High‐risk social drinkers and heavy drinkers display similar rates of alcohol consumption

Alcohol consumption is often assessed over weeks to months, but few attempts have been made to characterize alcohol consumption rates at the level of an individual drinking session. Here, we aimed to compare the rate of alcohol consumption in social drinkers at high risk for alcohol use disorder (AUD) and heavy drinkers. One hundred and sixty social drinkers and 48 heavy drinkers participated in an alcohol self‐administration study. Social drinkers were classified as low risk or high risk for AUD based on sex, impulsivity, and family history of alcoholism. Participants received a priming dose of intravenous alcohol to assess alcohol‐induced craving and completed a 125‐minute intravenous alcohol self‐administration session to assess rate of achieving a binge‐level exposure (blood alcohol concentration greater than or equal to 80 mg%). There were no differences between rates of binging in high‐risk and heavy drinkers (hazard ratio = 0.87; 95% CI, 0.48‐1.56). Heavy drinkers reported higher levels of craving than high‐risk and low‐risk drinkers at baseline. However, following a priming dose of alcohol, there were no longer differences in craving between high‐risk and heavy drinkers. These results indicate that high‐risk social drinkers demonstrate binging behavior that is similar to heavy drinkers, which may be driven by alcohol‐induced craving. Prospective studies are needed to elucidate whether these patterns of craving and consumption in high‐risk social drinkers are predictive of future AUD. Using an intravenous alcohol self‐administration paradigm, we compared rates of achieving a binge level of intoxication between heavy drinkers and social drinkers at high and low risk for alcohol use disorder. We found that high‐risk social drinkers and heavy drinkers had similar rates of alcohol consumption. Additionally, unlike low‐risk social drinkers, high‐risk social drinkers had increased craving following alcohol exposure, which may help explain their elevated levels of consumption.