A Prospective 5-Year Re-examination of Alcohol Response in Heavy Drinkers Progressing in Alcohol Use Disorder

Abstract

Background The main neurobiological theories of the development of addiction, including tolerance, sensitization, incentive-sensitization, and allostasis have not been tested in longitudinal human alcohol response research. To address this issue, we conducted the first controlled prospective investigation of subjective and neuroendocrine responses to alcohol measured over a five year interval in at-risk young adult heavy drinkers and light drinker controls. Methods Participants were 156 individuals, 86 heavy drinkers (HD) and 70 light drinkers (LD), undergoing an initial oral alcohol challenge testing (0.8 g/kg alcohol vs. placebo) and an identical re-examination testing 5–6 years later. Alcohol use disorder (AUD) symptoms and drinking behaviors were assessed in the interim follow-up period. Results At reexamination, HD continued to exhibit higher sensitivity on alcohol’s stimulating and rewarding effects with lower sensitivity to sedative effects and cortisol reactivity, relative to LD. In HD with high AUD symptom trajectories over follow-up, heightened alcohol stimulation and reward persisted at reexamination. HD with low AUD symptoms showed reduced alcohol stimulation over time and lower reward throughout compared with the HD with high and intermediate AUD symptoms. Conclusions Results support the early stage phase of the allostasis model, with persistently heightened reward sensitivity and stimulation in heavy drinkers exhibiting AUD progression in early mid-adulthood. While there are multiple pathways to development of a disorder as complex as AUD, maintenance of alcohol stimulatory and rewarding effects may play an important role in the continuation and progression of alcohol addiction.

CBI-20: Psychometric Properties for the Coping Behaviors Inventory for Alcohol Abuse in Brazil

“…This is a critical moment because one should bear in mind that it is rather a complex process which is directly related to the coping styles and strategies employed in the past (12). In this way, it was suggested that patients who persevere in their behavior might have a higher sensitivity to the stimulating effects of alcohol, and this might be also related to a lower cortisol and sensitivity (13–15). Furthermore, and since coping styles are well-recognized to quit alcohol, studies have examined whether these styles may predict how patients respond to treatment.…”

Effect of Alcohol on Encoding and Consolidation of Memory for Alcohol-Related Images

“…Individuals differ markedly in subjective and rewarding response to alcohol: some are more sensitive to the positive, rewarding effects of alcohol, experiencing euphoria, arousal and increased talkativeness, whereas others are more sensitive to the negative effects and report feeling down, sluggish, and tired (Holdstock and de Wit, 1998; Newlin and Thomson, 1990; Quinn and Fromme, 2011). Greater sensitivity to alcohol-induced stimulation is associated with greater alcohol consumption, and longitudinal evidence suggests that ‘stimulant responders’ are at greater risk for developing alcohol use disorder symptoms (King et al, 2011; King et al, 2014; King et al, 2016; Newlin and Thomson, 1990; Quinn and Fromme, 2011). Given that stimulant responders are more sensitive to the positive rewarding effects of alcohol, we propose that they may also be more likely to form memory associations between contextual stimuli and the rewarding effects of the drug.…”

Impulsivity Moderates Subjective Responses to Alcohol in Alcohol-Dependent Individuals

“…Recent studies involving the differentiator model have focused primarily on drinking history and SR domain with less emphasis on limb of intoxication. King et al (2016) reported that, among heavy social drinkers, individuals who experienced high stimulation and low sedation at peak breath alcohol concentration (BrAC) reported more binge drinking and AUD symptoms at both 2-and 6-year follow-ups and that these response patterns were fairly stable.…”

“…Drobes et al (2004) found that participants with AD experienced greater subjective stimulation than social drinkers in the hour following consumption of a gender-adjusted dose of alcohol (0.40 g/kg for males and 0.34 g/kg for females). King et al (2016) examined SR in participants with low (M = 0.9, SD = 0.2), intermediate (M = 3.2, SD = 0.2) and high (M = 6.4, SD = 0.6) AUD symptoms at baseline and at 5-6 years follow-up. Individuals with moderate and high AUD symptoms experienced greater subjective stimulation, wanting and liking during a follow-up session, as compared to the low AUD group.…”