Context Excessive consumption of alcohol is a major problem in the United States and abroad. Despite many years of study, it is unclear why some individuals drink alcohol excessively while others do not. It has been postulated that either lower or greater acute responses to alcohol, or both, depending on the limb of the breath alcohol concentration curve, contribute to propensity for alcohol misuse. Objective To prospectively assess the relationship of acute alcohol responses to future binge drinking. Design Within-subject, double-blind, placebo-controlled, multidose laboratory alcohol challenge study with intensive follow-up. Each participant completed 3 randomized sessions examining responses to a high (0.8 g/kg) and low (0.4 g/kg) alcohol dose and placebo, followed by quarterly assessments for 2 years examining drinking behaviors and alcohol diagnoses. Setting Participants recruited from the community. Participants High-risk heavy social drinkers aged 21 to 35 years who habitually engage in weekly binge drinking (n=104) and light drinker controls (n=86). Intervention We conducted 570 laboratory sessions with a subsequent 99.1% follow-up (1506 of 1520). Main Outcome Measures Biphasic Alcohol Effects Scale, Drug Effects Questionnaire, cortisol response, Time-line Follow-Back, Drinker Inventory of Consequences–Recent, and DSM-IV alcohol abuse and dependence. Results Alcohol produced greater stimulant and rewarding (liking and wanting) responses and lower sedative and cortisol responses in heavy vs light drinkers. Among the heavy drinkers, greater positive effects and lower sedative effects after alcohol consumption predicted increased binge drinking frequency during follow-up. In turn, greater frequency of binge drinking during follow-up was associated with greater likelihood of meeting diagnostic criteria for alcohol abuse and dependence. Conclusions The widely held low level response theory and differentiator model should be revised: in high-risk drinkers, stimulant and rewarding alcohol responses even at peak breath alcohol concentrations are important predictors of future alcohol problems. Trial Registration clinicaltrials.gov Identifier: NCT00961792

Quaternary ammonium compounds (QACs) are active ingredients in over 200 disinfectants currently recommended by the U.S. EPA for use to inactivate the SARS-CoV-2 (COVID-19) virus. The amounts of these compounds used in household, workplace, and industry settings has very likely increased, and usage will continue to be elevated given the scope of the pandemic. QACs have been previously detected in wastewater, surface waters, and sediments, and effects on antibiotic resistance have been explored. Thus, it is important to assess potential environmental and engineering impacts of elevated QAC usage, which may include disruption of wastewater treatment unit operations, proliferation of antibiotic resistance, formation of nitrosamine disinfection byproducts, and impacts on biota in surface waters. The threat caused by COVID-19 is clear, and a reasonable response is elevated use of QACs to mitigate spread of infection. Exploration of potential effects, environmental fate, and technologies to minimize environmental releases of QACs, however, is warranted.

Background Propensity for alcohol misuse may be linked to an individuals’ response to alcohol. This study examined the role of alcohol response phenotypes to future drinking problems. Methods One hundred four young heavy social drinkers participated in a within-subject, double-blind, placebo-controlled laboratory alcohol challenge study with 6-year follow-up. Participants were examined for subjective responses before and after receiving an intoxicating dose of alcohol (.8 g/kg) or a placebo beverage, given in random order. Follow-up was conducted in 5 waves over 6 years after the sessions to assess drinking behaviors and alcohol use disorder (AUD) symptoms. Retention was high with 98% (509 of 520) of possible follow-ups completed. Results Greater sensitivity to alcohol, in terms of stimulation and rewarding effects (like, want more) and lower sensitivity to alcohol sedation predicted greater number of AUD symptoms through 6 years of follow-up. Cluster analyses revealed that for half the sample, increasing levels of stimulation and liking were predictors of more AUD symptoms with the other half divided between those showing like and want more and want more alone as significant predictors. Conclusions The findings extend previous findings and offer new empirical insights into the propensity for excessive drinking and alcohol problems. Heightened alcohol stimulation and reward sensitivity robustly predicted more alcohol use disorder symptoms over time associated with greater binge-drinking frequency. These drinking problems were maintained and progressed as these participants were entering their third decade of life, a developmental interval when continued alcohol misuse becomes more deviant.

No abstract