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BLACKOUTS FROM ALCOHOL

Best to remember this

by Rowan Hooper

A couple of years ago the British artist Damien Hirst explained why he now lays off alcohol: “Blackouts. I used never to get blackouts. . . . I was walking around in the morning, and they’d be going, ‘You did this.’ Did I? I couldn’t even remember the violence.”

After drinking, memories often conflict with reality, even if not usually as extremely as with Hirst. For most of us, after an evening when alcohol was present and abundant, our recall of events may not tally with that of someone who didn’t drink. And if large amounts of alcohol have been consumed, there may be complete memory loss.

The first type, partial memory loss, is known as a fragmentary blackout. Complete loss of memory after heavy drinking is known as an en bloc blackout.

Now researchers have shown what many drinkers might have suspected all along. People who experience fragmentary blackouts are more likely to misremember drinking experiences. In other words, they fill in the blanks with happy memories. You know the kind of thing: you remember that you were charming, witty, dashing, vivacious; in fact you were a drooling incomprehensible wreck.

Blackouts, even en bloc, are not necessarily a sign of alcoholism, though they are generally regarded as a warning sign of problem drinking. (If you regularly wake up in a police cell with no idea how you got there then you can confidently acknowledge that you might have a problem.) But what the new research, published in the April issue of Alcoholism: Clinical & Experimental Research, has found, is that heavy drinkers who experience fragmentary blackouts both misremember drinking experiences and simultaneously report strong positive expectations about future alcohol consumption. Consequently, blackouts can exacerbate problem drinking, say the researchers.

“There are two types of blackouts,” said Kim Fromme, associate professor of psychology at the University of Texas at Austin and corresponding author for the study. ” ‘En bloc blackouts’ involve complete memory loss for all events occurring within a particular time interval during intoxication. ‘Fragmentary blackouts (FBs)’ also involve the failure to recall aspects of drinking events; however, these may reflect just portions, or fragments, of experience for which memory is impaired. Another key distinction between the two types of blackouts is that people can use cues or reminders to help access and recall the content of an FB, whereas the content of an en bloc blackout can never be recovered, regardless of the presence of cues or reminders.”

Fromme and colleagues looked at the drinking habits of 108 college students (55 males, 53 females) aged between 21 and 30. To qualify for the study, the students had to report episodes of weekly “binge drinking.” Binge drinking means five or more consecutive drinks for males, four or more for females (on such classification it seems most journalists, most students and certainly many salarymen in Japan are regular binge drinkers).

The student sample was evenly distributed into those who had had FBs in the previous year and those who had not; The sample was further divided into those who consumed three alcoholic beverages for the study (the volume of which was standardized according to gender and body weight), and those who consumed three alcohol-tasting placebo beverages. Memory formation was assessed before and after beverage consumption. Alcohol expectancies were also assessed. In other words, the subjects were asked what they believed was a bad sign of drinking — vomiting or having a memory blackout.

“In the absence of alcohol, the memory ability of those who report FBs does not appear to be any different from those who do not experience these phenomena,” said Fromme. “Yet when they drink alcohol, people who experience FBs show poorer memory performance both during intoxication and after detoxification when compared to those who have not experienced blackouts. Alcohol therefore affects the memory of some individuals differently than others.”

It is this difference, found in those who experience FBs, that might lead to worsening drinking problems.

“Although common among college-student drinkers, blackouts represent one marker that may improve our ability to identify those at risk of developing alcohol problems,” said William Corbin from the department of psychology at Yale University. “Many college students believe that they are at decreased risk when they begin to experience blackouts and eventually ‘pass out’ rather than vomit after drinking heavily. In fact, they are at higher risk because drinking to the blood alcohol level necessary for a blackout leads to increased tolerance to alcohol’s effects. ‘Increased tolerance’ is among the diagnostic criteria for alcohol dependence. Thus, blackouts should not be ignored as a prognostic sign.”

“Our results clarify how alcohol can adversely affect the memory of some individuals differently than others,” said Fromme. “Though the more extreme en bloc blackout has been studied and theorized about for several decades, our study sheds light on how a less extreme and much more common type of memory impairment after drinking may contribute to distorted beliefs about alcohol and ultimately to future negative drinking consequences.”

The disturbing conclusion is that we can’t simply laugh off those times when we can’t recall exactly what happened when we were out drinking. Or, if we do laugh them off, at least remember that some of those who have done that in the past ended up blue in someone’s bathroom.

Keith Richards said that turning blue in someone else’s bathroom was the height of bad manners. But that was easy for him to say: Most people who hung out with Keef are now dead.