Free‐access intravenous alcohol self‐administration in social drinkers and individuals with alcohol use disorder: Evaluation of relationships with phosphatidylethanol and self‐reported alcohol consumption

• Published in: Alcohol, clinical & experimental research clinical & experimental research, 2023-08, Vol.47 (8), p.1453-1466
• Main Authors: Olsson, Yasmin, Hodzic, Kenan, Wass, Caroline, Lidö, Helga, Stangl, Bethany L., O'Connor, Sean, Plawecki, Martin H., Ramchandani, Vijay A., Söderpalm, Bo, Jerlhag, Elisabet
• Format: Article
• Language: English
• Subjects: alcohol addiction; CAIS; ethanol; gut-brain peptides; Neurosciences; Neurovetenskaper; phosphatidylethanol
• ISSN: 2993-7175; 0145-6008; 2993-7175
• DOI: 10.1111/acer.15132

Background The free‐access (FA) intravenous alcohol self‐administration (IV‐ASA) paradigm is an experimental approach that can identify modulators of alcohol consumption in humans. Moreover, the outcome measures of IV‐ASA paradigms are associated with self‐reported alcohol intake using the timeline follow‐back method (TLFB). To evaluate how FA IV‐ASA reflects drinking in real life, we examined the relationship between an objective marker of recent alcohol intake, phosphatidylethanol in blood (B‐PEth), and TLFB and measures obtained during IV‐ASA in individuals with alcohol use disorder (AUD) and social drinkers (SD). We also explored the associations between these measures and gut‐brain peptides involved in AUD pathophysiology. Methods Thirty‐eight participants completed a laboratory session in which they self‐administered alcohol intravenously. The safety limit was 200 mg%, and main outcomes were mean and peak breath alcohol concentrations (BrAC). Blood samples were drawn prior to IV‐ASA and subjective alcohol effects were rated during the experiment. Results The study sample comprised 24 SD and 14 participants with DSM‐5 mild AUD. Although BrACs were not associated with B‐PEth or TLFB in the full sample or AUD subgroup, there was an association with TLFB in SD. In both subgroups, BrACs were associated with alcohol craving but with differential timing. Total ghrelin levels were higher in AUD participants than in SD. Conclusions No associations between B‐PEth levels and achieved BrACs were observed in the mild AUD group, the SD group, or the full sample. The ability for FA IV‐ASA to reflect recent drinking was confirmed only for TLFB in SD, whereas there were no associations within the smaller subsample of participants with mild AUD or in the full sample. Further studies that include a larger AUD sample are warranted. The association of BrACs with craving for alcohol suggests that the IV‐ASA method may be useful for assessing interventions that target craving. This could be explored by using the FA IV‐ASA model to evaluate the effects on craving of approved pharmacotherapies for AUD. This study examined how well the experimental method free access intravenous alcohol self‐administration (IV‐ASA) reflects real‐life drinking as measured by an objective alcohol marker (B‐PEth) and self‐reported recent drinking history (TLFB) in participants with AUD and in social drinkers (SD). No associations were identified for IV‐ASA and B‐PEth, whereas IV‐ASA and TLFB wer