Can a wearable prevent harmful alcohol-related consequences?

A noninvasive biometric sensor can detect alcohol concentration from imperceptible amounts of sweat on the skin and be useful in the prevention of alcohol-related harm.

In a study, all five measures obtained with a transdermal alcohol concentration (TAC) sensor—area under the curve (AUC), peak TAC, rise rate (rate of absorption), fall rate (rate of elimination), and duration of concentration—correlated with self-reported number of drinks consumed.

Higher levels of intoxication (higher peaks), greater cumulative biological alcohol exposure (larger AUCs), faster intoxication (larger rise rates), and gradual alcohol elimination (slower fall rates) were significantly predictive of day-level alcohol-related consequences. [Alcohol Clin Exp Res 2022;46:100-113]

The data were obtained from 222 young adults (mean age 22.3 years, 64 percent female) who were heavy drinkers. They were asked to participate in a 5-day study that involved wearing the sensor around the ankle during sleep and wake hours, as well as completing an ecological momentary assessment (EMA) of alcohol consumption on a mobile app.

EMA comprised two survey types. The first prompted participants to complete surveys at fixed times in the morning (10 AM), afternoon (4 PM), and evening (9 PM). The second was a participant-initiated survey sequence, meaning the participant started a “first drink” survey while consuming their first drink during an event, then a notification would pop up every 30 minutes for the participant to report the number of drinks they consumed since the last survey.

It was worth noting that in the study, the association between TAC features and number of drinks consumed were strong for fixed-timed EMA reports (r=0.6–0.7) but only moderate for episodic EMA survey sequence (r=0.3–0.5).

When numbers don’t add up

“Understanding how much alcohol you have consumed is nuanced,” said lead study researcher Dr Michael Russell, assistant professor of biobehavioural health at The Pennsylvania State University, Pennsylvania, US.

Russell pointed out that their study shed light on the role of peak intoxication and the possible negative consequences of drinking. For example, if a person consumed six drinks on Friday and six equivalent drinks on Saturday, they would be more likely to experience alcohol-related harm on the day they became more intoxicated. This is because peak intoxication can be affected by several factors, including how fast a person drank and what they had eaten recently.

“By using wearable technology to predict alcohol-related consequences—which range from automobile accidents to hangovers to missing work to sexual assault and beyond—we can begin to prevent alcohol-related consequences. Our research shows that wearable sensors can be used to help people understand when their drinking is becoming risky,” he said.

Less burdensome

Compared with available methods for measuring intoxication, transdermal sensors have the advantage of being passive and unobtrusive. In contrast, breathalysers and blood sample analyses require active cooperation by the person being measured and can be intrusive.

One-hundredth of alcohol consumed is excreted in sweat, and this allows estimation of a person’s blood alcohol content on the skin, Russell pointed out. Furthermore, the alcohol levels in sweat are similar to those in blood, making transdermal sensors a good alternative to measuring blood alcohol content, which requires a blood draw.

Russell said that their research is the first step toward using technology to limit the harm that alcohol can cause.