Preliminary evidence for perceived rapid alcohol tolerance growth as a risk factor for problematic alcohol use.

Background: Preclinical research with animals suggests that a propensity to more rapidly adapt to the effects of alcohol could be an important neurobiological difference underlying alcohol use disorder (AUD). Research translating this work to humans is scarce. We tested whether adults' self-perceptions of rapidly developing alcohol tolerance following the onset of regular drinking was associated with increased risk of problematic alcohol use (using scores that excluded tolerance items), while controlling for several potentially important confounders.

Methods: Adults who reported current heavy drinking completed an online survey (N = 160; M(SD) = 32.24(9.30) years old; 56.3% Black, 43.8% White; 55% Female, 45% Male). Participants reported the extent to which "my tolerance to alcohol seemed to build up very quickly once I started drinking frequently." Initial subjective response was measured as the number of drinks to experience alcohol effects during the first five drinking experiences and acquired tolerance as the difference between current and initial subjective response. Participants reported on alcohol consequences and dependence symptoms using modified DSM-5 criteria (i.e. problematic alcohol use), past year alcohol consumption, and demographic characteristics.

Results: Hierarchical linear regression showed that perceived rapid tolerance growth was uniquely associated with problematic alcohol use (excluding tolerance symptoms) after controlling for initial subjective response, acquired tolerance, DSM-5-related tolerance, alcohol consumption, race, sex, and age.

Conclusions: Individuals who reported experiencing rapid tolerance growth when they started regularly drinking showed increased risk for problematic alcohol use. Future prospective research on this topic is warranted and could help uncover a novel risk factor for AUD.