New research from the Prevention Research Center of the Pacific Institute for Research and Evaluation and the University of Pittsburgh finds that greater symptoms of lifetime alcohol use disorder (AUD) are related to greater volatility in drinking quantities. Drinkers with more AUD symptoms, especially greater symptoms of craving, tolerance, and withdrawal, vary much more in the amounts they consume from one drinking occasion to another. This greater volatility leads to heavier drinking and problems associated with alcohol use.
The authors analyzed survey data from a random sample of regular drinkers in California who reported consuming two or more drinks at least twice a month over the previous year. Survey questions assessed distributions of drinking quantities across occasions over the previous 28 days, respondents’ socioeconomic characteristics, assessments of drinking motives, impulsivity and sensation seeking, and symptoms of lifetime AUD, especially focusing upon pharmacological effects related to craving, tolerance, and withdrawal.
The results showed that:
- Greater numbers of lifetime symptoms of AUD were related to greater volatility in drinking quantities across drinking occasions.
- This effect was most strongly related to greater numbers of pharmacological symptoms, alcohol craving, tolerance, and withdrawal.
- Greater variability in drinking quantities is a key source of excess risks related to drinking among lifetime AUD drinkers.
Says Dr. Paul Gruenewald of the Pacific Institute for Research and Evaluation, “Symptom criteria related to lifetime AUD lead regular drinkers to have much greater risks for heavier drinking and problems.”
Source: Gruenewald, P. J., Caetano, R., & Mair, C. (2026). Variability in drinking quantities related to impaired control and pharmacological criteria for lifetime alcohol use disorder. Addictive Behaviors, 108679.
