Relationship between level of response to alcohol and acute tolerance

Abstract

Background: A low level of response (low LR) to alcohol correlates with the later development of alcohol-related problems. Although some of the underpinnings of LR are understood, little is known about the potential relationship between LR and acute tolerance. The current analyses tested the hypothesis that a low LR will be explained in part by more intense acute tolerance to alcohol during a drinking session.Methods: Data were generated through a reanalysis of data from 120 individuals who were 18to 25-year-old, sex-matched pairs of low and high LR drinkers who at baseline did not yet meet criteria for an alcohol use disorder. Each subject participated in an oral alcohol challenge after consuming about 0.7ml ethanol per kg and acute tolerance was measured as the differences in alcohol's effects at similar breath alcohol levels (BrACs) during the rising and falling breath alcohol (BrAC) curve. Measures included aspects of the Subjective High Assessment Scale (SHAS) and body sway.Results: Contrary to our hypothesis, but similar to results with other alcohol measures, acute tolerance was actually significantly attenuated in low LR compared with high LR individuals on most SHAS scores. Neither LR group demonstrated acute tolerance to alcohol for sleepiness or body sway. Men and women did not differ on any of these measures. Conclusion:These data do not support a role of acute tolerance in the low LR to alcohol as measured by subjective feelings of intoxication or body sway in these subjects, findings that were similar across males and females. In addition, consistent with the literature, the analyses demonstrated differences in acute tolerance across measures such that this phenomenon was observed for most measures of subjective effects but not for body sway. Among the subjective effects, acute tolerance was observed for alcohol's intoxicating effect but not for feeling sleepy.

Do personality characteristics predict future alcohol problems after considering current demography, substance use, and alcohol response?

“…Low Levels of Response also added significantly to Step 4 in every hierarchical regression analysis in Tables 3 and 4 and Table S1. Consistent with the literature (e.g., Schuckit, 2018Schuckit, , 2022Schuckit et al, 2008Schuckit et al, , 2021, the relationship between Time 1 low response to future alcohol problems was observed even after controlling for Time 1 demography, usual drinking quantities and frequencies, alcohol problems, AUD family histories, personality traits, and cannabis use.…”

“…This retrospective questionnaire asks the number of standard drinks required to actually experience up to four effects: feeling any effect, slurring speech, feeling unsteady when standing or walking, and unintentionally falling asleep. The average number of drinks needed for those effects during the approximate first five times of drinking produced the SRE-5 score that is likely to be most analytically useful for relatively young drinkers, and the average drinks needed for effects during the period of heaviest drinking (SRE-H) is thought to reflect both initial sensitivity and the development of tolerance (Anthenelli et al, 2021;Schuckit, 2018Schuckit, , 2022Schuckit et al, 2021). The SRE has retest and predictive reliabilities regarding alcohol-related problems of 0.7 or higher (Kalu et al, 2012;Ray et al, 2011;Schuckit, 2022;Schuckit et al, 1997) and current Cronbach alphas for SRE-5 and SRE-H were 0.84 and 0.75, respectively.…”

“…The SRE has retest and predictive reliabilities regarding alcohol-related problems of 0.7 or higher (Kalu et al, 2012;Ray et al, 2011;Schuckit, 2022;Schuckit et al, 1997) and current Cronbach alphas for SRE-5 and SRE-H were 0.84 and 0.75, respectively. Documentation of significant positive correlations between higher numbers of drinks needed for effects (i.e., a lower LR per drink) and future heavier alcohol intake and alcohol problems have come from the San Diego Prospective Study, COGA, the U.K.-based Avon Longitudinal Study of Parents and Children (ALSPAC), and other investigations (e.g., Chung & Martin, 2009;Schuckit et al, 2008Schuckit et al, , 2019Schuckit et al, , 2021. Measures of alcohol responses determined by the SRE or from earlier protocols using alcohol challenges overlap about 60% in predicting future drinking quantities and problems (Schuckit et al, 2009).…”

“…One such characteristic involves higher stimulation that is most prominent at rising blood alcohol concentrations (BACs; King et al, 2021;Newlin & Renton, 2010), and another relates to the magnitude of variations in resting heart rate (Cheng et al, 2019). Our research team has had extensive experience with a third type of alcohol response, the low Level of Response (low LR) to alcohol typically observed at peak and falling BACs McKenna et al, 2022;Schuckit, 2018Schuckit, , 2022Schuckit et al, 2008Schuckit et al, , 2021. A low LR involves the need for higher numbers of drinks and higher BACs to produce alcohol-related changes in feelings of intoxication, standing steadiness, and/or alterations in physiologic effects of alcohol, including those seen in electroencephalographic, event-related potentials/oscillations, brain connectivity, hormonal, and/or functional magnetic imaging measures (McKenna et al, 2022;Schuckit, 2022).…”

“…However, because such alcohol challenges are expensive and timeconsuming, our research group developed the Self-Report of the Effects of alcohol (SRE) questionnaire, where participants indicate the number of drinks required for up to four effects across three timeframes. A higher average number of drinks needed for effects on the SRE (i.e., a higher SRE score) is a corollary of lower response at a given BAC in alcohol challenges, and each of these characteristics relates to a higher risk for future heavier drinking and alcohol problems (Chung & Martin, 2009;Ehlers et al, 1999;Luczak et al, 2002;Pedersen & McCarthy, 2013;Schuckit et al, 2008Schuckit et al, , 2021.…”