How much and how fast: Alcohol consumption patterns, drinking-episode affect, and next-day consequences in the daily life of underage heavy drinkers

Background: Understanding how alcohol consumption patterns are associated with negative and positive outcomes can inform efforts to reduce negative consequences through modification of those patterns. This is important in underage drinkers, many of whom drink heavily despite negative consequences. Most work has focused on the amount of alcohol consumed, but amount provides limited information about consumption patterns compared to rate of consumption, or how fast individuals drink. We therefore examined associations of both amount and rate of consumption with negative and positive outcomes (immediate affective states and next-morning consequences) in daily life. Method: Ninety-five college students aged 18-20 years completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and positive and negative affect hourly within drinking episodes. Estimated blood alcohol concentration (eBAC) values were used to create amount and rate of consumption indicators. Each morning after drinking, participants reported negative (e.g., blackout, hangover) and positive (e.g., new friend, making others laugh) consequences. Results: Within drinking episodes, multilevel models showed faster consumption was associated with reduced negative affect and both larger amount and faster consumption were associated with greater positive affect. Further, amount and rate were both associated with greater likelihood of a negative consequence the next morning. Rate, but not amount, was associated with more positive consequences. Conclusions: Not only how much but also how fast individuals drink may be important for the positive and negative outcomes they experience. Interventions to reduce negative alcohol-related outcomes should consider not only amount, but also rate of consumption.Y