Relationship between level of response to alcohol and acute tolerance

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 18‐ to 25‐year‐old, sex‐matched pairs of low and high LR drinkers who at baseline did not meet criteria for an alcohol use disorder. Each subject participated in an oral alcohol challenge in which they consumed about 0.7 ml 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 concentration (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 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 across measures such that acute tolerance 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. Among children diagnosed with FASD at seven years of age, 18.4% were born preterm, 51.4% were small‐for‐gestational‐age (SGA), and 5.9% were both preterm and SGA, compared to 12%, 28%, and 0.5% for non‐FASD controls. After controlling for the usual number of drinks per drinking day in 1st trimester, the number of trimesters drank, maternal education, tobacco use, and maternal age, the odds ratio of an FASD diagnosis by age seven was significantly associated with SGA (OR = 2.16, 95% CI:1.35–3.45).