Rate of alcohol consumption in the daily life of adolescents and emerging adults

Rationale Alcohol consumption in adolescents and emerging adults is a significant issue. However, our understanding of the topography of alcohol use within drinking episodes in this population is at a nascent stage. Objectives This study characterized rate of alcohol consumption in the daily lives of problem drinkers ages 16-24 years (N = 75). We examined whether AUD symptoms and the presence of peers, factors relevant to alcohol consumption in youth, were associated with rate of consumption. Methods Ecological momentary assessment (EMA) was used (N-observations = 799). Rate of consumption was defined as change in estimated blood alcohol concentration (eBAC) relative to the start of the drinking episode. Piecewise multi-level modeling was used to test hypotheses. As a comparison, we examined whether indicators of quantity and frequency (Q-F) were associated with AUD symptoms and presence of peers. Results For all participants, eBAC increased sharply early in the episode, then plateaued. Participants with more AUD symptoms or who were in the presence of peers had significantly steeper increases in eBAC over the early part of the episode. Participants with more AUD symptoms were also more likely to engage in binge-like behavior. For Q-F, only peak eBAC and peak number of standard drinks were associated with AUD symptoms, and not presence of peers. Conclusions Findings highlight the value of rate of consumption as an indicator of use in youth, one sensitive to the influence of relevant person-level and situational factors. Intervention efforts may benefit from targeting the speed at which youth drink.