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Colin MacKenzie M.D.
December 5, 2020

BINGE DRINKING AND THE VULNERABILITY FOR ALCOHOL USE DISORDER

 

Introduction

Alcohol use disorder (AUD) is a chronic substance use disorder characterized by the difficulty to control problematic drinking despite social, occupational, and health hazards. It is a relapsing disorder associated with significant morbidity and mortality. Targeting the risk factors for AUD can lead to early interventions that mitigate the later development of the disorder.

Several risk factors are associated with alcohol use disorder including a family history of alcoholism, male gender, impulsivity, absence of acute alcohol-related skin flush, pre-existing schizophrenia or bipolar disorder, and a low level of response to alcohol. 

Binge drinking is defined as the rapid consumption of alcohol in a single drinking session resulting in a blood alcohol concentration of 80mg% and may be an early indicator of alcohol use disorder. Binge drinking may correlate with an individual’s preference for higher brain alcohol exposure and predispose these individuals to an alcohol use disorder.  Identifying which risk factors are likely to predict binge drinking behavior could likewise be used to identify those at risk of alcohol use disorder. 

Design

Joshua L. Gowin and colleagues conducted a study to determine individuals at risk of developing alcohol use disorder (vulnerable individuals) by correlating binge drinking with pre-determined risk factors including positive family history, male sex, impulsivity, and level of response to alcohol. The study inducted 159 (non-alcoholic) social drinkers between 21 and 45 years old. Their pre-determined risk factors were assessed using different scales before conducting a binge drinking trial.  Study participants were then allowed to self-administer alcohol intravenously during a single session after which blood alcohol concentration was measured.

Results

A higher rate of binging occurred at a significantly higher rate for those with relatives with alcoholism, male gender, and those with greater impulsivity.  Those individuals with all three of these risk factors has the highest rates of binging during the study trial.  A family history of alcoholism conferred the greatest risk of binging than the other positive risk factors. 

Conclusion

The results suggest a neurobiological predilection for higher alcohol exposures which may contribute to a higher risk of later onset of alcohol use disorder.  This is consistent with other studies demonstrating the significance of genetic risk factors for alcohol use disorder. Knowing the risk factors for binging allows for the implementation of early interventions that target these risk factors which can also reduce the risk of alcohol use disorder.  

Gowin JL, Sloan ME, Stangl BL, Vatsalya V, Ramchandani VA. Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption. Am J Psychiatry. 2017 Nov 1;174(11):1094-1101. doi: 10.1176/appi.ajp.2017.16101180. Epub 2017 Aug 4. PMID: 28774194; PMCID: PMC5667663.