The role of carving in human alcohol consumption in heavy and light drinkers: thinking about drinking

Authors

• JL Gowin
• ME Sloan
• VA Ramchandani

Abstract

Despite the recent addition of craving as a criterion for alcohol use disorder, it is not known how craving affects drinking behavior during an individual alcohol consumption episode. Determining how craving affects the likelihood of risky patterns of drinking, such as binge drinking (i.e. achieving blood breath alcohol levels concentrations (BrAC) greater than 80 mg%), is therefore a priority. To assess this, we recruited 111 light drinkers (1–7 drinks/week), 56 moderate drinkers (females: 8–13 drinks/week, males: 8–20 drinks/week), and 44 heavy drinkers (females: 14+ drinks/week, males: 21+ drinks/week). Participants came to the laboratory for an opportunity to self-administer alcohol via an IV using the Computer-Assisted Infusion System (CAIS), which uses a pharmacokinetic model-base algorithm that controls for age, sex, weight and height to standardize BrAC. The experiment consisted of a 25-minute priming phase and a 125-minute free access phase where participants could self-administer alcohol up to a maximum BrAC of 120 mg%. To assess craving, participants completed the Alcohol Urge Questionnaire immediately before the priming phase and again at minute 20, when BrAC was approximately 15mg%. Kruskal-Wallis tests demonstrated that alcohol craving differed between drinking groups. Post-hoc tests revealed significant differences between light and heavy drinkers for both baseline and post-prime measures of alcohol craving (p-values of 0.001 and 0.008 respectively). All other post-hoc comparisons were not significant (p > 0.05 for all tests). We then tested if alcohol craving contributed to the rate of binging above and beyond drinking group using an adjusted Cox proportional hazards model. Craving following alcohol priming was a significant predictor of rate of binging throughout the session (HR: 1.05, 95% CI: 1.03 to 1.07, p < 0.001). These findings support the hypothesis that higher levels of craving are characteristic of heavy drinkers and that craving predicts risky drinking behavior.

Scientific Focus Area: Social and Behavioral Sciences

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