The prognostic importance of blackouts in young men

In order to test the commonly held perception that blackouts are an early diagnostic sign of alcoholism, we evaluated a sample of 230 nonalcoholic young men longitudinally over an 8-12 year follow-up period. Consistent with the literature, blackouts were a common occurrence in this cohort, with 26% of the men reporting blackouts by their early twenties, and 30% of the subjects experiencing blackouts over the approximately 10-year follow-up. Alcohol-related amnestic episodes were associated with the quantity and frequency of drinking, and men with blackouts (especially four or more) were more likely to have other problems related to their heavy drinking. Although few alcoholics will report not having had such amnestic spells, blackouts are not sensitive indicators of the risk for developing alcoholism. The data suggest that blackouts should be viewed as an important warning sign of problem drinking, but not as the "hallmark" of alcoholism.