Alcohol Tolerance: Prevalence and Potential Implications in Young Drinkers

Some teenagers and young adults report tolerance (an increase in the amount required to achieve intoxication) without meeting criteria for alcohol dependence. To define the prevalence and correlates of tolerance in this age group, investigators analyzed data from a sample of 649 persons aged 18–22 years who drank alcohol and whose alcohol and other substance use was well-characterized.  

Tolerance was defined as participants reporting that they needed to “drink a great deal more in order to get an effect” or “could no longer get high on the amount [they] used to drink.”

• Nine percent of participants reported tolerance but no current or past alcohol use disorder (AUD).*

• Persons with tolerance but not an AUD were more likely to have alcohol-related problems than those without tolerance.

• Though participants with tolerance but no AUD reported illicit drug use more commonly than those without tolerance, tolerance was not associated with illicit drug use in multivariable analysis.

Comments:

Nearly 1 in 10 young adults who drink alcohol report tolerance but do not meet criteria for alcohol abuse or dependence. Tolerance is associated with alcohol consequences in this age group, yet many current screening tools do not ask about tolerance. Research on the potential health benefits of identifying and intervening with young people who drink and have tolerance but not an alcohol use disorder is needed.

Marc N. Gourevitch, MD, MPH

Reference:

Schuckit MA, Smith TL, Hesselbrock V, et al. Clinical implications of tolerance to alcohol in nondependent young drinkers. Am J Drug Alcohol Abuse. 2008;34(2):133–149.