title: 'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy.
abstract: OBJECTIVE
  We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol.
  
  
  METHODS
  Street intercept surveys (n = 4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months.
  
  
  METHODS
  Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities.
  
  
  METHODS
  The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72).
  
  
  METHODS
  Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use.
  
  
  RESULTS
  Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P = 0.004) and energy drink consumers (0.074%; P < 0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P < 0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P < 0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P = 0.198; energy drinks P = 0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours.
  
  
  CONCLUSIONS
  While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.
authors.affiliation: Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne and Centre for Alcohol Policy Research, Turning Point, Eastern Health, Melbourne, Vic, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Pennay
authors.forename: Peter
authors.initials: P
authors.lastname: Miller
authors.forename: Lucy
authors.initials: L
authors.lastname: Busija
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jenkinson
authors.forename: Nicolas
authors.initials: N
authors.lastname: Droste
authors.forename: Brendan
authors.initials: B
authors.lastname: Quinn
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Jones
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D001315:Australia / Q000453:epidemiology; D000697:Central Nervous System Stimulants; D061215:Energy Drinks / Q000706:statistics & numerical data*; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D000431:Ethanol
keywords: Alcohol; blood alcohol concentration; energy drinks; intoxication; licensed venues; night-time economy; pre-drinking; stimulants