Differing patterns of stress and craving across the day in moderate-heavy alcohol consumers during their typical drinking routine and an imposed period of alcohol abstinence

Background: Stress is a known factor related to alcohol use. However, how the relationship between alcohol craving and stress varies across the day is not fully understood. As craving is a consistent predictor of alcohol use disorder (AUD), understanding stress and craving patterns across the day in routine, non-dependent, moderate-heavy alcohol consumers may help in understanding those who may be vulnerable to transitioning into AUD. Method: Moderate-heavy drinkers were recruited from the local community (n = 32) and assessed for fluctuations in craving and stress intensity across the day via Ecological Momentary Assessment (EMA) during 3 consecutive days of imposed alcohol abstinence (abstained trial) and their normal drinking routine (normal trial). A multilevel modeling statistical approach assessed differences in diurnal craving and stress patterns with the Alcohol Craving Experience Questionnaire (ACE) examined as a moderator. Results: Immediately following alcohol consumption on normal trials, EMA craving levels were significantly reduced compared to pre-drinking levels. Moreover, the post-drinking craving levels were lower than on abstained trials. Higher ACE scores were associated with significantly higher EMA craving across the day and higher peaks at midday. Higher ACE scores were also associated with greater EMA stress across the day. Drinking relieved stress relative to abstained trials, but not in individuals with higher ACE scores. Higher stress was associated with greater EMA craving, which was stronger among those with higher ACE scores. Conclusion: These findings suggest that ACE scores are important to understanding patterns of stress and craving experienced across the day in routine, non-dependent, moderate-heavy drinkers and may provide new insights for vulnerability to transitioning into AUD.