Craving, Stimulation, and Sedation as Predictors of Alcohol Demand Under Intoxication

Public Health Significance Statement This study suggests that the acute effects of alcohol may lead to alcohol being perceived as more valuable, and that enhanced craving and alcohol's stimulating effects may play a role in this process. Objective: Alcohol demand has been evaluated predominately as a trait-like construct, reflecting individual differences in alcohol's reinforcement value. Increases in state-dependent alcohol demand under intoxication have been demonstrated, indicating a potential mechanism that may influence drinking behavior. This study evaluated the roles of craving and subjective alcohol response (stimulation, sedation) in this process, testing whether increases in craving and stimulation, and reductions in sedation, predicted increased alcohol demand during a laboratory-based drinking episode. Method: Young adults (N = 90; 53% male; M age = 22.2) attended two sessions in a within-subjects alcohol/placebo design. Craving, stimulation, sedation, and alcohol demand (breakpoint, O (max), intensity) were assessed once before beverage consumption and at multiple points afterward at varying blood alcohol concentrations (M peak BrAC = 0.102 g%). Multilevel models tested associations between momentary and between-person predictors (craving, stimulation, sedation) and alcohol demand after accounting for sex, time trends, and baseline covariates. Results: When intoxicated, participants reported higher alcohol demand across the majority of the ascending limb and decreasing demand across the descending limb. Participants reported increased demand at moments when experiencing higher craving, ps <= .001, and stimulation, with momentary stimulation incrementally predicting demand above craving, ps <= .04. Between-persons, higher alcohol-induced craving was associated with increased demand, ps <= .001, whereas between-person stimulation and sedation were less robustly associated with demand indicators. Conclusions: Results indicate that within-person craving and stimulation during intoxication are independently associated with changes in alcohol's reinforcing value. Findings suggest the potential for state-dependent alcohol demand to serve as an additional motivational index of processes underlying ongoing drinking behavior.