Peak Blood Alcohol Concentration Research Articles

What Should We Do When Participants Report Dangerous Drinking? The Impact of Personalized Letters Versus General Pamphlets as a Function of Sex and Controlled Orientation

Research in which participants report potentially dangerous health-related behaviors raises ethical and professional questions about what to do with that information. Policies and laws regarding reportable behaviors vary across states and Institutional Review Boards (IRB). In alcohol research, IRBs often require researchers to respond to participants who report dangerous drinking practices. Researchers have little guidance regarding how best to respond in such cases. Personalized feedback or general nonpersonalized information may prove differentially effective as a function of gender and/or level of self-determination. This study evaluated response strategies for reducing peak blood alcohol concentration (BAC) among participants reporting dangerous BACs (≥ .35%) in the context of a two-year longitudinal intervention trial with 818 heavy drinking college students. After each assessment, participants who reported drinking to estimated BACs at or greater than .35% were sent either a personalized letter expressing concern and indicating their reported BAC or a nonpersonalized pamphlet that included general information about alcohol and other substances, referral information, and a BAC handout. Hierarchical linear modeling results revealed that both strategies were associated with reduced peak BAC when controlling for previous BAC. The personalized letter was more effective for women and for students who tend to regulate their behavior based on others' expectations and contingencies in the environment. This research provides some guidance for researchers considering appropriate responses to participants who report dangerous health behavior in the context of a research trial.

Extension of the simulated drinking game procedure to multiple drinking games.

The present study extended the Simulated Drinking Game Procedure (SDGP) to obtain information about different types of drinking games. Phase I participants (N = 545) completed online screening questionnaires assessing substance use and drinking game participation. Participants who met the selection criteria for Phase II (N = 92) participated in laboratory sessions that consisted of three different periods of drinking game play. Sixty-two percent (N = 57) of the sample was female. Data from these sessions was used to estimate the peak Blood Alcohol Concentration (BAC) a participant would achieve if they consumed alcohol while participating in the SDGP. Total consumption and estimated BAC varied as a function of game type. The total consumption and estimated BAC obtained while playing Beer Pong and Memory varied significantly as a function of group. Total ounces consumed while playing Three Man varied significantly as a function of group; however, the variation in estimated BAC obtained while playing Three Man was not significant. Results indicated that estimated BACs were higher for female participants across game type. Previous experience playing the three drinking games had no impact on total drink consumption or estimated BAC obtained while participating in the SDGP. The present study demonstrated that the SDGP can be used to generate estimates of how much alcohol is consumed and the associated obtained BAC during multiple types of drinking games. In order to fully examine whether previous experience factors in to overall alcohol consumption and BAC, future research should extend the SDGP to incorporate laboratory administration of alcohol during drinking game participation.

Mood and Implicit Alcohol Expectancy Processes: Predicting Alcohol Consumption in the Laboratory

Implicit positive alcohol expectancy (PAE) processes are thought to respond phasically to external and internal stimuli-including mood states-and so they may exert powerful proximal influences over drinking behavior. Although social learning theory contends that mood states activate mood-congruent implicit PAEs, which in turn lead to alcohol use, there is a dearth of experimental research examining this mediation model relative to observable drinking. Moreover, an expectancy theory perspective might suggest that, rather than influencing PAEs directly, mood may moderate the association between PAEs and drinking. To test these models, this study examined the role of mood in the association between implicitly measured PAE processes (i.e., latency to endorse PAEs) and immediate alcohol consumption in the laboratory. Gender differences in these processes also were examined. College students (N = 146) were exposed to either a positive, negative, or neutral mood induction procedure, completed a computerized PAE reaction time (RT) task, and subsequently consumed alcohol ad libitum. The mood manipulation had no direct effects on drinking in the laboratory, making the mediation hypothesis irrelevant. Instead, gender and mood condition moderated the association between RT to endorse PAEs and drinking in the laboratory. For males, RT to tension reduction PAEs was a stronger predictor of volume of beer consumed and peak blood alcohol concentration in the context of general arousal (i.e., positive and negative mood) relative to neutral mood. RT to PAEs did not predict drinking in the laboratory for females. The results show that PAE processes are important determinants of immediate drinking behavior in men, suggesting that biased attention to mood-relevant PAEs-as indicated by longer RTs-predicts greater alcohol consumption in the appropriate mood context. The findings also highlight the need to consider gender differences in PAE processes. This study underscores the need for interventions that target automatic cognitive processes related to alcohol use.

Alcohol-involved assault: Associations with posttrauma alcohol use, consequences, and expectancies

Victim alcohol consumption is common prior to sexual assault, and a burgeoning literature suggests that victims who were intoxicated during assault may differ in post-assault adjustment compared to those who were not impaired. Less is known about potential relationships between experiencing an alcohol-involved assault (AIA) and later drinking behavior. In this study, we examined the relationships between sexual assault, subsequent drinking behavior and consequences, and alcohol expectancies in a sample of 306 undergraduate women who reported current alcohol use and reported either no trauma history ( n = 53), non-AIA ( n = 69), or AIA ( n = 184). Differences emerged for alcohol use ( F(2, 298) = 12.78, p < .001), peak blood alcohol content ( F(2, 298) = 9.66, p < .001), consequences ( F(2, 296) = 7.38, p < .005), and positive alcohol expectancies ( F(14, 796) = 1.93, p < .05). In particular, women with an AIA reported greater alcohol use and positive expectancies compared to women with no trauma history and women with a non-alcohol influenced assault. In addition, both assault groups reported greater drinking consequences than women with no trauma history. Findings suggest that it is the women who are assaulted while under the influence of alcohol who evidence more alcohol use and alcohol-related problems following assault.

Use and correlates of protective drinking behaviors during the transition to college: Analysis of a national sample

Objective This study examined patterns and correlates of protective drinking behaviors among incoming first-year college students. Method Incoming first-year students (n = 76,882) from 258 colleges across the U.S. provided baseline data on demographics, drinking practices, and protective behaviors as part of a web-based alcohol education program. Across the several colleges, responses to protective behavior questions were collected from seven weeks before the start of the school year to five weeks after. Results Factor analysis identified three protective behavior sub-factors: Limit Drinking, Avoid Drinking and Driving, and Intent to Get Drunk. Both Limit Drinking and Avoid Drinking and Driving generally declined over the course of the data collection period while Intent to Get Drunk and peak blood alcohol concentration increased immediately after the start of school. In multiple regression analyses, the number of heavy drinking episodes in the past two weeks had a strong negative association with a Total Protective Behavior Score and the Limit Drinking Score, and a positive association with the Intent to Get Drunk Score. With the exception of the Intent to Get Drunk Score, women were more likely to use protective behaviors than men. Underage drinkers used protective behaviors less often than their of-age peers, though the effect was small. Race/ethnicity, time to matriculation, and intent to join/membership in a fraternity/sorority had negligible effects on protective behavior scores. Conclusions College students increase risky drinking after the start of school while progressively using fewer behaviors that might mitigate the consequences of drinking.

Protective Effects of Parent–College Student Communication During the First Semester of College

Objective: Recent studies suggest that parents maintain influence as their adolescents transition into college. Advances in communication technology make frequent communication between parents and college students easy and affordable. This study examines the protective effect of parent–college student communication on student drinking behaviors, estimated peak blood alcohol concentration (eBAC), and serious negative consequences of drinking. Participants: Participants were 746 first-year, first-time, full-time students at a large university in the United States Methods: Participants completed a baseline and 14 daily Web-based surveys. Results: The amount of time spent communicating with parents on weekend days predicted the number of drinks consumed, heavy drinking, and peak eBAC, consistent with a protective within-person effect. No association between communication and serious negative consequences was observed. Conclusions: Encouraging parents to communicate with their college students, particularly on weekend days, could be a relatively simple, easily implemented protective process to reduce dangerous drinking behaviors.

Evaluation of Two Web-Based Alcohol Interventions in the U.S. Military

The U.S. military has traditionally had high rates of alcohol misuse and alcohol-related problems, necessitating effective treatment programs that minimize participant burden. Web-based interventions have shown promise as efficient treatment options for college students and adults but have not been widely evaluated in the military. This study evaluated the efficacy of two web-based alcohol interventions originally created for civilians and then adapted for U.S. military personnel. Two web-based alcohol interventions, Alcohol Savvy and Drinker's Check-Up, were adapted for use among military populations. The interventions were evaluated using a convenience sample of 3,070 active-duty military personnel at eight installations. Following a baseline survey, participants were assigned to one of three treatment conditions: (a) Alcohol Savvy, (b) Drinker's Check-Up, or (c) control (no program participation). Follow-up surveys were completed by 1,072 participants 1 month following baseline and by 532 participants 6 months following baseline. At 1-month follow-up, participants who completed the Drinker's Check-Up intervention had significant reductions in multiple measures of alcohol use relative to controls. Positive outcomes were found for average number of drinks consumed per occasion, frequent heavy episodic drinker status, and estimated peak blood alcohol concentration. These reductions in alcohol use at the 1-month follow-up were maintained at the 6-month follow-up. There were no statistically significant changes in alcohol use for participants who completed Alcohol Savvy. This study expands the literature on the effectiveness of web-based treatment for alcohol misuse. Findings indicate that web-based programs (Drinker's Check-Up in particular) can significantly decrease several indicators of alcohol use in U.S. military personnel.

Electronic screening and brief intervention for risky drinking in Swedish university students — A randomized controlled trial

BackgroundThe limited number of electronic screening and brief intervention (e-SBI) projects taking place in young adult student populations has left knowledge gaps about the specific methods needed to motivate reduced drinking. The aim of the present study was to compare differences in alcohol consumption over time after a series of e-SBIs was conducted with two groups of young adult students who were considered risky drinkers. The intervention group (IG) (n=80) received extensive normative feedback; the control group (CG) (n=78) received very brief feedback consisting of only three statements. MethodAn e-SBI project was conducted in naturalistic settings among young adult students at a Swedish university. This study used a randomized controlled trial design, with respondents having an equal chance of being assigned to either the IG or the CG. The study assessed changes comparing the IG with the CG on four alcohol-related measurements: proportion with risky alcohol consumption, average weekly alcohol consumption, frequency of heavy episodic drinking (HED) and peak blood alcohol concentration (BAC). Follow-up was performed at 3 and 6months after baseline. ResultsThe study documented a significant decrease in the average weekly consumption for the IG over time but not for the CG, although the differences between the groups were non-significant. The study also found that there were significant decreases in HED over time within both groups; the differences were about equal in both groups at the 6-month follow-up. The proportion of risky drinkers decreased by about a third in both the CG and IG at the 3- and 6-month follow-ups. ConclusionsAs the differences between the groups at 6months for all alcohol-related outcome variables were not significant, the shorter, generic brief intervention appears to be as effective as the longer one including normative feedback. However, further studies in similar naturalistic settings are warranted with delayed assessment groups as controls in order to increase our understanding of reactivity assessment in email-based interventions among students.

Truncation of Breath Alcohol Measurements and Its Effect on Peak Concentrations

An intra-subject comparative study was performed using breath analysis to assess the forensic implications of data truncation on peak blood alcohol concentrations (Cmax). Accordingly, several other forensically relevant pharmacokinetic parameters associated with Cmax were investigated, including the time-to-peak (Tmax), plateau (PLAT) duration, and the rise in blood alcohol concentration (BAC) following the end of drinking (EOD). The study consisted of three drinking sessions, nine subjects per session, with drinking intervals of 30, 90, and 180 minutes, and ethanol doses of 1.0, 1.1, and 1.6 g/kg, respectively. Three-digit breath measurements were collected in duplicate at 10, 30, 45, 60, 75, 90, 105, 120, 135, 195, and 255 minutes following EOD using a fuel-cell based breath instrument (Intox ECIR®). Breath results were then computed using two different data treatment methods. The first method averaged duplicate three-digit breath measurements and reported results to the third digit. The second method used the lower of the two duplicate measurements and reported results to the truncated second digit. The results of the two data treatment methods were then compared using general statistics and alcohol concentration-time profiles. The overall rise in BAC following EOD for three-digit results was 0.009 g/210L with a range of 0.000–0.030 g/210L (standard deviation 0.008 g/210L). When breath measurements where truncated, 25 of the 27 subjects had a rise in BAC of 0.02 g/210L or less. In total, 6 subjects had no rise in BAC following the EOD when evaluating the three-digit results. In contrast, when BAC results were truncated, 11 subjects exhibited no increase in BAC following EOD. The overall Tmax was reduced from 41 minutes to 26 minutes, and overall PLAT durations were extended from 22 to 39 minutes, when the breath measurements were truncated.

Characterizing binge drinking among U.S. military Veterans receiving a brief alcohol intervention

Background Brief web-based alcohol interventions (BAIs) are effective for reducing binge drinking in college students and civilian adults, and are increasingly being applied to U.S. military populations. However, little is known about factors associated with binge drinking in Veteran populations and therefore some concern remains on the generalizability of studies supporting BAIs for addressing binge drinking in this population. This study sought to better understand the characteristics (e.g., demographic, coping related mental health factors, prior exposure to traumatic events, and factors assessing motivation to change alcohol use) of a predominantly male sample of binge drinking Veterans receiving a BAI from a VA provider. Methods A primarily male (93.5%) sample (N = 554) of Veterans completed a BAI consisting of brief assessment and personalized feedback. Results We found that Veterans who were younger, used drugs/alcohol to cope with symptoms of PTSD and depression (e.g., nightmares and flashbacks and sleep difficulties), and had experienced sexual assault, had higher self-reported peak blood alcohol concentration and a higher likelihood for a binge drinking episode in the last 90 days. Conclusions BAIs may be a promising approach for addressing binge drinking in Veterans. However, binge drinking among a sample of mostly male Veterans receiving a BAI may be associated with a complex set of factors that are less prevalent in the college student population and thus studies demonstrating the efficacy of BAIs with Veterans are needed.

Impaired perceptual judgment at low blood alcohol concentrations

Males and females show different patterns of cognitive impairment when blood alcohol concentrations (BACs) are high. To investigate whether gender differences persist at low BACs, cognitive impairment was tested in 21 participants (11 female, 10 male) using a brief computerized perceptual judgment task that provides error rate and response time data. Participants consumed a measured dose of alcohol (average peak BAC: females: 0.052 g/100 mL, males: 0.055 g/100 mL), and were tested at four time points spanning both the rising and falling limbs of the BAC curve, in addition to a prealcohol time point. Comparisons were made against performance of these same participants at equivalent time points in an alcohol-free control condition. Males and females displayed a trend toward slower responses and more errors, even when mildly intoxicated. These data indicate that cognitive function can be impaired at BACs that are below the legal limit for driving in most countries.

The efficacy of a targeted personalized drinking feedback intervention among intercollegiate athletes: A randomized controlled trial.

College athletes are an at-risk population for excessive alcohol use and subsequent alcohol-related harms. The purpose of this study was to test the efficacy of an electronically delivered personalized drinking feedback (PDF) intervention targeted specifically to college athletes, both in comparison with a standard (i.e., nontargeted) PDF intervention and an education-only (EO) condition that also included targeted information. Data were collected on 263 intercollegiate athletes from three colleges (76% women, 86% White) who were randomly assigned to one of the conditions. Results provided partial support for the efficacy of the targeted PDF intervention. Students in the targeted PDF condition reported a lower peak blood alcohol concentration (BAC) at the 6-month follow-up than those in the other conditions. Heavy drinking students in the targeted PDF condition reported a lower peak BAC than those in the other conditions at the 1-month follow-up and a lower peak BAC than those in the EO condition at the 6-month follow-up. Finally, in-season athletes in the targeted PDF condition reported fewer drinks per week than those in the PDF-standard condition at the 1-month follow-up. These findings provide preliminary support for the use of targeted PDF interventions with at-risk alcohol users, such as college athletes.

Associations Between Heavy Drinking and Changes in Impulsive Behavior Among Adolescent Boys

Impulsive behavior in humans predicts the onset of drinking during adolescence and alcohol use disorders (AUDs) in adulthood. It is also possible, however, that heavy drinking may increase impulsive behavior by affecting the development of brain areas that support behavioral control or through other associated mechanisms. This study examined whether drinking heavily during adolescence is related to changes in impulsive behavior with a specific focus on how the association differs across individuals, contingent on the developmental course of their impulsiveness. Data came from a sample of boys (N = 503) who were followed annually from approximate age 8 to age 18 and again at approximate age 24/25. Heavy drinking was defined as experiencing a blood alcohol concentration (BAC) level of 0.08% or higher. At each assessment, the parent and child each reported whether the child was impulsive. First, group-based trajectory analysis was used to identify 4 groups differing in the level and slopes of their trajectories of impulsive behavior from age 9 to age 17: low (13.9%), early adolescence-limited (18.7%), moderate (60.8%), and high (6.6%). These trajectory groups differed in their prevalence of any heavy drinking, peak BACs, and rates of alcohol dependence in adolescence and AUD in early adulthood, with the less impulsive groups being lower on these measures than the more impulsive groups. Heavy drinking was then entered into the model as a time-varying covariate; this measure was lagged so that the results represent change in impulsive behavior the year following heavy drinking. Among boys on the moderate trajectory, those who drank heavily were rated as significantly more impulsive the following year compared to those who did not drink heavily. The association between heavy drinking and impulsive behavior may depend on earlier levels of impulsive behavior with those who are moderately impulsive appearing to be at greatest risk for increased impulsive behavior following heavy drinking. Further research is needed to clarify this association.

Brief alcohol interventions for mandated college students: comparison of face‐to‐face counseling and computer‐delivered interventions

College students who violate alcohol policies are often mandated to participate in alcohol-related interventions. This study investigated (i) whether such interventions reduced drinking beyond the sanction alone, (ii) whether a brief motivational intervention (BMI) was more efficacious than two computer-delivered interventions (CDIs) and (iii) whether intervention response differed by gender. Randomized controlled trial with four conditions [brief motivation interventions (BMI), Alcohol 101 Plus™, Alcohol Edu for Sanctions(®), delayed control] and four assessments (baseline, 1, 6 and 12 months). Private residential university in the United States. Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems and recidivism. Piecewise latent growth models characterized short-term (1-month) and longer-term (1-12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow-up year. No differences in recidivism were found. Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males.

Development of a simulated drinking game procedure to study risky alcohol use.

The aim of the current study was to initiate and describe the development of a Simulated Drinking Game Procedure (SDGP), a safe, efficient, and alcohol-free laboratory protocol for studying drinking game behavior. Fifty-two undergraduates completed the SDGP in a laboratory session, where participants played singles and/or doubles games of Beer Pong. Water was substituted for alcohol in all of the games. The number of drinks consumed during matches and 20-min play periods were coded during each session, and software was used to estimate the peak blood alcohol concentration (BAC) a participant would achieve if he or she had consumed actual alcohol while participating in the SDGP. Results indicated that participation in Beer Pong can lead to rapid consumption of alcohol and an associated rise in BAC. Results also highlight additional risks for female participants associated with participation in drinking games. The SDGP is a research tool capable of increasing our understanding of drinking games.

Examination of posttraining supervision of peer counselors in a motivational enhancement intervention to reduce drinking in a sample of heavy-drinking college students

Importance of peer counselor posttraining supervision on motivational interviewing (MI) microskills and postintervention drinking outcomes were evaluated in a sample of heavy-drinking undergraduate students completing Brief Alcohol Screening and Intervention for College Students (BASICS; L.A. Dimeff, J.S. Baer, D.R. Kivlahan, & G.A. Marlatt, 1999). Two peer counselor groups were trained using identical protocols. Posttraining, one group was randomized to receive supervision, whereas the other received no supervision. Groups were subsequently compared on MI microskills. College students ( n = 122) were randomly assigned to either assessment-only control, supervision, or no supervision groups and completed a BASICS intervention. Postintervention drinking outcomes were examined. Results suggested supervision aided peer counselors in reducing use of closed-ended questions. Both treatment groups reduced total drinks per week and heavy-drinking behaviors compared to control. No differences on peak blood alcohol concentration (BAC) or alcohol-related consequences were observed. Differences in supervision did not influence drinking outcomes; however, posttraining supervision for peer counselors deficient in MI microskills may be needed to improve BASICS fidelity.

P-121: Does gastric banding and sleeve gastrectomy alter alcohol metabolism?

Patients who have undergone gastric bypass surgery have been shown to have significantly altered alcohol metabolism postoperatively with peak blood alcohol content (BAC) and time to sobriety being increased. The alteration in alcohol metabolism following gastric bypass may be due to bypassing alcohol dehydrogenase receptors in the stomach and increased absorption via the Roux limb. Our hypothesis is that alcohol metabolism for patients undergoing gastric banding or sleeve gastrectomy would not be significantly altered.

Alcohol pharmacokinetics, decision making and folk wisdom: A reply to Moxnes and Jensen (2009)

Moxnes and Jensen (2009) present a study of decision making under conditions of uncertainty using a computerised simulation of alcohol pharmacokinetics. In their article, they conclude that their findings challenge the ‘folk wisdom’ that advises against drinking on an empty stomach. We contend that this is a problematic conclusion for three reasons: (1) the study and findings presented in their paper are simply not sufficient to allow one to, even tentatively, draw such a conclusion; (2) the conclusion is contrary to basic pharmacological knowledge concerning alcohol absorption, metabolism and the implications for peak blood alcohol concentration; and (3) the implications for understanding the process of decision making while alcohol intoxicated are not considered in the study. The Moxnes and Jensen (2009) study did not involve alcohol administration and is therefore an examination of decision making in situations of uncertainty rather than a specific exploration of drinking-related decision making. Recent formulations of the effects of alcohol on cognitive processing would lead to different conclusions than those presented by Moxnes and Jensen (2009). We conclude by suggesting our understanding of the implications of the study.

The language of motivational interviewing and feedback: Counselor language, client language, and client drinking outcomes.

Previous research has suggested that motivational interviewing (MI) may affect client language, which in turn predicts client drinking outcome. In this study, we examined the relationship between counselor language and client language, personalized feedback and client language, and client language and client drinking outcome, in a sample of heavy-drinking college students. MI was delivered in a single session with or without a personalized feedback report (MI with feedback [MIF]; MI only). Sessions were coded using the Motivational Interviewing Skill Code 2.1. A composite drinking outcome score was used, consisting of drinks per week, peak blood alcohol concentration, and protective drinking strategies. We found three main results. First, in the MIF group, MI consistent counselor language was positively associated with client change talk. Second, after receiving feedback, MIF clients showed lower levels of sustain talk, relative to MI only clients. Finally, in the MIF group, clients with greater change talk showed improved drinking outcomes at 3 months, while clients with greater sustain talk showed poorer drinking outcomes. These results highlight the relationship between counselor MI skill and client change talk, and suggest an important role for feedback in the change process.

Reactivity to alcohol assessment measures: an experimental test

Previous research has suggested that alcohol screening and assessment may affect drinking. This study was a randomized test of reactivity to alcohol assessment questionnaires among a group of heavy drinking college students. A total of 147 university students completed a screening questionnaire and were randomized to either immediate assessment or delayed assessment. The immediate assessment group completed a set of drinking questionnaires at baseline, 3, 6 and 12 months, while the delayed assessment group completed questionnaires only at 12 months. Primary outcomes included overall volume of drinking, risky drinking and use of risk reduction behaviors. We found a significant effect of assessment on measures of risky drinking and risk reduction behaviors, but not on overall volume of drinking. Specifically, at 12 months, participants who had previously completed drinking assessments had a lower peak blood alcohol concentration (BAC) (d = -0.373), were more likely to report a low score on the Alcohol Use Disorders Identification Test (AUDIT; odds ratio = 2.55) and tended to use more strategies to moderate their alcohol consumption (d = 0.352). Risk reduction behaviors that were affected tended to be those that limited alcohol consumption, rather than those that minimized consequences. These results may have implications for the development of brief interventions.