥4 for women) per occasion 1–4 times/week, >14 units weekly and low-risk, light drinker (n = 86) were defined as those who consumed 1–6 drinks/weekly with no/rare heavy drinking. Participants were individually tested in two 5 h afternoon laboratory sessions in which they consumed either 0.8 g/kg alcohol or placebo in random order under double-blind conditions. They were told the beverage could contain a stimulant, sedative, alcohol or placebo or a combination of two substances. The University of Chicago Institutional Review Board approved the study
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