Examining alcohol-induced blackouts in young adults using alcohol sensors

Project Summary Young adult drinking is a major public health problem. Approximately 1 in 3 report frequent heavy episodic drinking (4+/5+ drinks in two hours for females/males). Over 12.5% report consuming two to three times these amounts (high intensity drinking). Young adults engaging in either of these “risky” drinking behaviors are at

high risk of experiencing alcohol consequences (e.g., alcohol-induced blackouts (AIBs), injury, sexual assault). Although brief interventions have shown efficacy in reducing drinking, the findings have been mixed for consequences. Concerns have been raised that the field has a limited understanding of the process by which

“accelerant-like” consequences (i.e., AIBs) are associated with additional and more harmful consequences and the validity of self-reports of drinking on heavy drinking occasions. The overall goal of the proposed research is to greatly extend the field by using objective transdermal alcohol concentration (TAC) biosensors

to increase our understanding of why AIBs occur (en bloc and fragmentary) and their relationships with other harmful consequences. Our pilot data showed risky drinking young adults experience AIBs on 1 out of every 3 drinking days. We also conducted a secondary analysis of ~800 student drinkers over 18 weekend evenings

which showed that on nights when AIBs occurred, students experienced ~3.5 more consequences than on non-AIB nights. Closer observation revealed at least one of these additional consequences would be considered severe (e.g., injury, sexual, legal). Evidence from our team and others indicate that at equivalent

levels of drinking, combining alcohol and cannabis, playing drinking games, pregaming, and rapid escalation in blood alcohol concentration predict greater AIB risk. These findings suggest that the manner in which individuals consume alcohol, in addition to the number of drinks, is important for the prediction of AIBs. To

focus on examining the manner in which individuals drink, our team has used objective transdermal alcohol concentration (TAC) biosensors. TAC assesses alcohol use in near real time and records the manner in which alcohol is being consumed through continuous measurement. Our research shows users have positive

experiences wearing TAC. Our data also provide evidence that TAC features predict consequences adjusting for self-reported drink counts.Toward this end, the aims are as follows: Aim 1 will examine the associations between TAC drinking features, AIBs, and other consequences; Aim 2 will conduct a theory-driven

examination of social and psychological influences, and biological risk related to TAC features, AIBs, and other consequences. The scientific premise of our research is fully supported by the literature to be the first to establish: 1) whether and to what extent TAC features can predict AIBs and other consequences; and 2) social

and psychological influences, and biological risk related to TAC features, AIBs, and other consequences. Our approach is highly rigorous, capturing day-, burst-, and person-level prediction of AIBs and consequences.