Alternative substance paradigm: effectiveness of beverage blinding and effects on acute alcohol responses

A fundamental goal of double-blind alcohol challenge studies is to reduce alcohol expectancies, though there is little research on the effectiveness of blinding procedures and their relationship to acute alcohol responses. This study examined social drinkers' perception of beverage content and related alcohol response during 3 separate double-blind experimental sessions with placebo, low-dose alcohol (0.4 g/kg), and high-dose alcohol (0.8 g/kg). Using the alternative substance paradigm, participants (N = 182) were informed that the beverage they consumed might contain alcohol, a stimulant, a sedative, or a placebo. At several time points, subjective and objective measures were obtained, and participants were asked to identify which substance they received. During both placebo and low-dose alcohol sessions, 33% and 50% of participants, respectively, did not correctly identify the beverage content; during the high-dose alcohol session, 20% did not correctly identify the beverage. Although correct and incorrect identifiers at any dose level did not differ on major background variables, drinking characteristics, or psychomotor performance during these sessions, they did differ on self-reported subjective responses, with greater sedation reported by incorrect identifiers in the placebo and high-dose conditions. In summary, results suggest that the alternative substance paradigm may be a viable option for alcohol laboratory studies, particularly for repeated sessions in within-subject designs and in cases in which the experimenter wants to reduce expectancy by not revealing a priori that alcohol is being administered.