RATIONALE Violence and drug use are significant public health challenges that are strongly linked. It is known that alcohol plays a major role in the causation of unnatural deaths and that stimulants like cocaine and amphetamine are often implicated in aggressive acts or violence. However, a clear causal relationship between these substances and aggression, and more specifically a blood concentration threshold at which intoxicated aggression emerges is lacking. In case of a crime and subsequent law enforcement, knowledge about dose-response relationships could be of pivotal importance when evaluating the role of alcohol and drugs in aggressive offences. AIMS The present review aimed to determine whether there is a causal relation between intoxication with these psychoactive substances and aggression, and to define blood concentration thresholds above which these substances elicit aggression. METHODS Empirical articles published between 2013 and 2017 and review papers containing the predefined search strings were identified through searches in the PubMed and Embase databases and additional reference list searches. The complete search query yielded 1578 publications. Initially all articles were manually screened by title and abstract. Articles with irrelevant titles, given the selected search terms and review aims were discarded. Remaining articles were carefully studied and those that did not comply with the main objectives of this review were discarded. At the end of this process, 167 titles were found eligible for review. FINDINGS AND CONCLUSION While placebo-controlled experimental studies clearly showed a causal link between alcohol and aggression, it is evident that such a link has not yet been established for cocaine and amphetamines. In case of alcohol, it is clear that there are various individual and contextual factors that may contribute to the occurrence of an aggressive act during intoxication. A clear threshold blood alcohol concentration has not been defined yet for alcohol, but a statistically significant increase of aggression has been demonstrated at a dose of 0.75 g/kg and higher. Future studies into intoxicated aggression should include multiple doses of alcohol and stimulants and take into account individual and contextual factors.

中文翻译：

---

醉酒攻击：酒精和兴奋剂会导致剂量相关的攻击吗？回顾

基本原理 暴力和吸毒是密切相关的重大公共卫生挑战。众所周知，酒精在非自然死亡的原因中起着重要作用，可卡因和安非他明等兴奋剂通常与攻击性行为或暴力有关。然而，缺乏这些物质与攻击性之间明确的因果关系，更具体地说，缺乏出现醉酒攻击性的血液浓度阈值。在犯罪和后续执法的情况下，在评估酒精和毒品在侵略性犯罪中的作用时，有关剂量反应关系的知识可能至关重要。目的 本次审查旨在确定这些精神活性物质中毒与攻击行为之间是否存在因果关系，并定义血液浓度阈值，高于该阈值这些物质会引起攻击。方法 2013 年至 2017 年间发表的实证文章和包含预定义搜索字符串的评论文章是通过在 PubMed 和 Embase 数据库中进行搜索以及其他参考列表搜索来确定的。完整的搜索查询产生了 1578 篇出版物。最初，所有文章都是按标题和摘要手动筛选的。鉴于选定的搜索词和评论目的，标题不相关的文章被丢弃。其余文章经过仔细研究，不符合本次审查主要目标的文章将被丢弃。在此过程结束时，发现 167 个标题符合审核条件。结果和结论 虽然安慰剂对照的实验研究清楚地显示了酒精和攻击性之间的因果关系，但显然可卡因和安非他明尚未建立这种联系。在酒精的情况下，很明显，有各种个人和背景因素可能有助于在醉酒期间发生攻击性行为。尚未为酒精定义明确的血液酒精浓度阈值，但已证明在 0.75 g/kg 或更高的剂量下，攻击性会显着增加。未来对醉酒攻击的研究应该包括多剂量的酒精和兴奋剂，并考虑到个人和环境因素。很明显，有各种个人和环境因素可能会导致在醉酒期间发生攻击性行为。尚未为酒精定义明确的血液酒精浓度阈值，但已证明在 0.75 g/kg 或更高的剂量下，攻击性会显着增加。未来对醉酒攻击的研究应该包括多剂量的酒精和兴奋剂，并考虑到个人和环境因素。很明显，有各种个人和环境因素可能会导致在醉酒期间发生攻击性行为。尚未为酒精定义明确的血液酒精浓度阈值，但已证明在 0.75 g/kg 或更高的剂量下，攻击性会显着增加。未来对醉酒攻击的研究应该包括多剂量的酒精和兴奋剂，并考虑到个人和环境因素。