Is the deliberate self-induction of alcohol tolerance associated with negative alcohol outcomes?

Research indicates 10% of college student drinkers report deliberately training to increase alcohol tolerance (a diagnostic criterion for alcohol use disorder) to avoid passing out early or to keep up with peers. Given that tolerance training may be considered a harm reduction technique designed to reduce acute aversive consequences, we examined the associations between tolerance training and the use of protective behavioral strategies (PBS) more generally. A cross-sectional survey of 1080 lifetime drinkers was conducted at a large Midwestern university. Of this sample, 5.6% (n=60) reported training to increase their tolerance. Drinkers who endorsed having trained to increase tolerance reported notably more alcohol-related problems than those who reported never training (M=51.80 versus M=39.30; p<0.0001). Further, participants who endorsed tolerance training reported utilizing significantly fewer PBS (e.g., avoid drinking games) on the Protective Behavioral Strategies Scale (PBSS, Martens et al., 2005) than participants who had never trained (M=16.89 versus M=18.90; p<0.01). An exception was that drinkers who trained to avoid passing out early used significantly more PBS (e.g., using a designated driver, knowing where your drink is at all times). Despite this, these trainers consumed more alcohol and experienced more alcohol-related harms. The present findings support previous research demonstrating that trainers consume more alcohol than non-trainers, and provide further evidence that deliberately training to increase tolerance is indicative of problematic drinking behavior. Prevention efforts might aim to inform drinkers of the problems associated with deliberately inducing alcohol tolerance, and focus on developing alternative strategies for minimizing acute harm from drinking.