Good News for Alcohol Treatment Studies: Drinking in Lab Setting Reflects Real-World Alcohol Use

Rates of alcohol use disorder (AUD) have risen in the US in recent years. A small number of pharmacotherapies (drug treatments) are available for AUD, but there is an urgent need for more treatments to be evaluated. Increasingly, novel medications, as well as behavioral interventions, are tested in laboratory-based studies, where the impact on participants’ alcohol consumption can be directly assessed. However, it is not known if drinking in the laboratory setting accurately reflects individuals’ real-life drinking behavior and therefore if study findings hold true in the real-world. A new report in the journal Alcoholism: Clinical and Experimental Research by researchers from the NIAAA-supported Center for the Translational Neuroscience of Alcoholism at Yale University addresses this issue, by examining the extent to which individuals’ drinking in a laboratory setting correlates with their (self-reported) alcohol use in the lead-up to the study.

The analysis used data from a 1-day pharmacotherapy study involving 64 heavy drinkers who met criteria for alcohol dependence or abuse and who also had a family history of alcohol dependence. This analysis used data obtained before any study medication was administered. On arrival at the laboratory, participants completed detailed questionnaires to report on their alcohol use over the past 30 days, as well as the maximum number of drinks consumed in a single occasion during the previous year and ever during their lifeime. Participants then completed a laboratory-based alcohol drinking paradigm, involving exposure to a priming drink followed by  three closely monitored 1-hour drinking periods. During the drinking periods, participants had the choice of consuming up to four alcoholic drinks (12 drinks in total) or receiving the equivalent drink price in cash. Craving for alcohol (another important measure in pharmacotherapy trials) was also assessed regularly throughout the day. Participants returned home the next morning.

Over the previous 30 days, participants had, on average, had a total of 165 drinks, consumed seven drinks per drinking day, and drunk alcohol on three out of every four days. Using statistical analysis, the researchers showed that the level of drinking in the previous 30 days reported by participants was significantly related to the total number of drinks consumed in the laboratory drinking session, such that those who reported higher levels of past drinking also consumed more drinks on the day of the study. Several measures of usual and past drinking correlated with consumption in the laboratory, including average number of drinks per drinking day, number of drinking days, and maximum drinks in the past year and lifetime. The level of alcohol craving assessed in the laboratory was also strongly associated with measures of self-reported previous drinking.

The findings provide important support for the use of laboratory-based alcohol assessment as a reflection of real-world drinking behavior. However, the researchers note that the findings will need to be replicated in more diverse groups of participants.

Examining the Relationship between Self-Reported Drinking and In-Laboratory Drinking and Craving: Is There Concordance? K.S. DeMartini, B. Pittman, J.H. Krystal, S.S. O’Malley, S. Krishnan-Sarin (pages xxx).

ACER-19-4170.R1

 

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