From the, Department of Psychiatry and Behavioral Neuroscience, (AV, MH, DF, ACK), University of Chicago, Chicago, Illinois.
Department of Ophthalmology and Visual Sciences, (DC), University of Illinois at Chicago, Chicago, Illinois.
Alcohol Clin Exp Res. 2020 Dec;44(12):2588-2597. doi: 10.1111/acer.14478. Epub 2020 Nov 2.
There remains a paucity of research quantifying alcohol's effects in drinkers with alcohol use disorder (AUD), particularly responses to very high alcohol doses (≥0.8 g/kg). As drinkers with AUD frequently engage in very heavy drinking (8 to 10 drinks/occasion), doses of ≤0.8 g/kg may lack ecological validity. The present study examined the feasibility, tolerability, and safety of administering a very high alcohol dose (1.2 g/kg) to non-treatment-seeking AUD participants.
Sixty-one young adult AUD drinkers enrolled in the Chicago Social Drinking Project and completed 3 laboratory sessions at which they consumed a beverage with 1.2, 0.8, and 0.0 g/kg alcohol. Physiological responses (vital signs, nausea and vomiting, breath alcohol concentrations [BrAC]) were monitored throughout the sessions. After each session, participants completed a next-day survey of substance use, engagement in risky behaviors, and related consequences.
Overall, the sample demonstrated good compliance with study procedures; 93% of participants adhered to presession alcohol abstinence requirements (indicated by BrAC < 0.003 g/dl), with no participants exhibiting serious alcohol withdrawal symptoms at arrival to study visits. The 1.2 g/kg alcohol dose achieved an expected mean peak BrAC of 0.13 g/dl at 60 minutes after drinking, which was well tolerated; the majority of the sample did not experience nausea (70%) or vomiting (93%), and dose effects on vital signs were not clinically significant. Finally, we demonstrated that the 1.2 g/kg alcohol dose is safe and not associated with postsession consequences, including reduced sleep time, atypical substance use, accidents or injuries, and severe hangovers.
Results support the feasibility, tolerability, and safety of administering a very high alcohol dose to young adult drinkers with AUD within the context of a well-validated laboratory alcohol challenge paradigm. Utilizing an alcohol dose more consistent with naturalistic drinking patterns may foster greater ecological validity of laboratory paradigms for persons with moderate to severe AUD.
目前，关于酗酒者（AUD）对酒精影响的研究还很少，特别是对非常高的酒精剂量（≥0.8 g/kg）的反应。由于 AUD 患者经常大量饮酒（8 至 10 杯/次），≤0.8 g/kg 的剂量可能缺乏生态有效性。本研究旨在检验向非治疗性 AUD 参与者给予非常高剂量酒精（1.2 g/kg）的可行性、耐受性和安全性。
61 名年轻的 AUD 饮酒者参加了芝加哥社交饮酒计划，并完成了 3 次实验室饮酒实验，他们在实验中分别摄入了含有 1.2、0.8 和 0.0 g/kg 酒精的饮料。在整个实验过程中监测了生理反应（生命体征、恶心和呕吐、呼气酒精浓度 [BrAC]）。每次实验后，参与者完成了关于次日物质使用、危险行为和相关后果的调查。
总体而言，该样本对研究程序的依从性良好；93%的参与者遵守了会前酒精禁欲要求（以 BrAC < 0.003 g/dl 表示），没有参与者在研究访问时出现严重的酒精戒断症状。1.2 g/kg 酒精剂量在饮酒后 60 分钟达到预期的平均峰值 BrAC 0.13 g/dl，耐受性良好；大多数样本没有出现恶心（70%）或呕吐（93%），生命体征的剂量效应没有临床意义。最后，我们证明 1.2 g/kg 酒精剂量是安全的，与实验后的后果无关，包括睡眠时间减少、非典型物质使用、事故或伤害以及严重宿醉。
结果支持在经过充分验证的实验室酒精挑战范式中，向 AUD 年轻成年饮酒者给予非常高剂量酒精的可行性、耐受性和安全性。使用与自然饮酒模式更一致的酒精剂量可能会增强实验室范式对中度至重度 AUD 患者的生态有效性。
