Premenstrual symptomatology, alcohol consumption, and family history of alcoholism in women with premenstrual syndrome

OBJECTIVE: The purpose of this study was to examine the relationship among family history of alcoholism (FH), premenstrual syndrome (PMS) symptoms, and alcohol consumption in women with a PMS diagnosis. METHOD: Participants (N = 46) were predominantly white (73%) women, of whom 17 (37%) reported multigenerational alcoholism on the paternal side (FH positive [FH+]) using the Family Alcohol and Drug Survey. Subjects recorded alcohol consumption and PMS symptoms using a daily record form for 3 consecutive months. RESULTS: Demographics and alcohol consumption during the follicular phase (FOL) and premenstrual phase (PREM) of the menstrual cycle did not differ by FH; however, change in drinking from FOL to PREM was greater in FH+ (mean change = 2.78 drinks/week) versus FH negative (FH-; mean change = -0.72 drinks/week) women. During PREM, FH- women reported more PMS symptomatology compared with FH+ women, and alcohol consumption during PREM was positively correlated with ratings of bloating, craving for alcohol, craving for food, and low energy in FH- but not FH+ women. CONCLUSIONS: Although FH+ women increased their drinking premenstrually, such use was unrelated to PMS symptom severity.     

Beyond the "Binge" threshold: heavy drinking patterns and their association with alcohol involvement indices in college students

Despite its ubiquity, the term "Binge" drinking has been controversial. Among other things, the grouping of drinkers into a single risk category based on a relatively low threshold may not capture adequately the nature of problem drinking behaviors. The present study is an initial examination of the utility of delineating heavy drinkers into three groups; those who typically drink below the traditional "Binge" cutoff (less than 4+/5+ drinks per occasion for women/men), those who met traditional "Binge" drinking criteria, and a higher "Binge" cutoff of 6+/7+ (women, men). We examined differences in drunkenness, drinking frequency, and unique types of alcohol problems. Participants (N=356; 184 women) were regularly drinking college students at a mid-sized U.S. university who completed a battery of self-report measures including a calendar of daily alcohol consumption, and the 8-domain Young Adult Alcohol Consequences Questionnaire (YAACQ). Estimated Blood Alcohol Levels (eBALs) were calculated. We found that the standard 4+/5+ drink "Binge" cutoff distinguishes drinkers across some but not all indices of alcohol involvement. "Binge" drinkers differed from their "Non-Binge" counterparts on eBAL, but for other indicators (drinking frequency, total alcohol consequences), only "Heavy Binge" drinkers differed significantly from "Non-Binge" drinkers. Importantly, "Heavy Binge" drinkers experienced higher levels of those specific consequences associated with more problematic alcohol involvement. Findings suggest that not all "Binge" drinkers drink alike, are equally drunk, or experience similar consequences. As such, there may be utility in distinguishing among heavy drinkers, in order to focus appropriately on those at greatest risk for different types of consequences.     

Gender,history of alcohol use and number of drinks consumed predict craving among drinkers in a field setting

To the extent that craving serves to compel excessive drinking, it would be important to predict the intensity of an individual's craving over the course of a drinking episode. Previous research indicates that regular alcohol use (measured by the AUDIT) and the number of drinks individuals have already consumed that evening independently predict craving to drink (Schoenmakers & Wiers, 2010). The current study aims to replicate those findings by testing whether these same variables predict craving to drink in a sample of 1320 bar patrons in a naturalistic setting. In addition, we extend those findings by testing whether regular alcohol use and self-reported number of drinks consumed interact to predict craving, and whether gender independently predicts craving or interacts with other variables to predict craving. Results indicate that for men, AUDIT score alone predicted craving, whereas for women, AUDIT score and number of drinks consumed interacted to predict craving, with craving highest among women with either high AUDIT scores or relatively high consumption levels. Our findings have implications for targeted intervention and prevention efforts, as women who have a history of harmful alcohol use and consume several drinks in an evening might be at the greatest risk for continued alcohol consumption.     

Alcohol craving predicts drinking during treatment: an analysis of three assessment instruments

OBJECTIVE: The purpose of this investigation was to examine the utility of thee craving instruments to predict drinking during treatment. The three assessments used were the Penn Alcohol Craving Scale (PACS), the Alcohol Urge Questionnaire (AUQ) and Items 1-6 of the Obsessive subscale (OBS) of the Obsessive Compulsive Drinking Scale (OCDS). METHOD: The three instruments were administered during the course of a 9-month, double-blind, placebo-controlled trial of 100 mg/day of naltrexone, and a manual-based psychosocial intervention using the BRENDA manual conducted at the University of Pennsylvania's Treatment Research Center. Participants (133 men and 50 women at the initiation of the study) used these instruments to self-report craving on a weekly or biweekly basis. The weekly number of drinks was reported using the Timeline Followback interview. The data were analyzed with generalized estimating equations using craving scores at 1 week as the independent variable and number of drinks in the subsequent treatment week as the dependent variable. RESULTS: Each of the three scales predicted drinking during the subsequent treatment week. The PACS was the strongest predictor followed closely by the OBS and then the AUQ. Most important, craving as measured by the three scales was a stronger predictor of subsequent drinking than was drinking during the prior treatment week. CONCLUSIONS: Craving assessment provides a useful means of predicting drinking during treatment. Such information would be helpful in designing clinical trials and for many treatment modalities.     

Measurement of alcohol craving

Despite considerable research activity and application in treatment, the construct of craving remains poorly understood. We propose that cravings and urges are cognitive–emotional events in time, characterised by frequency, duration, intensity and salience. Commonly used measures of alcohol craving are reviewed, and their strengths and weaknesses identified. Most measures confound craving with behaviours, or with separable cognitive phenomena such as expectancies, intentions, or perceived behavioural control. These confounds have limited our advances in understanding the determinants and consequences of craving. Based on the criteria applied in this review, among the better performing multi-item measures are the Penn Alcohol Craving Scale and Obsessive subscale of the Obsessive–Compulsive Drinking Scale. Optimal assessment strategies are likely to involve daily assessments of peak intensity of cravings, desires or urges and of the frequency and duration of craving episodes. Of particular interest are measures of intensity at times when individuals are at risk of drinking or of other functional impacts from craving.     

Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: results from the 2000 National Alcohol Survey

OBJECTIVE: Few population-based studies have explored differences in alcohol consumption by sexual orientation. This study examined the prevalence of abstinence, drinking, heavier drinking, alcohol-related problems, alcohol dependence and help-seeking among homosexual and bisexual women and men compared with heterosexuals. METHOD: Data are from the 2000 National Alcohol Survey, a national population-based survey of adults (N = 7,612), a Random Digit Dialing telephone survey of all 50 states of the United States and Washington, DC. Four categories of sexual orientation were created using questions on both sexual orientation self-identification and behavior: homosexual identified, bisexual identified, heterosexual identified with same sex partners and exclusively heterosexual. Five alcohol measures (past year) were used in the analyses: (1) mean number of drinks, (2) days consuming five or more drinks on a single occasion, (3) drunkenness, (4) negative social consequences (2 or more) and (5) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol dependence. A lifetime measure of help-seeking for an alcohol problem was also analyzed. RESULTS: Few significant differences were found among men by sexual orientation. By contrast, both lesbians and bisexual women had lower abstention rates and significantly greater odds of reporting alcohol-related social consequences, alcohol dependence and past help-seeking for an alcohol problem. CONCLUSIONS: These findings suggest that alcohol dependence and alcohol-related consequences differ by sexual orientation, particularly among women. These findings also emphasize the need for the inclusion of sexual-orientation items in population-based surveys so that prevalence rates within these subgroups can be effectively monitored.     

Alcohol Use,Drug Use,and Sexual Activity among Pharmacy Students at Three Institutions

ObjectiveTo determine alcohol and drug use and sexual activity among pharmacy students at three colleges of pharmacy.Design and SettingA survey to obtain self-reported information on alcohol and drug use, and sexual activity was administered to professional pharmacy students at the University of Iowa (UI), Massachusetts College of Pharmacy, and Texas Southern University.Main Outcome MeasuresInformation on sexual activity and condom use, alcohol and drug consumption, and the effect of alcohol on unintended sexual activity.Results848 students (50% response rate) completed the survey. Alcohol use was high at all three institutions, and most students had consumed five or more drinks on one or more occasions within the last three months. The extent of drug use among pharmacy students was similar to that reported in other college students. The majority of students were sexually active. More men than women reported having been sexually active with one or more partners. Most students reported having had sexual intercourse without a condom. Significant numbers of students had engaged in unintended sex after alcohol use, especially at UI (χ² = 12.6, p = 0.002). Sexual contact and drinking were strongly correlated (Pearson r = 0.31, p = 0.0001).ConclusionAlcohol consumption among pharmacy students was high. Heavy drinking (five or more drinks on one occasion) was associated with unintended sexual contact. Given low condom use and increased sexual contact, pharmacy students are at an increased risk for HIV infection. Strategies should be developed to reduce alcohol intake and unprotected sexual activity among pharmacy students.     

Mindfulness buffers the effects of cue-induced craving on alcohol demand in college drinkers

Alcohol consumption among young adult college students represents a significant public health problem. The presence of alcohol-related cues in drinkers' environments can trigger powerful alcohol cravings, which may influence drinking outcomes. Less is known about how this cue-induced craving influences behavioral economic demand for alcohol. In addition, research has suggested that trait mindfulness may be an important buffer of the effects of internal states of craving on drinking decisions. Based on this literature, we hypothesized that cue-induced cravings would be associated with increased alcohol demand, an effect that would be attenuated among drinkers who have higher levels of mindfulness. Young adult college student drinkers (n = 69) completed a laboratory-based cue-induced craving assessment, a self-report assessment of trait mindfulness, and an alcohol purchase task. Findings revealed that cue-induced craving was related to higher alcohol demand. Consistent with the study hypothesis, acceptance, a component of mindfulness, buffered the effects of cue-induced craving on alcohol demand. Results raise the possibility that mindfulness-based interventions may be useful in helping disrupt the link between internal states of craving and drinking decisions in young adult college student drinkers.     

Drinking restraint versus alcohol expectancies: which is the better indicator of alcohol problems?

OBJECTIVE: The relationship between expectancies and other psychological constructs related to drinking is unclear. The current study assesses the power of drinking restraint, measured by the Temptation and Restraint Inventory (TRI), along with alcohol expectancy and drinking refusal self-efficacy, measured by the Drinking Expectancy Profile (DEP), as indicators of alcohol use and problem drinking. METHOD: Volunteer students (N = 359), consisting of 113 men with a mean (+/-SD) age of 25.31 +/- 10.61 years and 246 women with a mean age of 23.04 +/- 8.90, completed the TRI, DEP and Alcohol Dependence Scale (ADS) as well as frequency and quantity measures of self-reported drinking. RESULTS: Drinking Restraint was a stronger indicator of higher scores on the ADS, accounting for 54% and 45% of the variance for men and women, respectively, with Alcohol Expectancies and Drinking Refusal Self-Efficacy being the better indicator of frequency of alcohol consumption, accounting for 20% of the variance for men and 26% for women. Both measures were represented by similar variances within the quantity of drinking measure. CONCLUSIONS: Drinking restraint and alcohol expectancies were seen to measure kindred but unique cognitive subsets, providing further insight into the progression of alcohol problems. Alcohol expectancies and drinking refusal self-efficacy may be acquired early in the development of drinking behavior, as evidenced by stronger associations with risky drinking; drinking restraint and its associated loss of control factors appear to be more specifically related to problem drinking. Alcohol expectancy and drinking refusal self-efficacy may thus have broader use in the assessment of drinking behavior.     

Gender, alcohol consumption, and differing alcohol expectancy dimensions in college drinkers

Examinations of gender differences in alcohol expectancies among college drinkers typically have used self-report measures to assess single expectancy dimensions and often have been confounded by drinking level. This study examined gender differences in alcohol expectancies using 2 assessment methods. College students (N = 88) completed self-report questionnaires, including expectancy likelihood and subjective evaluation endorsements of expectancies, and a computerized expectancy accessibility task. Expectancy accessibility and endorsement were modestly correlated, with higher alcohol consumption and female gender linked to greater accessibility and endorsement of social enhancement expectancies. Gender moderated the relation between consumption and sociability expectancy accessibility; among men, heavier drinking was associated with more rapid activation of expectancies. Findings suggest complexity in associations among these variables and underscore the need to capture the multidimensionality of the expectancy construct and its relationship to alcohol use.     

Relating alcohol use and mood: results from the Tromsø study

OBJECTIVE: The interrelationships between alcohol consumption and depressed mood were studied in a population to determine if the relationships differed by sex and consumption. METHOD: Alcohol consumption and mood were surveyed at a 7-year interval by self-report (N = 8,260; 4,407 women). Frequency of intoxication was used to divide the sample into moderate and immoderate drinkers. Structural equations modeling was then applied to describe the interrelationships of drinking and mood both cross-sectionally and over time. RESULTS: Overall, self-reported drinking was stable over a 7-year period, although drinking patterns were less stable for immoderate drinkers. Drinking predicted higher levels of depressed mood among the immoderate drinkers of both sexes at follow-up. Drinking also weakly predicted depressed mood among moderately consuming men. However, among moderately consuming women dysphoric mood predicted less drinking. Depressed mood was related to higher levels of concurrent drinking among the immoderately drinking men. Among immoderately drinking women, however, concurrent depressed mood predicted more drinking. CONCLUSIONS: Generally, drinking predicted subsequent depressed mood although this pattern was reversed among moderately drinking women. Furthermore, a synchronous effects model indicated that some immoderately drinking women used alcohol as a response to emotional distress. It appears that gender and the level of consumption need to be taken into account in studies relating mood and drinking.     

Differential response to alcohol in light and moderate female social drinkers

Individuals who are moderate drinkers are at increased risk to abuse alcohol. Moreover, women are more vulnerable than men to the adverse consequences of alcohol consumption and recent data indicate that the drinking pattern in women is becoming more similar to that of men. However, few studies have determined whether female moderate drinkers (MD) show a differential response to the subjective and performance effects of alcohol, compared to female light drinkers (LD). Fifteen female MD who consumed an average of 34.7 drinks/month were compared to 15 female LD who consumed an average of 6.7 drinks/month. None of the participants had a first-degree family history of alcoholism or substance abuse. The acute effects of alcohol (0, 0.25, 0.50, 0.75 mg/kg) were evaluated using a double-blind, placebo-controlled outpatient design. Drug effects were assessed using a full range of performance measures, subjective-effects questionnaires and observer ratings. Alcohol impaired performance in a dose-related manner on all performance tasks for both groups of females. However, MD were less impaired than LD on balance and Digit Symbol Substitution Test (DSST). This reduced response was also evident from the observer ratings, with MD being viewed as less impaired by alcohol than LD. While ratings of Drug Liking increased in both groups of women on the ascending limb of the breath alcohol curve, alcohol was disliked by LD on the descending limb and LD reported increased ratings of Bad Drug Effects following the high dose of alcohol. The reduced performance impairment, coupled with the positive subjective effects and relative absence of adverse subjective effects, suggestive of behavioral tolerance, could result in a progression towards increased alcohol consumption among moderate female social drinkers.     

Impairments in daily functioning after heavy and extreme episodic drinking in university students

Introduction and Aim. Excessive consumption of alcohol is a major public health issue in university students. The dangers of heavy drinking are well known, with both acute and long‐term consequences; however, there is limited information on patterns of extreme drinking (twice over the recommended threshold for low‐risk drinking), and the differential effects of heavy versus extreme drinking on immediate consequent functioning in daily life. The current study investigated drinking patterns in a sample of university students and the association of different levels of alcohol consumption with self‐reported physical, cognitive and emotional function the day after the drinking episode. Design and Methods. Data for this study were collected from a sample of 281 University of Otago students using a 21 day Internet‐based daily diary. Participants reported on their drinking the previous night and their physical, cognitive and emotional functioning on that day. Results. Participants reported drinking on 26.8% days overall and consuming an average of 7.2 standard drinks per occasion. Only heavy drinking (7+standard drinks for men, 5+standard drinks for women) and particularly extreme drinking (14+for men, 10+for women) predicted significant decreases in physical and cognitive functioning the next day. However, low‐risk drinking (≤ 6 drinks for men,≤ 4 for women) was not associated with next‐day impairment. Discussion and Conclusions. Findings suggest that there are adverse, intermediate consequences of excessive drinking on dimensions relevant to students' lives. Drinking within low‐risk guidelines is recommended.[Polak MA, Conner TS. Impairments in daily functioning after heavy and extreme episodic drinking in university students. Drug Alcohol Rev 2012;31:763–769]     

Epidemiological trends in drinking by age and gender: providing normative feedback to adults

OBJECTIVE: The purpose of this research was to evaluate drinking rates as a function of age and gender and to disseminate current estimates of U.S. population drinking norms based on age and gender. METHODS: Participants included 42,706 men and women 18 years and older who provided information about their drinking from the National Epidemiologic Survey on Alcohol and Related Conditions [National Alcohol Survey on Alcohol and Related Conditions (NESARC, 2001) dataset collected between 2001 and 2002 from a representative, non-institutionalized sample. RESULTS: Results revealed greater frequency and typical quantity of alcohol consumption among men versus women. Age differences in drinking frequency suggests a sharp increase with legal drinking age followed by a period of reduced frequency, in turn followed by gradual increase up to retirement age. Age differences in typical drinking quantity suggest a sharp increase with legal drinking age followed by a gradual linear decline in number of drinks per occasion. Age differences in typical quantity were more pronounced among men. CONCLUSIONS: Analyses provide epidemiological trends in drinking rates by age and gender, and emphasize the importance of within group differences when examining drinking rates. Discussion focuses on explaining how to incorporate norms information in prevention and treatment.     

A European union concerted action: Alcohol consumption and alcohol problems among women in European countries

Traditionally, less research has been conducted on women's drinking as compared to men's. But women's drinking has been shown to differ from men's in terms of consumption patterns and in factors determining heavy and problematic drinking. Thus, special efforts are needed to increase knowledge in this field. This article introduces a set of papers from the recently completed concerted action project “Alcohol Consumption and Alcohol Problems among Women in European Countries, “ supported by the European Commission. The aim of the study was to examine and compare the drinking patterns and problems of women in 9 European countries. This was done by comparing alcohol consumption and alcohol problem rates within and between countries and between men and women and among women. The project also developed recommendations for much needed standardized measures of alcohol consumption and alcohol problems for use in European alcohol epidemiological research.     

Situational determinants of alcohol abuse among Caucasian and African-American college students

The present study examined gender, race, and binge status differences in alcohol consumption among Caucasian and African-American college students as well as situational differences as qualified by the race of binge drinkers. A confidential questionnaire was voluntarily completed by Caucasians (n = 102) and African-Americans (n = 81) at a medium-sized regional university. The data analysis revealed a significant gender effect on alcohol consumption, with men consuming more alcohol than women. There was no significant main effect of race on alcohol consumption. In addition, Caucasian binge drinkers had significantly higher interpersonal problem behavior scores than did binge-drinking African-Americans, and binge-drinking African-Americans had higher intrapersonal problem behavior scores than did binge-drinking Caucasians.     

Depression and heavy drinking occasions: a cross-sectional general population study

The purpose of this study was to assess the association between depression and heavy drinking occasions in the Finnish general population. A subsample (2086/4020, response rate 51.9%) of the National FINRISK 2007 Study was used. Depression was assessed with a modified Beck Depression Inventory (short form) and alcohol problems with the Alcohol Use Disorders Identification Test. Total alcohol intake and number of heavy drinking occasions (≥7 drinks for men, ≥5 drinks for women) were evaluated using the Timeline Followback. Of the sample, 13.0% (123/946) of men and 17.4% (198/1140) of women were classified as being depressed. Further, 7.5% (71/946) of men and 3.5% (40/1140) of women reported having at least four heavy drinking occasions in the previous 28days. In an adjusted logistic regression model, these men had a 2.6-fold risk (95% C.I. 1.2-5.3) of depression, as compared to men with less than four heavy drinking occasions. The association was found irrespective of total alcohol consumption and alcohol problems. This association was not found in women.     

The validity of an Australian modification of the AUDIT questionnaire

The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. \[Degenhardt LJ, Conigrave KM, Wutzke SE, Saunders JB. The validity of an Australian modification of the AUDIT questionnaire. Drug Alcohol Rev 2001;20:143-154]     

Tobacco chippers show robust increases in smoking urge after alcohol consumption

Objective and rationale Heavy social drinkers often engage in occasional cigarette smoking, especially in the context of consuming large quantities of alcohol. The current study assessed alcohol’s effects on smoking urge as a function of alcohol dose and time course in tobacco chippers with heavy social drinking patterns. Method The study assessed 39 chippers who underwent three separate evening sessions. Each subject received a placebo (1% volume alcohol as a taste mask), a low alcohol dose (two to three drinks equivalent), and a high alcohol dose (four to five drinks equivalent) in random order. No smoking was permitted during the sessions and the participants were abstinent from smoking for at least 3 h before arrival. Throughout the session, cigarette craving was assessed by the Brief Questionnaire of Smoking Urges and alcohol response was assessed by the Biphasic Alcohol Effects Scale (BAES). Results The results showed that alcohol significantly increased cigarette craving in a dose-dependent manner (p<0.001). At the high alcohol dose, craving was heightened during the rising portion of the blood alcohol curve (BAC). There was a strong relationship between BAC and craving for positive reinforcement and this relationship was partially mediated by BAES stimulation, but not sedation. Conclusions The findings show that alcohol directly increases smoking urge in chipper smokers. Tobacco chippers may crave cigarettes more during heavier than during lighter drinking bouts, and this effect appears to be driven by heightened stimulation levels rather than as a means to offset alcohol’s sedative effects.     

Gender comparison of alcohol exposure on drinking occasions

OBJECTIVE: This study was designed to assess the influence of gender, age, drinking style and other selected demographic variables on the rate of alcohol beverage consumption on drinking days. The data were used to predict possible differences in ethanol exposure levels (peak blood alcohol concentration [BAC]) among the subgroups examined. METHOD: A representative sample (N = 2,627) of the U.S. adult population was surveyed using computer-assisted telephone interviewing to assess alcohol use (past 12 months) in quantity, frequency and type of beverage, as well as the time (minutes) usually required to consume the typical quantity of alcohol on drinking days. RESULTS: Of the 1,833 current drinkers (1,028 men, 805 women), women reported consuming a mean of 2.2 standard drinks (1 drink = 12 g ethanol) on typical drinking occasions (days); men reported consuming a mean of 3.2. The duration of the drinking episode was similar for women (122 minutes) and men (126 minutes). The hourly rate of drink consumption was thus lower for women (approximately 1.1 drinks/hour) than for men (approximately 1.6 drinks/hour). For both men and women, there was an age-related increase in the frequency of drinking but a decrease with age in predicted peak BACs and in the alcohol intake per drinking episode. Peak BACs achieved during typical drinking episodes were estimated to be quite similar for men (0.037) and for women (0.036) when prediction equations were based on equal rates of alcohol elimination in both genders. The estimated peak BACs were lower in women than in men when the prediction equation assumed a higher rate of ethanol elimination in women. CONCLUSIONS: Information on the rate of alcohol beverage consumption on drinking days facilitates prediction of BACs typically experienced in men and women of different demographic group memberships. The exposure values obtained will depend upon as yet unsettled norms for ethanol elimination rates in men and women.