Is Behavioral Tolerance Learned?

Is Behavioral Tolerance Learned? MURIEL VOGEL-SPROTT, PH.D. Both scientific and anecdotal evidence indicates that social drinkers can develop resistance (i.e., behavioral tolerance) to alcohol’s impairing effects over time. Although repeated exposure to alcohol is thought to explain tolerance development on a physiological level, the acquisition of behavioral tolerance appears to involve additional factors. In particular, learned associations between a drinker’s behavior following alcohol consumption and the subsequent consequences may play an important role. When favorable consequences result from displaying unimpaired (i.e., tolerant) behavior after drinking, a drinker learns to develop behavioral strategies to compensate for alcohol’s effects. In contrast, if a drinker does not receive a reward for unimpaired behavior—or finds that a more favorable outcome follows the display of intoxicated behavior—tolerance does not develop. Studies show that subjects also can develop behavioral tolerance to alcohol when they practice a task while impaired by factors other than alcohol or when they mentally rehearse task performance while under the influence of alcohol. KEY WORDS: AOD tolerance; reinforcement; AOD impairment; AODE (alcohol and other drug effects); behavior; AOD intoxication; expectancies; learning; context dynamics; literature review he term “tolerance” refers to a conditions (i.e., homeostasis). A com- exposure to alcohol, giving their bod- reduction in the intensity of the pensatory response usually is assumed ies repeated opportunities to activate Teffect of alcohol (or other to become stronger each time a person increasingly strong compensatory drugs) over the course of repeated use. uses alcohol or other drugs and to responses. In addition, alcoholics may Thus, a person developing tolerance subside gradually during a period of display remarkable resistance (i.e., to alcohol must drink greater quanti- abstinence. tolerance) to the effects of drinking ties of alcoholic beverages to produce Research on the effects of alcohol alcoholic beverages in quantities that the same effect that had been previ- on cellular and neuronal functions has would greatly impair social drinkers. ously achieved at a lower consump- provided much information on where tion level. This phenomenon may and how alcohol acts in the brain to MURIEL VOGEL-SPROTT, PH.D., is a produce its physiological effects. In reflect the acquisition of tolerance to professor in the Department of alcohol’s physiological effects (e.g., contrast, no direct causal relationship Psychology at the University of reduced body temperature) as well as has been established between any Waterloo, Waterloo, Ontario, Canada. its behavioral effects (e.g., impaired specific biological change induced by motor coordination). Researchers alcohol exposure and a particular 1Throughout this article, the term “social generally believe that the physiologi- behavioral response (e.g., Hunt 1993). drinker” refers to a person who consumes cal actions of alcohol and other drugs Nonetheless, clinical observations alcohol but does not experience any alcohol- contribute to tolerance by triggering suggest that tolerance plays an impor- related problems and is not alcohol dependent. the body to produce opposite physio- tant role in alcohol abuse and addic- The terms “alcoholic” and “alcohol abuse” as used in this article encompass all levels of logical reactions in an effort to com- tion. For example, compared with problem alcohol use and do not refer to a pensate and restore stable internal social drinkers,1 alcoholics have more particular diagnostic system. VOL. 21, NO. 2, 1997 161 These observations accord with the fully account for the development of MacNish’s notion that circum- notion that apparent sobriety after behavioral tolerance in social stances following drinking can affect drinking or an “ability to handle one’s drinkers. Thus, the question remains: behavioral tolerance has been liquor” (i.e., exhibit tolerance to alco- What additional factors in drinking advanced during the 20th century as hol’s behavioral effects) may be a situations affect the acquisition of well. Goldberg (1943) speculated that useful pathological diagnostic symp- tolerance to alcohol’s behavioral ef- “psychic compensation” contributed tom (American Psychiatric Assoc- fects among social drinkers? to the tolerance displayed by alco- iation 1994). This article focuses on an intrigu- holics. A few decades later, Dews The transition from social to abusive ing potential factor currently undergo- (1962) proposed that drinkers’ toler- drinking often occurs gradually over ing investigation in behavioral ance might result from new learned years of drinking sessions, however, neuroscience research—the idea that behavior that compensates for alco- and only in some drinkers. This finding environmental events associated with hol’s impairing effects. In addition, suggests that the acquisition of behav- a drinker’s behavior following alcohol MacAndrew and Edgerton (1969) ioral tolerance to alcohol in social consumption (e.g., positive or nega- noted that drinking orgies in aborigi- drinkers results from factors in addition tive consequences) play a role in de- nal cultures resulted in gross intoxica- to the extent of alcohol exposure. termining whether the drinker will tion in some societies but tolerance in One research-supported explana- develop behavioral tolerance (see box, others; they attributed this variance to tion involves environmental events p. 167). This research has been guided learned conformity to different cultur- that predict drug administration. by the theory that environmental ally specific standards of behavior Investigators have found that the events known to affect the learning of under alcohol. expectation of receiving a drug can new behavior likewise will influence Anecdotes about grossly inebriated affect tolerance. For example, studies behavioral tolerance to alcohol.2 This drinkers who become sober when they have shown that animals made toler- article first presents some historical believe it is important to do so also ant to a drug through repeated admin- background for theories on the devel- suggest that events after drinking istrations in a distinctive setting opment of behavioral tolerance, then alcohol can affect tolerance. This subsequently will display greater reviews contemporary findings and ability of drinkers to “sober up” ap- tolerance when the drug is adminis- their implications. (For a more de- parently provided the impetus for tered in this same setting as opposed tailed discussion of this work, see introducing the breathalyzer to mea- to a new one (see, for example, Siegel Vogel-Sprott 1992.) sure blood alcohol concentration 1989). Researchers have interpreted (BAC) levels for forensic purposes. these results in terms of associative Before the breathalyzer was available, HISTORICAL BACKGROUND learning: When distinctive events a medical examination of suspected reliably precede drug administration, Although the view that tolerance intoxicated drivers was required to they serve as a signal that provides a stems from alcohol-induced compen- support the charge. Goldberg and basis for expecting the drug. When satory reactions is prevalent in the Havard (1968) reported that these tolerance is established, this expecta- scientific literature, other possibilities clinical assessments were completely tion results in anticipatory compen- have received attention. The idea that unreliable. They noted that suspects satory reactions to reduce the drug’s environmental events following alco- faced with a doctor called in by the effect. Consequently, “tolerance is hol consumption contribute to toler- police often were capable of “pulling maximally displayed following ‘ex- ance development has roots in the themselves together” to pass all the pected’ drug administration but not 19th century, when opinion held that clinical tests. After the suspect satis- following ‘unexpected’ drug adminis- tolerance was largely under volitional fied the police physician and was free tration” (Siegel 1989, p. 116). control. For example, more than 100 to leave, however, signs of intoxica- People likely acquire tolerance to years ago, MacNish penned the fol- alcohol’s behavioral effects in drink- lowing observation: 2This article presents evidence that learning ing situations where reliable cues, plays a crucial role in the acquisition and The mind exercises a consider- display of behavioral tolerance to alcohol in such as liquor bottles, signal alcohol able effect upon drunkenness, and drinkers who have no alcohol-related prob- availability. Research indicates that may control it powerfully. When lems. For drinkers who have become physical- when alcohol is expected and in the company of a superior ly dependent on alcohol, however, the story received, however, a social drinker whom we respect, or of a woman may differ. Research cited in this article still leaves open the possibility that the behavioral may demonstrate behavioral tolerance in whose presence it would be tolerance of alcohol-dependent drinkers while performing one task but not indelicate to get intoxicated, a involves some alcohol-induced biological another (see, for example, Vogel- much greater portion of liquor changes. In other words, the processes initiat- Sprott 1979). Alcohol expectations may be withstood than in soci- ing behavioral tolerance to alcohol may be entirely different from those sustaining toler- arising from events that precede eties

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