Individual differences in the priming effect of ethanol in social drinkers

Responses to a "Typical" Morning Dose of Kratom in People Who Use Kratom Regularly: A Direct-Observation Study

INTRODUCTION

Use of kratom has outpaced systematic study of its effects, with most studies reliant on retrospective self-report.

METHODS

We aimed to assess acute effects following kratom use in adults who use regularly, and quantify alkaloids in the products, urine, and plasma. Between July and November 2022, 10 adults came to our clinic and orally self-administered their typical kratom dose; blinding procedures were not used. Physiological measures included blood pressure, respiratory rate, heart rate, pulse oximetry, temperature, and pupil diameter. Subjective outcomes included Subjective Opioid Withdrawal Scale, Addiction Research Center Inventory, and Drug Effects Questionnaire. Psychomotor performance was also assessed.

RESULTS

Participants were 6 men and 4 women, mean age 41.2 years. Nine were non-Hispanic White; 1 was biracial. They had used kratom for 6.6 years (SD, 3.8 years) on average (2.0-14.1). Sessions were 190.89 minutes on average (SD, 15.10 minutes). Mean session dose was 5.16 g (median, 4.38 g; range, 1.1-10.9 g) leaf powder. Relative to baseline, physiological changes were minor. However, pupil diameter decreased (right, b = -0.70, P < 0.01; left, b = -0.73, P < 0.01) 40-80 minutes postdose and remained below baseline >160 minutes. Subjective Opioid Withdrawal Scale pre-dosing was mild (5.5 ± 3.3) and decreased postdose (b = [-4.0, -2.9], P < 0.01). Drug Effects Questionnaire "feeling effects" increased to 40/100 (SD, 30.5) within 40 minutes and remained above baseline 80 to 120 minutes (b = 19.0, P = 0.04), peaking at 72.7/100; 6 participants rated euphoria as mild on the Addiction Research Center Inventory Morphine-Benzedrine-scale. Psychomotor performance did not reliably improve or deteriorate postdosing.

CONCLUSIONS

Among regular consumers, we found few clinically significant differences pre- and post-kratom dosing. Alkaloidal contents in products were within expected ranges.

The impact of alcohol priming on craving and motivation to drink: a meta-analysis

BACKGROUND AND AIMS

An initial dose of alcohol can motivate-or prime-further drinking and may precipitate (re)lapse and bingeing. Lab-based studies have investigated the alcohol priming effect; however, heterogeneity in designs has resulted in some inconsistent findings. The aims of this meta-analysis were to (i) determine the pooled effect size for motivation to drink following priming, measured by alcohol consumption and craving, and (ii) examine whether design characteristics influenced any priming effect.

METHODS

Literature searches of PsycINFO, PubMed and Scopus in October 2020 (updated October 2021) identified lab-based alcohol priming studies that assessed effect of priming on motivation to drink. A tailored risk-of-bias tool assessed quality of lab-based studies. Random effects meta-analyses were computed on outcome data from 38 studies comparing the effect of a priming dose of alcohol against control on subsequent alcohol consumption/self-reported craving. Study characteristics that might have affected outcomes were design type (within/between-participant), dose of prime, time of motivation assessment, type of control drink (placebo alcohol/soft drink).

RESULTS

Relative to control, alcohol had a small-to-moderate priming effect on subsequent alcohol consumption (standardised mean difference [SMD] = 0.336 [95% CI, 0.171, 0.500]) and craving (SMD = 0.431 [95% CI, 0.306, 0.555]). Aspects of study design differentially affected consumption and craving. The size of the priming dose had no effect on consumption, but larger doses were sometimes associated with greater craving (with craving generally following the blood alcohol curve). Alcohol priming effects for consumption, but not craving, were smaller when compared with placebo, relative to soft drink, control.

CONCLUSIONS

Lab-based alcohol priming studies are a valid paradigm from which to investigate the impact of acute intoxication on alcohol motivation. Designs are needed that assess the impact of acute consumption on motivation to drink in more varied and realistic ways.

Topiramate decreases the salience of motivationally relevant visual cues among smokers with alcohol use disorder

BACKGROUND

There is preliminary evidence that the anticonvulsant topiramate increases the likelihood of both smoking and alcohol abstinence among smokers with alcohol use disorder (AUD), but its therapeutic mechanism has not been determined. We used event-related potentials (ERPs) to evaluate topiramate's effect on the salience of drug-related, emotional, and neutral pictorial cues to identify whether one of its potential therapeutic mechanisms involves reduction of the salience of motivationally relevant cues.

METHODS

Participants enrolled in a multisite clinical trial treating smokers with AUD were randomly assigned to receive placebo, low-dose topiramate (up to 125 mg/day), or high-dose topiramate (up to 250 mg/day), along with brief behavioral compliance enhancement treatment. A subsample (n = 101) completed ERP assessments at baseline (1 week pre-medication) and week 5 (5 weeks on medication; 1 week pre-quit). We assessed the salience of pleasant, unpleasant, cigarette-related, alcohol-related, and neutral pictorial cues using the late positive potential (LPP) ERP component and measured self-reported substance use, reinforcement, craving, and withdrawal.

RESULTS

Five weeks of high-dose topiramate treatment decreased LPP amplitudes in response to both emotional (pleasant and unpleasant) and drug-related cues (alcohol and cigarette), but not to neutral cues. However, results showed that the LPPs were not significant mediators of the relationship between topiramate dose and post-quit measures of substance use, reinforcement, craving, or withdrawal.

CONCLUSIONS

These findings suggest that high-dose topiramate (up to 250 mg/day) decreases the motivational salience of both drug-related and emotional cues among smokers with AUD. However, the nonsignificant mediation analyses preclude any firm conclusions about whether this effect represents one of topiramate's therapeutic mechanisms of action.

Striatal activation to monetary reward is associated with alcohol reward sensitivity

One well-known phenotypic risk factor for the development of alcohol use disorder is sensitivity to the rewarding effects of alcohol. In the present study, we examined whether individuals who are sensitive to alcohol reward are also sensitive to nondrug rewards, thereby reflecting a broader individual difference risk factor. Specifically, we tested the hypothesis that subjective response to acute rewarding effects of alcohol would be related to neural activation during monetary reward receipt relative to loss (in the absence of alcohol). Community-recruited healthy young social drinkers (N = 58) completed four laboratory sessions in which they received alcohol (0.8 g/kg) and placebo in alternating order under double-blind conditions, providing self-report measures of subjective response to alcohol at regular intervals. At a separate visit 1-3 weeks later, they completed a reward-guessing game, the 'Doors' task, during fMRI in a drug-free state. Participants who reported greater motivation (i.e., wanting) to consume more alcohol after a single moderate dose of alcohol also exhibited greater neural activation in the bilateral ventral caudate and the nucleus accumbens during reward receipt relative to loss. Striatal activation was not related to other subjective ratings including alcohol-induced sedation, stimulation, or pleasure (i.e., feeling, liking). Our study is the first to show that measures of alcohol reward are related to neural indices of monetary reward in humans. These results support growing evidence that individual differences in responses to drug and nondrug reward are linked and together form a risk profile for drug use or abuse, particularly in young adults.

The priming effect of food persists following blockade of dopamine receptors

The priming effect of rewards is a boost in the vigor of reward seeking resulting from the previous receipt of a reward. Extensive work has been carried out on the priming effect of electrical brain stimulation, but much less research exists on the priming effect of natural rewards, such as food. While both reinforcement and motivation are linked with dopamine transmission in the brain, the priming effect of rewards does not appear to be dopamine-dependent. In the present study, an operant method was developed to measure the priming effect of food and then applied to investigate whether it is affected by dopamine receptor antagonism. Long-Evans rats were administered saline or one of the three doses (0.01, 0.05, 0.075 mg/kg) of the dopamine D1 receptor family antagonist, SCH23390, or the dopamine D2 receptor family antagonist, eticlopride. Although dopamine receptor antagonism affected pursuit of food, it did not eliminate the priming effect. These data suggest that despite the involvement of dopamine transmission in reinforcement and motivation, the priming effect of food does not depend on dopamine transmission.

Modeling Relapse to Pavlovian Alcohol-Seeking in Rats Using Reinstatement and Spontaneous Recovery Paradigms

BACKGROUND

Animal models are critical for studying causal explanations of relapse. Using a Pavlovian conditioning procedure with alcohol, we examined relapse after extinction triggered by either re-exposure to alcohol (reinstatement) or a delay between extinction and test (spontaneous recovery).

METHODS

Male, Long-Evans rats were acclimated to 15% alcohol in the home-cage using an intermittent-access 2-bottle choice procedure. Next, they received Pavlovian conditioning sessions in which an auditory-conditioned stimulus (CS; 20 second white noise; 8 trials/session; variable time 240 seconds) was paired with 15% alcohol (0.3 ml/CS; 2.4 ml/session) that was delivered into a fluid port for oral ingestion. In subsequent extinction and test sessions, CS presentations occurred as before, but without alcohol.

RESULTS

In experiment 1, exposure to either alcohol or water in the fluid port following extinction reinstated CS-elicited port entries at test 24 hours later. In a follow-up study using the same procedure (experiment 2), reinstatement was more robustly stimulated by alcohol, compared to a familiar lemon-flavored liquid. In experiment 3, systemic alcohol injections (0, 0.5, or 1.0 g/kg, intraperitoneal) administered either 24 hours or 15 minutes before test did not reinstate CS-elicited alcohol-seeking. Importantly, enzymatic assays in experiment 4 revealed detectable levels of alcohol in the blood following oral alcohol intake or intraperitoneal injection, suggesting that a pharmacological effect was likely with either route of administration. Last, in experiment 5, a 23-day delay between extinction and test resulted in a robust spontaneous recovery of CS-elicited alcohol-seeking.

CONCLUSIONS

The reinstatement and spontaneous recovery effects revealed herein provide evidence of viable new behavioral paradigms for testing interventions against relapse.

Silencing the insular-striatal circuit decreases alcohol self-administration and increases sensitivity to alcohol

Internal drug states/cues can impact drug taking, as pretreatment with a moderate to high alcohol dose (i.e., loading dose) can decrease subsequent alcohol self-administration, alcohol-seeking, and relapse-like drinking. The insular cortex (IC) is implicated in processing information about internal states and findings show that silencing the IC and its projections to the nucleus accumbens core (AcbC) enhance sensitivity to the interoceptive effects of alcohol. Therefore, the goal of the present work was to determine the functional role of IC-AcbC projections in modulating the effects of alcohol pretreatment on operant alcohol self-administration. Long-Evans rats were trained to self-administer a sweetened alcohol solution (15% alcohol (v/v) + 2% sucrose (w/v)) and on test sessions received pretreatment with an alcohol loading dose. A chemogenetic strategy (i.e., hM4D Designer Receptors Exclusively Activated by Designer Drugs [DREADDs]) was implemented to silence the IC-AcbC projections and test the functional role of the insular-striatal circuitry in regulating self-administration following the alcohol loading doses. Alcohol self-administration decreased following pre-session treatment with alcohol, confirming titration of alcohol drinking following a loading dose of alcohol. Chemogenetic silencing of IC-AcbC projections decreased alcohol self-administration under baseline conditions (i.e., water loading dose) and the reduction in self-administration of an alcohol loading dose, implicating a role for this circuit in the maintenance of alcohol self-administration and suggesting increased sensitivity to the alcohol loading dose. These findings provide evidence for the critical nature of insular-striatal circuitry in ongoing alcohol self-administration, and specifically in relation to interoceptive/internal cues that can impact alcohol drinking.

Inactivation of the Prelimbic Cortex Impairs the Context-Induced Reinstatement of Ethanol Seeking

Evidence indicates that drug relapse in humans is often provoked by exposure to the self-administered drug-associated context. An animal model called "ABA renewal procedure" has been used to study the context-induced relapse to drug seeking. Here, we reported a new and feasible training procedure for the ABA renewal method to explore the role of the prelimbic cortex in context-induced relapse to ethanol seeking. By using a saccharin fading technique, we trained rats to self-administer ethanol (10%). The drug delivery was paired with a discrete tone-light cue. Lever pressing was subsequently extinguished in a non-drug-associated context in the presence of the discrete cue. Rats were subsequently tested for reinstatement in contexts A or B, under extinction conditions. Ethanol-associated context induced the reinstatement of ethanol seeking and increased the expression of Fos in the prelimbic cortex. The rate of neural activation in the prelimbic cortex was 3.4% in the extinction context B and 7.7% in the drug-associated context A, as evidenced by double-labeling of Fos and the neuron-specific protein NeuN. The reversible inactivation of the neural activity in the prelimbic cortex with gamma-Aminobutyric acid (GABA) receptor agonists (muscimol + baclofen) attenuated the context-induced reinstatement of ethanol self-administration. These results demonstrated that the neuronal activation of the prelimbic cortex is involved in the context-induced reinstatement of ethanol seeking.

The role of varenicline on alcohol-primed self-administration and seeking behavior in rats

RATIONALE

Varenicline, a smoking-cessation agent, may be useful in treating alcohol use disorders. An important consideration when studying factors that influence drinking/relapse is influence of the pharmacological effects of alcohol on these behaviors. Pre-exposure to alcohol (priming) can increase craving, drinking, and seeking behaviors.

OBJECTIVES

The primary goal of this work was to determine the effects of varenicline on alcohol-primed self-administration and seeking behavior in male Long-Evans rats.

METHODS

First, we assessed whether varenicline (0, 0.3, 1, 3 mg/kg, IP) has alcohol-like discriminative stimulus effects and whether varenicline alters sensitivity to alcohol in rats trained to discriminate a moderate alcohol dose (1 g/kg, IG) vs. water. Second, animals trained to self-administer alcohol underwent assessments to test the effects of: (i) varenicline (0, 0.3, 1, 3 mg/kg, IP) on self-administration, (ii) alcohol priming (0, 0.3, 1 g/kg, IG) on self-administration and seeking behavior, and (iii) varenicline (1 mg/kg) in combination with alcohol priming (1 g/kg) on these behaviors.

RESULTS

Varenicline did not substitute for alcohol but disrupted the expression of sensitivity to alcohol. Varenicline decreased self-administration but only at a motor-impairing dose (3 mg/kg). Alcohol priming decreased self-administration and seeking behavior. Varenicline (1 mg/kg) blocked this effect under self-administration conditions, but not seeking conditions, which effectively resulted in increased alcohol intake.

CONCLUSIONS

These findings suggest the importance of further behavioral and mechanistic studies to evaluate the use of varenicline in treating alcohol use disorders and its potential impact on drinking patterns in smokers using varenicline as a smoking-cessation aid.

Individual variation in resisting temptation: implications for addiction

When exposed to the sights, sounds, smells and/or places that have been associated with rewards, such as food or drugs, some individuals have difficulty resisting the temptation to seek out and consume them. Others have less difficulty restraining themselves. Thus, Pavlovian reward cues may motivate maladaptive patterns of behavior to a greater extent in some individuals than in others. We are just beginning to understand the factors underlying individual differences in the extent to which reward cues acquire powerful motivational properties, and therefore, the ability to act as incentive stimuli. Here we review converging evidence from studies in both human and non-human animals suggesting that a subset of individuals are more "cue reactive", in that certain reward cues are more likely to attract these individuals to them and motivate actions to get them. We suggest that those individuals for whom Pavlovian reward cues become especially powerful incentives may be more vulnerable to impulse control disorders, such as binge eating and addiction.

neuroendocrinological responses to alcohol intoxication in healthy males: relationship with impulsivity, drinking behavior, and subjective effects

Ambiguous biochemical and subjective responses to alcohol may relate to preexisting individual differences in alcohol expectations, experience, or impulsivity. This study examined cortisol and alpha-amylase responses to alcohol and their association with trait impulsivity, alcohol expectancy, and subjective reports of alcohol's effects. Eighty-seven males assigned to an alcohol, sober, or placebo group provided biochemical and self-report measures. Both cortisol and alpha-amylase increased following alcohol administration. Impulsivity correlated with cortisol changes, and the greatest rise in cortisol correlated with high stimulating effects in the alcohol group. These findings emphasize the importance of individual differences in alcohol responses and support a relationship between hormonal responses and alcohol use.

"High" motivation for alcohol: what are the practical effects of energy drinks on alcohol priming?

BACKGROUND

While several researchers have proposed a causal relationship between alcohol mixed with energy drink (AmED) consumption and subsequent alcohol intake, there is a dearth of research exploring the potential mechanisms underpinning this association.

METHODS

Marczinski and colleagues (in press) report the results of a double-blind, placebo-controlled, between-groups study assessing whether an initial AmED dose primes an increased motivation to drink relative to alcohol alone. Participants (n = 80) received either alcohol (0.91 ml/kg vodka), energy drink (ED; 1.82 ml/kg Red Bull(®) ), AmED, or a placebo beverage and then self-reported their motivation to drink via the Desire-for-Drug scale.

RESULTS

Subjective ratings of "desire more alcohol" were significantly higher than predrink in the placebo, alcohol, and AmED conditions, with this effect apparent at more time points in the AmED condition. While it was concluded that EDs may increase alcohol priming, between-condition analyses revealed that ratings did not differ significantly in AmED and alcohol conditions, with moderate magnitude treatment effects at most, and ratings of desire generally closer to 0 (absence of desire) than 100 (very much desire).

CONCLUSIONS

While the study by Marczinski and colleagues fills an important gap in the literature, direct measurement of AmED priming's effect on subsequent alcohol consumption using a within-subjects design and appropriate statistical comparison is required to (i) establish the practical implications of these results for AmED consumers and (ii) discount any individual differences in such priming effects.

Voluntary intravenous self-administration of alcohol detects an interaction between GABAergic manipulation and GABRG1 polymorphism genotype: a pilot study

BACKGROUND

Operant responding paradigms quantify a subject's motivation for reward, but such studies employing ingested alcohol cannot assure the same incremental increase in brain exposure to alcohol across subjects because of substantial variability in absorption kinetics. We developed a human progressive ratio (PR) paradigm using the computer-assisted self-infusion of ethanol (CASE) system that overcomes such variability and conducted a pilot study to assess its utility for detecting an interaction of subjects' GABRA2 or GABRG1 genotype and pretreatment with 1 mg of lorazepam (LZ) vs. placebo on their willingness to work for alcohol rewards.

METHODS

Twenty healthy, nondependent drinkers, aged 21 to 27, were balanced on rs279871 and rs2350439 single nucleotide polymorphisms in the GABRA2 and GABRG1 genes, respectively. Subjects worked for alcohol, with water as an alternative reinforcer (AR), using a progressive schedule of a task that required constant attention and adapted to both fatigue and drug effects. Testing began 1 hour after pretreatment with 1 mg LZ or placebo in a crossover design.

RESULTS

The CASE system performed well, and the constant attention task was perceived as work by all subjects. GABRA2 homozygosity did not significantly predict either breakpoint or cumulative work, whereas a significant GABRG1 genotype by LZ pretreatment interaction for cumulative work was detected (p = 0.04). Breakpoint revealed a weak trend toward pretreatment drug effects (p = 0.11), and a somewhat stronger interaction of LZ pretreatment with GABRG1 genotype (p = 0.06). GABRG1 status revealed a more complex relationship with respect to motivation for alcohol with and without LZ pretreatment; AG and GG individuals worked more for alcohol under both pretreatment conditions, while AA individuals worked more for the AR.

CONCLUSIONS

The CASE PR paradigm shows promise as a laboratory method for use in drug development and phenotyping studies.

Reduced subjective response to acute ethanol administration among young men with a broad bipolar phenotype

Elevated lifetime prevalence rates of alcohol use disorders (AUDs) are a feature of bipolar disorder (BD). Individuals at-risk for AUDs exhibit blunted subjective responses to alcohol (low levels of response), which may represent a biomarker for AUDs. Thus, individuals at-risk for BD may exhibit low responses to alcohol. Participants were 20 unmedicated adult males who reported high rates of hypomanic experiences (bipolar phenotype participants; BPPs), aged 18 to 21 years, and 20 healthy controls matched on age, gender, IQ, BMI, and weekly alcohol intake. Subjective and pharmacokinetic responses to acute alcohol (0.8 g/kg) vs placebo administration were collected in a randomized, double-blind, cross-over, placebo-controlled, within-subjects design. BPP participants reported significantly lower subjective intoxication effects ('feel high': F=14.2, p=0.001; 'feel effects': F=8.1, p=0.008) across time, but did not differ in their pharmacokinetic, stimulant, or sedative responses. Paradoxically, however, the BPP participants reported significantly higher expectations of the positive effects of alcohol than controls. Our results suggest that unmedicated young males with previous hypomanic experiences exhibit diminished subjective responses to alcohol. These blunted alcohol responses are not attributable to differences in weekly alcohol intake, pharmacokinetic effects (eg, absorption rates), or familial risk of AUDs. These observations suggest that the dampened intoxication may contribute to the increased rates of alcohol misuse in young people at-risk for BD, and suggest possible shared etiological factors in the development of AUDs and BD.

Human laboratory paradigms in alcohol research

BACKGROUND

Human laboratory studies have a long and rich history in the field of alcoholism. Human laboratory studies have allowed for advances in alcohol research in a variety of ways, including elucidating neurobehavioral mechanisms of risk, identifying phenotypically distinct subtypes of alcohol users, investigating the candidate genes underlying experimental phenotypes for alcoholism, and testing mechanisms of action of alcoholism pharmacotherapies on clinically relevant translational phenotypes, such as persons exhibiting positive-like alcohol effects or alcohol craving. Importantly, the field of human laboratory studies in addiction has progressed rapidly over the past decade and has built upon earlier findings of alcohol's neuropharmacological effects to advancing translational research on alcoholism etiology and treatment.

METHODS AND RESULTS

To that end, the new generation of human laboratory studies has focused on applying new methodologies, further refining alcoholism phenotypes, and translating these findings to studies of alcoholism genetics, medication development, and pharmacogenetics. The combination of experimental laboratory approaches with the recent developments in neuroscience and pharmacology has been particularly fruitful in furthering our understanding of the impact of individual differences in alcoholism risk and in treatment response.

CONCLUSIONS

This review of the literature focuses on human laboratory studies of subjective intoxication, alcohol craving, anxiety, and behavioral economics. Each section discusses opportunities for phenotype refinement under laboratory conditions, as well as its application to translational science of alcoholism. A summary and recommendations for future research are also provided.

Individual variation in the motivational properties of cocaine

Cues in the environment associated with drug use draw the attention of addicts, elicit approach, and motivate drug-seeking and drug-taking behavior, making abstinence difficult. However, preclinical studies have identified large individual differences in the extent to which reward cues acquire these incentive motivational properties. For example, only in some rats does a spatially discrete food cue become attractive, eliciting approach and engagement with it, and acts as an effective conditioned reinforcer. Moreover, a discrete cocaine cue also acquires greater motivational control over behavior in rats prone to attribute incentive salience to a food cue. In this study, we asked whether there is similar individual variation in the extent to which interoceptive cues produced by cocaine itself instigate cocaine-seeking behavior. After quantifying individual variation in the propensity to attribute incentive salience to a food cue, rats were trained to self-administer cocaine in the absence of an explicit conditional stimulus. We then assessed motivation for cocaine by: (1) performance on a progressive ratio schedule, and (2) the degree to which a cocaine 'prime' reinstated cocaine-seeking following extinction of self-administration behavior. We found that rats prone to attribute incentive salience to a food cue worked harder for cocaine, and showed more robust cocaine-induced reinstatement. We conclude that there is considerable individual variation in the motivational properties of cocaine itself, and this can be predicted by the propensity to attribute incentive salience to reward cues.

In vino silentium? Individual, situational, and alcohol-related factors in reporting violence to the police

This study identifies the individual, situational, and alcohol-related factors associated with reporting violent victimization to the police. Factors positively associated with reporting included older age and incident severity (the assailant's use of a weapon, incurring injury that required attendance at an emergency department). Factors negatively associated with reporting included higher educational qualifications, assault in the nighttime economy (NTE), and drinking more than two alcoholic drinks immediately prior to victimization. It is possible that drinkers engage in "moratorium" on reporting violence in the NTE. Recognizing and reducing the acceptability of violence in the NTE may help reduce incidence of alcohol-related violence. Organizations that use police records of violence to inform practice and policy should account for uneven distributions in reporting behavior when analyzing trends in violence.

Extraversion and Altered State of Awareness Predict Alcohol Cue-Reactivity

Studies have shown that regular drinkers respond to alcohol-related stimuli with increases in urge to drink and changes in affect. Evidence indicates that there is individual variability in responses to alcohol-related cues. The current study aimed to examine (1) the role of extraversion in understanding variability in responses to alcohol cues and (2) whether cue-elicited altered states of awareness are related to urge to drink and affective responses. Forty-one participants were exposed first to a neutral and then to an alcohol cue; urge and affective responses were then measured. Extraversion was a significant positive predictor of urge to drink, while altered state of awareness was a significant positive predictor of urge to drink and positive affect. Interestingly, altered state of awareness significantly improved prediction of both urge to drink and positive affect after controlling for levels of extraversion. These findings suggest that changes in states of awareness following presentation of alcohol cues may facilitate the observed increases in urge to drink and positive affect.

Binge drinking in undergraduates: relationships with sex, drinking behaviors, impulsivity, and the perceived effects of alcohol

Binge drinking on university campuses is associated with social and health-related problems. To determine the factors that may predict this behavior, we collected information on alcohol use, alcohol expectations, and impulsivity from 428 undergraduate students attending a Canadian university. The subjective effects of a binge drinking dose of alcohol were assessed in a subset of participants. In the larger sample, 72% of students reported drinking at or above binge drinking thresholds on a regular basis. Men reported alcohol consumption per drinking occasion, which was consistent with other studies, but the frequency of drinking occasions among women was higher than in earlier studies, suggesting that consumption in women may be increasing. Compared with men, women reported different expectations of alcohol, specifically related to sociability and sexuality. Self-reported impulsivity scores were related, albeit weakly, to drinking behaviors and to expectations in both the sexes. Finally, intoxicated binge drinkers reported feeling less intoxicated, liking the effects more, and wanting more alcohol than did non-binge drinkers receiving an equivalent dose of alcohol. These results have implications for sex-specific prevention strategies for binge drinking on university campuses.

Cognitive processes in alcohol binges: a review and research agenda

Alcohol abuse is associated with a cluster of long-term changes in cognitive processes, as predicted by contemporary models of addiction. In this paper we review evidence which suggests that similar changes may occur during an alcohol binge, and as such they may play an important role in explaining the loss of control over alcohol consumption that occurs during alcohol binges. As a consequence of both acute alcohol intoxication (alcohol 'priming' effects) and exposure to environmental alcohol-related cues, we suggest that a number of changes in cognitive processes are likely. These include increased subjective craving for alcohol, increased positive and arousing outcome expectancies and implicit associations for alcohol use, increased attentional bias for alcohol-related cues, increased action tendencies to approach alcohol, increased impulsive decision-making, and impaired inhibitory control over drives and behaviour. Potential reciprocal relationships between these different aspects of cognition during an alcohol binge are discussed. Finally, we discuss the relationship between the current model and existing models of cognitive processes in substance abuse, and we speculate on the implications of the model for the reduction binge drinking and its consequences.

Stimulant alcohol effects prime within session drinking behavior

RATIONALE

Individual differences in subjective alcohol effects have been shown to differ by risk status (e.g., family history of alcoholism) and to predict future risk for alcohol-related problems. Presumably, individual differences in both stimulant and sedative responses affect the rewarding value of drinking which, in turn, impacts future drinking behavior. Although plausible, this theoretical model is largely untested.

OBJECTIVES

The current study attempted to provide experimental evidence for the impact of subjective alcohol responses on within session drinking behavior.

MATERIALS AND METHODS

Using a placebo-controlled between-subjects alcohol administration paradigm, experiences and evaluations of stimulant and sedative alcohol effects (after a target dose of 0.06 g%) were assessed as predictors of ad-libitum consumption in the context of anticipatory stress.

RESULTS

Analyses indicated that an initial dose of alcohol increased experiences of both stimulation and sedation although stimulant effects were evaluated much more positively. In addition, stimulant effects after a priming dose predicted further consumption, whereas sedative effects did not.

CONCLUSIONS

At least among moderate to heavy drinking college students, stimulant alcohol effects are more reinforcing and predict within session drinking behavior under social stress. Increased attention should be given to stimulant alcohol effects as a risk factor for excessive consumption in this population. Incorporating information about stimulant alcohol effects in prevention and intervention programs may also be important if additional research supports the current results.

Effects of a low dose of alcohol on cognitive biases and craving in heavy drinkers

RATIONALE

Heavy alcohol drinking increases the incentive salience of alcohol-related cues. This leads to increased appetitive motivation to drink alcohol as measured by subjective craving and cognitive biases such as attentional bias and approach bias. Although these measures relate to the same construct, correlations between these variables are often very low. Alcohol consumption might not only increase different aspects of appetitive motivation, but also correlations between those aspects.

OBJECTIVES

To investigate the effect of a low alcohol dose on changes in various measures of appetitive motivation.

MATERIALS AND METHODS

Twenty-three heavy social drinkers were tested in 2 sessions, once after receiving an alcohol prime dose and once after receiving a placebo drink. After drink administration, attentional bias was measured with a visual-probe task using concurrent eye movement monitoring. Furthermore, we measured the approach bias with a stimulus response compatibility task and subjective craving with the Desires for Alcohol Questionnaire.

RESULTS

After the alcohol prime dose, participants had higher levels of craving and more pronounced attentional bias (faster reaction times to probes that replaced alcohol rather than control pictures, increased maintenance of gaze on alcohol pictures, and a higher percentage of first eye movements directed toward alcohol pictures). Approach bias was not influenced by the alcohol prime dose. The correlation between attentional bias and approach bias was significantly higher after the alcohol than after the placebo drink.

CONCLUSIONS

A low alcohol dose increased most measures of appetitive motivation for alcohol and increased the interrelation between cognitive measures of this construct.

Volume and dose effects of experimenter-administered ethanol preloads on ethanol seeking and self-administration

The present experiment used a behavioral model developed to separate the initial behavior required to obtain access to ethanol (appetitive responding or lever presses) from the actual self-administration (consummatory responding or intake) to test the hypothesis that these responses are under the control of different behavioral/physiological processes, and therefore differentially affected by an ethanol priming dose. In male, Long Evans rats, "preload" volume (0.5 and 2.0ml) and dose (approximately 10%, 25%, and 50% of the total normally consumed in nontreatment sessions translating to 0.1, 0.25, and 0.5g/kg) of ethanol were varied and administered by the experimenter via oral gavage prior to an operant session. Overall, there were no priming effects, or increases, in ethanol-reinforced responding resulting from the ethanol preloads. The findings showed that the low preload volume produced linear, dose-dependent decreases in both intake and seeking. However, while the high volume also produced a linear dose-dependent decrease in ethanol seeking, there was a decrease in intake at every dose. That is, ethanol seeking was insensitive to preload volume, while intake was affected in a dose-dependent manner except at the lowest dose when preload volume did play a role in intake regulation. These findings indicate that "fullness" and pharmacological cues differentially impact the appetitive and consummatory behaviors reinforced by ethanol solutions, with intake being more sensitive to preload volume and seeking being more sensitive to preload pharmacology.

Preliminary data on the association among the serotonin transporter polymorphism, subjective alcohol experiences, and drinking behavior

OBJECTIVE

Individual differences in subjective responses to alcohol are believed to have a genetic basis and have been associated with increased risk of alcohol-related problems. There are, however, conflicting results from past studies, perhaps owing to differences in subjective alcohol effects by limb of the blood alcohol curve and the passage of time. The current pilot study evaluated relations among serotonin transporter (SERT) genotype, subjective alcohol responses, and drinking behavior across both the ascending and descending limbs of the blood alcohol curve.

METHOD

Participants (N=222; 68% male) were administered alcohol (target blood alcohol concentration of .06%) with a subsample (n=86) providing genetic data. Following a social stressor, participants were provided the opportunity to engage in ad libitum alcohol consumption.

RESULTS

SERT transporter was not significantly associated with ad lib drinking or subjective alcohol effects at individual time points, although a trend toward a SERT by blood alcohol concentration limb interaction was observed for ad lib drinking. In addition, SERT genotype predicted acute tolerance to alcohol effects, with participants homozygous for the long SERT allele developing acute tolerance more rapidly than other genotypes.

CONCLUSIONS

Although SERT genotype was not reliably associated with ad lib drinking behavior, the results suggest that individuals with the long-long (LL) genotype may develop acute tolerance to alcohol effects more rapidly than heterozygotes or individuals homozygous for the short SERT allele.

The ethanol self-administration context as a reinstatement cue: acute effects of naltrexone

A major difficulty in treating alcohol addiction is the high rate of relapse even after prolonged abstinence. Relapse can be triggered by several factors, including stress, re-exposure to the drug, conditioned discrete stimuli and exposure to the context in which alcohol consumption occurred. The present study investigated the role played by the environmental context on ethanol relapse using an extinction/reinstatement animal model: rats were trained to self-administer ethanol in a distinctive context, and extinction occurred in a setting that differed by visual, tactile and olfactory properties; reinstatement was tested by placing the animals into the ethanol-associated context in the absence of ethanol. We found that re-exposure to the ethanol-associated context significantly increased responses on the ethanol-paired lever. The increase in responding required the presence of the complete configuration of the multimodal context. The non-selective opioid receptor antagonist naltrexone (0.3 mg/kg) administered 20 min prior to the reinstatement test significantly attenuated context-induced reinstatement of lever press responding, compared with saline-treated subjects. These data indicate that the environmental context associated with ethanol availability influences ethanol-seeking behavior in the rat, and that endogenous opioids are involved in this process. Our findings are in accordance with clinical reports demonstrating naltrexone efficacy in the treatment of alcohol relapse in humans, and indicate that the context-induced reinstatement model described here may be useful to investigate the biological mechanisms underlying alcohol relapse.

The priming effect of alcohol pre-load on attentional bias to alcohol-related stimuli

BACKGROUND

Previous research has shown attentional bias toward alcohol-related stimuli in non-dependent social drinkers. The aim of this study was to investigate whether attentional bias towards alcohol-related stimuli would increase after priming with either one of two doses of alcohol (0.3 or 0.6 g/kg) or placebo.

METHODS

Questionnaires were used to measure alcohol use, mood states, craving for alcohol and alcohol outcome expectancies. Attentional bias was assessed using a dot-probe detection task and a modified Stroop task.

RESULTS

Mood ratings showed dose dependent increases in positive mood after the alcohol pre-load. In the dot-probe task, all subjects showed an attentional bias towards the alcohol-related stimuli over neutral stationery-related items, although the attentional bias was significantly positive only at the low alcohol dose. In addition, a negative correlation was found between the attentional bias under the high alcohol dose and the alcohol use questionnaire score. In the Stroop task, a dose related effect of alcohol was found, with subjects making more errors for alcohol-related words under the high alcohol dose.

CONCLUSIONS

These data support ideas derived from the incentive learning theories of drug addiction. Furthermore, these data suggest that history of alcohol exposure may influence the priming effects of an alcohol pre-load on attentional bias.

Alcohol-related motivational tendencies in hazardous drinkers: assessing implicit response tendencies using the modified-IAT

This study examined the utility of an implicit measure of cognitive associations, the Implicit Association Test (IAT; ), to assess alcohol-related approach dispositions. Forty-seven hazardous drinkers completed a modified IAT procedure that assessed the relation between alcohol and behavioral categories (i.e., approach and avoid). Participants completed a series of individual difference measures before an alcohol cue exposure task in which they anticipated alcohol consumption. Results indicate that the modified IAT is associated with binge drinking episodes, perceived difficulty controlling alcohol use, and appetitive responses to alcohol cues. Findings are discussed in terms of the potential value of this measure to assess alcohol-related memory associations among those whose alcohol use puts them at risk for harm.

The reinstatement model of drug relapse: history, methodology and major findings

RATIONAL AND OBJECTIVES

The reinstatement model is currently used in many laboratories to investigate mechanisms underlying relapse to drug seeking. Here, we review briefly the history of the model and describe the different procedures that have been used to study the phenomenon of reinstatement of drug seeking. The results from studies using pharmacological and neuroanatomical techniques to determine the neuronal events that mediate reinstatement of heroin, cocaine and alcohol seeking by acute priming injections of drugs, drug-associated cues and environmental stressors are summarized. In addition, several issues are discussed, including (1) the concordance between the neuronal mechanisms involved in drug-induced reinstatement and those involved in drug reward and discrimination, (2) the role of drug withdrawal states and periods in reinstatement of drug seeking, (3) the role of neuronal adaptations induced by exposure to drugs in relapse, and (4) the degree to which the rat reinstatement model provides a suitable preclinical model of relapse to drug taking.

CONCLUSIONS

The data derived from studies using the reinstatement model suggest that the neuronal events that mediate drug-, cue- and stress-induced reinstatement of drug seeking are not identical, that the mechanisms underlying drug-induced reinstatement are to some degree different from those mediating drug discrimination or reward, and that the duration of the withdrawal period following cocaine and heroin self-administration has a profound effect on reinstatement induced by drug cues and stress. Finally, there appears to be a good correspondence between the events that induce reinstatement in laboratory animals and those that provoke relapse in humans.

The effects of alprazolam and buspirone in light and moderate female social drinkers

Individuals who are moderate/heavy drinkers are at increased risk to abuse benzodiazepines and this risk is increased in women compared to men. However, no studies have determined whether female moderate drinkers (MD) show a differential response to the subjective and performance effects of benzodiazepines compared to female light drinkers (LD). Fourteen female MD who consumed an average of 36 drinks/month were compared to 14 female LD who consumed an average of 4.2 drinks/month. None of the participants had either a first- or second-degree family history of alcoholism. The acute effects of placebo, alprazolam (0.25, 0.50, 0.75 mg) and buspirone (5, 10, 15 mg) were evaluated using a double-blind, placebo-controlled outpatient design. Drug effects were assessed using a full range of performance measures and subjective-effects questionnaires. Alprazolam impaired performance in a dose-related manner on all performance tasks for both groups of females, whereas buspirone had minimal effects on performance. There were few differences between LD and MD with respect to subjective response or performance impairment following either alprazolam or buspirone. Although MD reported greater ratings of Good Drug Effect and Drug Liking than LD, this was neither dose-related, nor specific to alprazolam. The results of the present study suggest that female MD without a family history of alcoholism experience the same level of performance impairment as female LD, although they tend to report greater positive subjective effects from alprazolam.