Abstract
OBJECTIVE: Young adults reporting high-intensity drinking (HID, 8+/10+ drinks for females/males) are more likely to experience negative alcohol consequences than those reporting heavy episodic drinking (HED; 4+/5+ drinks for females/males). Identifying for whom and when HID is associated with same-day negative (and positive) consequences may inform intervention approaches. We hypothesized that negative consequences would be more likely on HID vs HED days, and when HID levels were reached more quickly. METHODS: Young adults reporting prior HID (N=203, 57% female) completed a 28-day ecological momentary assessment of alcohol use and consequences. Generalized hierarchical linear modeling was used to test hypothesized effects. Analyses also explored the odds of each unique negative (e.g., hangover) and positive (e.g., improved mood) consequence. RESULTS: HID (vs HED) was related to more same-day negative consequences. In exploratory analyses, HID was associated with increased odds of being rude/obnoxious, hurting/injuring oneself, feeling too drunk, nausea, vomiting, sleeping worse, hangover, and memory loss. HID (vs HED) was also related to more same-day positive consequences. In exploratory analyses, HID was associated with increased odds of expressing feelings more easily, feeling more energetic, improved mood, being more sociable, desirable level of intoxication, laughing with others, and a fun/exciting time. Drinking duration was not significantly related to consequences on HID days. CONCLUSION: Same-day positive consequences resulting from HID may help explain why this risky behavior recurs, despite negative consequences. From a prevention and intervention perspective, healthcare providers and clinicians are strongly encouraged to prioritize alcohol interventions for young adults reporting 8-10 drinks per occasion.