Increased salivary cortisol concentrations during chronic alcohol intoxication in a naturalistic clinical sample of men

BACKGROUND: Cortisol, the primary glucocorticoid in humans, is intimately involved in the regulation of such varied and critical biological processes as emotion, cognition, reward, immune functioning, and energy utilization. A persistent increase in cortisol concentration as a result of chronic intoxication could therefore result in alcohol-related disorders such as sleep disruption, cognitive deficits, diabetes, and mood disturbances. Although moderate levels of acute alcohol ingestion are reported to produce an increase in cortisol levels, it is uncertain whether cortisol remains persistently increased during long-term chronic intoxication. METHODS: Salivary cortisol and breath alcohol concentrations (BAC) were obtained on 73 subjects with primary alcohol dependence on initial presentation for treatment and 22 alcohol-dependent subjects participating in a residential treatment program. RESULTS: Both intoxicated alcohol-dependent subjects (n = 38) and nonintoxicated subjects in acute alcohol withdrawal (n = 30) demonstrated significantly increased salivary cortisol concentrations compared with abstinent subjects (n = 27; p < 0.001). Nonintoxicated subjects in acute withdrawal demonstrated significantly increased salivary cortisol concentrations compared with highly intoxicated subjects (BAC >100 mg/dl) but were similar to subjects with lower levels of intoxication (BAC, 10-100 mg/dl). CONCLUSIONS: Chronic alcohol-dependent subjects experience continuously increased concentrations of cortisol during both intoxication and withdrawal. Increased levels of cortisol during chronic intoxication seem to progressively increase with the onset of withdrawal. This suggests a daily cycle of hypercortisolemia during the active drinking phase, with further increases on the cessation of drinking and the emergence of withdrawal symptoms. Persistently increased levels of cortisol may extract a costly allostatic load, resulting in significant central nervous system and peripheral organ morbidity.     

How many drinks does it take you to feel drunk? Trends and predictors for subjective drunkenness

AIMS: To describe and model the sources of the variation and trends in the meaning of subjective drunkenness. DESIGN: Trend analyses of three cross-sectional surveys. SETTING: US general population. PARTICIPANTS: Those who report being drunk in the past year among those in the 1979, 1995 and 2000 National Alcohol Surveys. MEASUREMENTS: Number of drinks reported to feel drunk (dependent variable), past-year alcohol consumption measures, beverage preference, state drunk driving blood alcohol concentration (BAC) limit and demographics. FINDINGS: The mean reported number of drinks to feel drunk declined significantly between each survey and was significantly lower for women. Considerable variation was also found within surveys and was explained partially by available variables. Volume of alcohol and heavy drinking occasions were associated positively with the number of drinks to feel drunk. Higher educational attainment was associated negatively as was being a wine drinker, of older age, of African American ethnicity and of becoming drunk more frequently than once per month. Living in a state with a per se BAC limit of 0.08% was associated negatively in models for men. CONCLUSIONS: A substantial shift downward in the meaning of drunkenness occurred in the US between 1979 and 2000. This may be explained partly by the increase in educational attainment, the ageing of the population, the decline in per capita alcohol consumption and changes in alcohol policy towards lower BAC limits for drunk driving along with greater penalties, enforcement and awareness.     

Behavioural correlates of alcohol intoxication

Alcohol is used in most cultures despite knowledge of the physical, psychological and social problems associated with its abuse. Behavioural impairment is a function of several factors, including blood alcohol concentration (BAC) and the rate of alcohol metabolism by alcohol dehydrogenase and the microsomal ethanol-oxidizing system. Their availability and activity depend upon alcohol use history, ethnicity, other drug use and gender. Adverse social consequences related to alcohol intoxication include impaired driving, acts of aggression and violence towards self and others, and various types of accidents. About 40% of all fatal traffic accidents in Canada and the US in 1986-1987 were alcohol-related. Similar statistics have been reported in the UK and Europe (e.g. Sweden). The risk of a fatal car accident increases exponentially with a driver's BAC, prompting recommendations to lower the legal BAC limit for driving and piloting aircraft. Risks of falls, drownings, and fires and bums may also be increased by alcohol intoxication. At least 22% of work-related accidents may have involved alcohol use. These data are probably conservative estimates as under-reporting of alcohol use is likely. Alcohol facilitates aggressive behaviours, but it is difficult to separate the pharmacological effect from psychosocial effects or some other common factor (e.g. low CSF levels of the serotonin metabolite 5-H1AA have been reported in alcoholics, suicide attempters, violent offenders). In addition, alcohol interacts with other drugs to increase or decrease their behavioural and therapeutic effects. An acutely high BAC inhibits the metabolism of other CNS depressants (e.g. benzodiazepines), but long-term alcohol use increases the metabolism of most drugs. A potential amethystic agent, to block or reverse alcohol's effects, has been identified in preclinical studies (Ro15-4513, an imidazobenzodiazepine). Some clinical studies indicated that naloxone, lithium, ibuprofen, zimeldine and catecholamine agonists may reduce ethanol-induced behavioural or cognitive effects but the results have not been consistently replicated. More research is needed to determine the potential clinical use of amethystic agents and other pharmacotherapies in the prevention and treatment of problem behaviours associated with alcohol abuse and intoxication.     

One-Month Repeatability of Emotional Responses to Alcohol

Thirty-four subjects in the Colorado Alcohol Research on Twins and Adoptees (CARTA) were brought back between 30 to 60 days after their initial testing to be retested on all the CARTA procedures. As before, subjects were given a dose of ethanol (0.8 g/kg) calculated to bring their blood alcohol concentration (BAC) to near 0.10 g/dl. Additional doses were given at the end of each of the next 2 hr to maintain their BAC near peak for approximately 3 hr. During both testings, subjects' self-reports of their emotional responses and perceived intoxication following alcohol dosing were only minimally correlated with their alcohol metabolism parameters and reported average level of alcohol use. Repeatabilities (test-retest correlations) for subjects' self-reports of positive affect and of intoxication following alcohol dosing were consistently high, in contrast to earlier reports of minimal repeatabilities for alcohol metabolism and responses to alcohol on physiological, motor coordination, reaction time, and perceptual speed measures. Tester ratings of the subjects' levels of intoxication were also moderately stable between the two testings.     

Estimation of Blood Alcohol Concentrations in Young Male Drinkers

This research examined individual differences in the ability to self-monitor the effects of alcohol. Thirty-nine male subjects consumed 0.75 ml/kg alcohol and estimated their blood alcohol concentrations (BACs) at peak BAC and on the ascending and descending limbs of the blood alcohol curve. Family history of alcohol dependence did not affect the accuracy of estimation of BACs. Subjects who reported lower levels of subjective intoxication underestimated their BACs more than did subjects who reported higher levels of subjective intoxication. Subjects with less behavioral impairment underestimated their BACs more than subjects with greater behavioral impairment on the ascending limb of the blood alcohol curve. Accuracy was better on the ascending limb compared with peak BAC and the descending limb, and accuracy became worse over time on the descending limb. It appears that cues to the effects of alcohol rapidly become unavailable on the descending limb, which may contribute to decisions concerning further alcohol consumption and driving after drinking.     

Predicting Alcohol Impairment: Perceived Intoxication Versus BAC

The purpose of this study was to report the relationship among perceived intoxication, performance impairment, and actual blood alcohol concentration (BAC) levels. Fifteen subjects, aged 21 to 40, completed both single- and double-dose sessions of alcohol consumption. BACs, reaction and anticipation time, and perceived intoxication data were collected during both sessions. Analysis of data showed that perceived intoxication was significantly related to performance impairment, but the actual BAC was not.     

Fast, but error-prone, responses during acute alcohol intoxication: effects of stimulus-response mapping complexity

BACKGROUND: Although moderate doses of alcohol can impair performance on tasks that require information processing, little is known about the locus of the alcohol effects within the processing stream. This study used a psychological refractory period paradigm to investigate the effect of alcohol on the central, cognitive stage of information processing when task complexity is manipulated by altering stimulus-response compatibility. METHODS: Thirty-four healthy male social drinkers were assigned to one of two groups (n = 17) that performed two tasks. Each trial consisted of a task 1 stimulus (tone) followed by a task 2 stimulus (letter) that was presented after one of four stimulus onset asynchronies (50, 200, 500, or 1100 msec). A baseline test of performance was obtained before the groups received a beverage containing either 0.0 g/kg (placebo) or 0.65 g/kg alcohol. Both groups were retested when blood alcohol concentration (BAC) was increasing and was decreasing. RESULTS: The alcohol group made significantly more errors in task 1 compared with their drug-free baseline measure during the ascending phase of the BAC curve, and error rates increased to a greater extent for the more complex arbitrary stimulus-response mapping condition. Moreover, this increase in errors continued unabated during the descending phase of the BAC curve. Increasing BACs also slowed performance (longer reaction time), but unlike errors, reaction time returned to drug-free baseline levels when BAC was decreasing. CONCLUSIONS: The results provide evidence that an acute dose of alcohol can impair one aspect of the central, cognitive stages of information processing. The possibility that errors in information processing remain during decreasing BACs even after processing speed has returned to drug-free levels has important practical implications relating to the detrimental consequences of acute alcohol intoxication.     

Perception of intoxication and blood alcohol concentration of drinkers in social settings

This study examined associations among perception of intoxication, blood alcohol concentration (BAC), discriminability of internal physiological sensations, and awareness of external stimuli related to the number of drinks consumed of subjects in social drinking settings. A total of 156 randomly selected individuals consented to be interviewed as they walked by preselected drinking establishments, and afterward provided a breath sample to determine BAC. This study found that drinkers in social settings can make at least crude estimates of their level of intoxication, and that the accuracy of these estimates decreases as BAC increases.     

Pattern of Alcohol Administration and Physical Dependence

The purpose of this work was to study the influence of the pattern of alcohol administration on the intensity of withdrawal syndrome. Some rats were intoxicated by inhalation of ethanol vapor. The ethanol concentration in atmosphere was increased throughout the whole experiment in such a manner that the blood alcohol concentration (BAC) during the experiment increased as a linear function of time. When the area under BAC curve was varied by changing the duration of alcohol administration and keeping constant the slope of BAC increase, the intensity of withdrawal syndrome increased with the duration of alcohol intoxication. When the duration of alcohol administration and the slopes of the BAC curves were varied in such a manner that the area under the BAC curves was kept constant, the severity of the withdrawal syndrome increased with the slope of the BAC curves.     

Examination of Judgments of Drunkenness, Binge Drinking, and Drunk-Driving Tendencies in Teens With and Without a Family History of Alcohol Abuse

BACKGROUND: The present study examined judgment processes of individuals with and without a family history of alcohol abuse. Despite the alarming statistics involving alcohol-related consequences in this population, very little is known about what judgment processes they use or how beneficial these processes are at preventing intoxication and alcohol-related consequences. METHODS: Participants were 270 individuals, 16-18 years old, screened on the basis of the history of family alcohol abuse. Individuals were asked to (1) make judgments of drunkenness in relation to the legal limits in response to factorially manipulated external cues on number of drinks, time taken to consume, and type of beverage, using the methodology of Jaccard and Turrisi (1987), and (2) answer several questions regarding their alcohol-related behaviors. RESULTS: Our results indicated that individuals with a positive family history of alcohol abuse were more likely to make judgmental errors and underestimate their drunkenness relative to individuals without a positive family history of alcohol abuse. Moreover, the errors in judgments were more pronounced in situations involving moderate to heavy alcohol consumption. Finally, family history was found to moderate the relationship between underestimation errors and drinking, and drinking and driving tendencies. For individuals with a positive family history of alcohol abuse, the more they tended to underestimate their drunkenness, the more likely they were to binge drink and drive after drinking. CONCLUSIONS: The findings suggest that judgmental errors tend to be an important process variable in the relationship between family history and alcohol-related behavioral tendencies. The findings are discussed with respect to potential behavioral antecedents (e.g., student binge drinking) and development of prevention programs geared toward training students to make more accurate judgments, using external cues.     

Daidzin, an Antioxidant Isoflavonoid, Decreases Blood Alcohol Levels and Shortens Sleep Time Induced by Ethanol Intoxication

The extract from an edible vine, Pueraha lebata has been reported to be efficacious in lessening alcohol intoxication. In this study, we have tested the efficacy of one of the major components, daidzin, from this plant extract. When ethanol (40% solution, 3 g/kg body weight) was given to fasted rats intragastrically, blood alcohol concentration (BAC) peaked at 30 min after alcohol ingestion and reached 1.77 ± 0.14 mg/ml (mean values ±sd , n = 6). If daidzin (30 mg/kg) was mixed with the ethanol solution and given to animals intragastrically, BAC was found to peak at 90 min after alcohol ingestion and reached only 1.20 ± 0.30 mg/ml (n = 6) (p < 0.05 vs. controls). The ability of daidzin to delay and decrease peak BAC level after ethanol ingestion was also observed in fed animals, in both fasted and fed rats given alcohol without daidzin, BAC quickly declined after reaching its peak at 30 min. By contrast, BAC levels receded more slowly if daidzin was also fed to the animals. Daidzin showed a chronic effect. Rats fed daidzin for 7 days before ethanol challenge, but not on the day of challenge, also produced lower and later peak BAC levels. Interestingly, daidzin, whether fed to rats only once or chronically for 7 days, did not significantly alter activities of either alcohol dehydrogenase or mitochondrial aldehyde dehydrogenase in the liver. Further experiments demonstrated that daidzin shortened sleep time for rats receiving ethanol intragastrically (7 g/ kg) but not intraperitoneally (2 g/kg). To test whether daidzin delayed stomach-emptying, [Clpolyethylene glycol was mixed with ethanol and fed to rats. It was found that, 30 min after intragastric feeding, more ethanol and [¹⁴C]polyethylene glycol remained in the stomach if rats were also given daidzin. Because daidzin is an isoflavonoid glucoside that possesses strong antioxidant activity, two other antioxidants (i.e., vitamin E and thioctic acid) were tested. Similar to daidzin, these two antioxidants also delayed and suppressed peak BAC, as well as shortened sleep time induced by alcohol ingestion. We conclude that: (1) daidzin is effective in countering alcohol intoxication; (2) suppression of BAC by daidzin is due mainly to delay of stomach-emptying, but not to accelerated clearance of ethanol in circulation by liver enzymes; and (3) the effect of daidzin may in part be due to its antioxidant activity.     

Induction of steady-state blood alcohol levels: application to the study of within-session alcohol tolerance in rats

BACKGROUND: The study of within-session alcohol tolerance in the rat has been hampered by methodological difficulties related to the measurement of dependent variables at predictable blood alcohol concentrations (BAC) during a single session of alcohol exposure. This study characterizes a method for maintaining steady-state blood alcohol levels over several hours in the rat, referred to as the "alcohol clamp." METHODS: Wistar rats were implanted with an indwelling catheter in the carotid artery for blood sampling and another in the external jugular vein for alcohol infusion. To clamp BAC at a predetermined level, rats first were infused with a priming dose of alcohol to establish the desired or "target" BAC, followed by a continuous infusion of alcohol at a rate equal to that of alcohol metabolism in the rat. This maintained BAC at a constant level over time. BACs of 100, 200, or 300 mg% were maintained over several hours in separate groups of rats. The alcohol clamp was applied to the study of acute (within-session) alcohol tolerance in rats selectively bred for high and low alcohol drinking. Alcohol-induced hypothermia was used to index tolerance, and within-session alcohol tolerance was defined as a return of body temperature toward baseline during the course of the alcohol infusion while BAC was maintained at a constant level. RESULTS: The continuous alcohol infusion procedure maintained BAC in a steady state throughout the 3 hr alcohol infusion session at each of the three target BAC levels. Alcohol infusion induced a drop in body temperature, followed by a return of temperature toward baseline during the course of infusion, which indicated the development of within-session alcohol tolerance. CONCLUSIONS: The continuous alcohol infusion procedure (alcohol clamp) maintained BAC in a steady state, both within and between subjects, across a wide range of blood alcohol levels. The alcohol clamp appears to be a useful tool for subsequent studies of within-session alcohol tolerance in the rat.     

Age at First Alcohol Use as a Possible Risk Factor for Adolescent Acute Alcohol Intoxication Hospital Admission in the Netherlands

Background

The primary objective of this study is to determine whether age at first alcohol use is a determinant for adolescent acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and blood alcohol concentration (BAC) at hospital admission. Around the world, as in the Netherlands, a key aim of alcohol policy is to postpone the age at first alcohol use. This is based on cohort studies that indicate a relationship between a younger age at first alcohol use and subsequent adult alcohol use disorders.

Methods

This study was conducted using a cohort of data comprising individuals under 18 years of age. Data were collected between 2007 and 2017 by the Dutch Pediatric Surveillance System (NSCK) in order to monitor trends in admissions for acute alcohol intoxication. Multivariate linear regression analyses were used to determine the association between age at first alcohol use and acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and BAC at admission.

Results

This study indicates that among adolescents admitted for acute alcohol intoxication, adolescents who started drinking at ≤ 14 years of age are significantly more often female, lower educated, and raised in nontraditional family structures than adolescents who started drinking between 15 and 18 years of age. Multiple linear regression analyses indicated that age at first alcohol use, corrected for covariates, significantly predicted the age at acute alcohol intoxication and BAC at admission. The association between age at first alcohol use and age at intoxication was also found to be clinically relevant.

Conclusions

Although causation cannot be implied based on the results of these analyses, the results of this study suggest that interventions delaying the age at first alcohol use could be successful in increasing the average age that adolescents are admitted to the hospital for acute alcohol intoxication.

     

Drinking games,tailgating, and pregaming: Precollege predictors of risky college drinking

Background: The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems. Objective: The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college. Methods: Participants (n?=?936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days. Results: Using path analysis, ICDC was significantly associated with pBAC reached during the three risky drinking practices. ICDC had an indirect effect on both pBAC and alcohol-related problems via pBAC from drinking games, pregaming, and tailgating. Hopelessness and sensation seeking were significantly related to alcohol use outcomes. Conclusion: Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms. Interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.     

Patterns of alcohol, cigarette and illicit drug use in English adolescents

Aims. The aim of this study was to describe associations between alcohol, tobacco and illicit drug use in adolescents and demographic factors associated with substance use. Design, setting, subjects. The study was a classroom survey of the total population of pupils (n=5383, ages 11-16) in six schools selected from different locations around England. Measures. Respondents were asked confidentially about their use and extent of use of alcohol, cigarettes and illegal drugs. Findings. The prevalence of regular substance use within the sample rose from 30.4% at age 11 to 83.9% at age 16. The prevalence of alcohol use did not differ between girls and boys, but smoking was more prevalent in girls and illegal drug use was more prevalent in boys. Alcohol was used more frequently than any other substance, or combination of substances, and alcohol use almost invariably accompanied the use of other substances: exclusive use of cigarettes or illegal drugs was negligible. In addition, high levels of alcohol intoxication were associated with increased use of both illegal drugs and cigarettes. Overall, around half the drinkers (46.8%) preferred alcopops to other types of alcoholic drink; this figure was greater in girls (56.4%) than in boys (37.1%), but fell sharply with age (62.9% at age 11; 37.7% at age 16), particularly in boys. Preference for spirits increased with age, and was particularly marked in girls (28.4% in girls vs. 18.5% in boys at age 16). Spirits drinkers were more likely to use cigarettes and drugs, and had been more frequently drunk, than either beer/wine or alcopops drinkers; these measures also tended to be higher in alcopop drinkers than in beer/wine drinkers, particularly among 11-13-year-old girls. Conclusion. The use of both tobacco and illicit drugs appears to be strongly associated with alcohol use, which is more prevalent, and the risk of smoking and illicit drug use is particularly high in adolescents who report high levels of drunkenness. Our results are consistent with a simple threshold model of substance abuse in which alcohol occupies a low threshold position relative to the higher threshold of cigarettes and illegal drugs. Smoking, drug use and drunkenness were lowest in beer/wine drinkers, intermediate in alcopop drinkers, and highest in spirits drinkers.     

Alcohol-Related Aggression in Males and Females: Effects of Blood Alcohol Concentration, Subjective Intoxication, Personality, and Provocation

This study tested the combined predictive ability of blood alcohol concentration (BAC), subjective intoxication, and aggressive personality traits on physical aggression in males and females in Highland Low-provocation conditions. Sixty intoxicated White social drinkers (30 males and 30 females) competed against a fictitious opponent on a modified version of the Taylor aggression paradigm in which subjects both received and delivered electric shocks to their opponents in provoking and nonprovoking conditions. Provocation conditions (High and Low) were defined by the intensity of the shocks the subjects received. Aggression was operationalized as the intensity of the shocks selected by the subjects. Results indicated that, for males in the High-provocation condition, aggressive personality traits, subjective intoxication, and BAC were effective predictors of physical aggression. However, in the Low-provocation condition, only aggressive personality traits and BAC predicted aggression. None of the variables were effective predictors of aggression for intoxicated females.     

Childhood predictors of drunkenness in late adolescence among males: a 10-year population-based follow-up study

AIMS: To study childhood precursors of drunkenness frequency among 18-year-old boys in a representative, nation-wide 10-year follow-up study. DESIGN: In 1989, a general population sample of 2,946 8-year-old boys was collected. Three different informant sources were used: parents, teachers and the boys themselves. The follow-up was 10 years later in 1999, when the boys were called up for their obligatory military service at age 18. Information about drunkenness frequency was obtained from 78.3% (n=2306) of the original sample. SETTING: Finland, nation-wide; in 1989 at schools, in 1999 at the obligatory military call-up. PARTICIPANTS: General population sample of Finnish boys born in 1981. MEASUREMENTS: At age 8, the Rutter A2 scale, Rutter B2 scale and Child Depression Inventory (CDI) were used. At age 18, self-reported drunkenness frequency during the previous 6 months was determined. FINDINGS: Of the subjects, 15.0% reported never being drunk from alcohol, 74.6% reported being occasionally drunk and 10.4% reported being drunk at least once a week during the previous 6 months. After adjusting for other variables, teacher's estimate of the child's problem behaviour at age 8 predicted frequent drunkenness in late adolescence. Hyperactive problems predicted both occasional and frequent drunkenness. Conduct problems at age 8 predicted only frequent drunkenness. High teacher-reported scores of emotional problems predicted lower occurrence of drunkenness-orientated alcohol use. CONCLUSIONS: The educational system has a potential role in detecting boys at risk of later risk-taking behaviours, such as frequent drunkenness. Early interventions in children with conduct problems and hyperactivity are called for.     

Drunkenness, a "special circumstance" in crimes of violence: sometimes.

A preliminary investigation into belief systems of the public about interactions between drunkenness and crime is reported. Fifty respondents, randomly selected, were interviewed first about their beliefs regarding the "effects of alcohol" along three dimensions--control, responsibility, and accountability. Second, they were asked to consider whether being legally drunk when committing a violent crime constitutes a "special circumstance" deserving other than the usual penalty. Three other possible contributing factors were also examined to determine their relationship to drunkenness as a "special circumstance"--premeditation, alcoholism, and recidivism. Two preliminary conclusions are suggested: (1) it appears that many members of the public still view alcohol abuse as an associated criminal offense, and (2) respondnets' beliefs about the "effects of alcohol" do not demonstrate a rational consistency as relates to penalty judgments concerning violent crimes committed by drunken individuals. This finding is, in part, consistent wtih Linsky's earlier work.     

Acute Alcohol Intoxication in Women: Relationship to Dose and Menstrual Cycle Phase

This study investigated relationships between metabolic responses to acute alcohol intoxication and phases of the female menstrual cycle among women demonstrated to have ovulated during two consecutive cycles. Subjects were administered moderate (0.66 ml/kg) and high (1.0 ml/kg) alcohol doses during the early follicular, ovulatory, and midluteal phases of the menstrual cycles. Radioimmunoassays (RIAs) of serum estradiol, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were performed from blood collected before each alcohol administration. Results showed decreased elimination times, reduced areas under the BAC-time curve (AUCs), and faster disappearance rates associated with the midluteal menstrual phase compared to the early follicular and ovulatory phases which were consistent for both moderate and high alcohol doses. Decreased elimination times, smaller AUCs, and faster disappearance rates were associated with increased levels of progesterone, elevated progesterone to estradiol ratios, and decreased FSH levels. No differences were found in absorption time or peak BAC across phases of the menstrual cycle.