'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Aims: 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. Design: Street intercept surveys (n=4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Setting: Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. Participants: 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). Measurements: 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. Findings: 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.

Prevalence and correlates of drink driving within patrons of Australian night-time entertainment precincts

BACKGROUND: Drink driving is a significant public health concern, and contributes to many road fatalities worldwide. The current study is the first to examine the prevalence and correlates of drink driving behavior in a sample of night-time entertainment precinct attendees in Australia. METHODS: Interviews were conducted with 4214 night-time entertainment precinct attendees in two metropolitan and three regional cities in Australia. Seven correlates of self-reported drink driving were examined: gender, age, occupation, blood alcohol concentration (BAC), alcohol consumed prior to attending a licensed venue, energy drink consumption, and other drug consumption. RESULTS: Fourteen percent of night-time entertainment precinct attendees reported drink driving in the past three months. Bivariate logistic regression models indicated that males were significantly more likely than females to report drink driving in the past three months. Blue-collar workers and sales/clerical/administrative workers were significantly more likely to report drink driving behavior in the past three months than white-collar workers. The likelihood of reporting drink driving during the three months prior to interview significantly increased as BAC on the current night out increased, and when patrons reported engaging in pre-drinking or other drug use. The multivariate model presented a similar pattern of results, however BAC and pre-drinking on the night of the interview were no longer independent significant predictors. CONCLUSIONS: Males, blue collar/sales/clerical/administrative workers, and illicit drug consumers were more likely to report engaging in drink driving behavior than their counterparts. Interventions should focus on addressing the considerable proportion night-time entertainment precinct attendees who report engaging in drink driving behavior.