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January 08, 2021
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Initial stimulant, rewarding effects predict heavy alcohol use

Alcohol’s initial stimulant and rewarding effects served as predictors of heavy alcohol use, according to study results published in American Journal of Psychiatry.

“One way to examine vulnerability to [alcohol use disorder] is to characterize acute subjective responses to alcohol at different stages of development of the disorder,” Andrea King, PhD, of the department of psychiatry and behavioral neuroscience at the University of Chicago, and colleagues wrote. “Two large studies have found that greater initial stimulation and reward responses to alcohol, as well as lesser intoxicating and sedating responses, predict future drinking problems through young adulthood. These acute responses may change with chronic heavy drinking as a result of neuroadaptations that produce either tolerance or sensitization.”

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According to the researchers, longitudinal data are necessary to elucidate the role of acute subjective alcohol responses in developing and maintaining excessive drinking and alcohol use disorder. In the current study, they reported on 10 years of repeated examination of acute alcohol response in the Chicago Social Drinking Project, a multicohort, double-blind study. They analyzed data of 190 young adults who participated in an initial alcohol challenge of 0.8 g/kg of alcohol vs. placebo, repeated 5 and 10 years later. Further, they assessed drinking behavior and alcohol use disorder symptoms at multiple intervals during the decade. A total of 185 (99%) non-deceased active participants completed follow-up at 10 years, and 163 (91%) of those who were eligible for alcohol consumption participated in repeated laboratory testing during this interval.

Results showed 21% of participants met past-year alcohol use disorder criteria at decade’s end. Those who reported the greatest alcohol stimulation, liking and wanting at the initial alcohol challenge, had the highest risk for developing alcohol use disorder 10 years later. Among participants with the highest alcohol use disorder symptoms over the decade’s progression, alcohol-induced stimulation and wanting increased in reexamination testing.

“In terms of prevention of alcohol problems, rather than a sole focus on tolerance, young adults might be informed that marked stimulant-like, pleasurable and appetitive effects after consuming alcohol are risk factors for the development and maintenance of addiction,” King and colleagues wrote. “Pharmacological and behavioral interventions focused on reducing positive rewarding effects and motivational salience during acute alcohol consumption may be crucial in future medication development and treatment of [alcohol use disorder].”