How to know when holiday drinking is hurting your brain
Drinking on holiday brings a good mood, but it can also be a sign of problematic drinking.
For many, the holidays are indeed the best time of the year. Families and friends come together and enjoy food, a good mood - and often alcohol.
Commercially, it seems that alcohol and the holidays are made for each other. Alcohol can be a quick and easy way to get into the spirit of celebration.
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And it feels good. After two glasses of wine, the brain is activated by complex neurobiochemical processes that naturally release dopamine, a neurotransmitter of great importance.
When the dopamine molecule attaches to its receptor on the surface of a neuron or basic brain cell, a "buzz" occurs. It is often desirable to expect before the second glass is empty.
This picture shows an illustration of a man drinking half a liter of beer, showing how the body metabolizes alcohol and the organs affected by that alcohol. Welcome pictures via Flickr,
However, there are those who drink into intoxication and often in trouble right after the buzz. For them, the brain releases the same delightful dopamine, no different from what happens in the casual drinker, but it doesn't stop there. This can lead to an intoxication with alcohol.
As someone who has dealt with alcohol use disorders for over 15 years and has treated thousands of patients with the disorder, I think this is a large, but often poorly understood, public health problem. Our culture seems to go beyond the point of labeling people with opioid addictions as "weak," and I hope we can do the same for people with alcohol use disorder, which is more common than people might appreciate. Excessive drinking was one in ten deaths among working-age adults in the United States.
Go beyond judgment
Although alcohol is felt to be stress reliever, it contributes to 88,000 deaths each year in the United States. That's more than double the number of people killed by heroin and opioid overdoses, another major public health crisis, in 2014.
Additionally, more than 66.7 million Americans reported binge drinking in the past month in 2015. This emerges from the general surgeon's most recent addiction report.
The consequences for individuals and families are staggering, affecting physical and mental health, an increasing spread of infectious diseases, a reduced quality of life, increased motor vehicle accidents and abuse and neglect of children, to name just a few.
Scientific studies of the brain have helped explain excessive drinking, although it may be difficult for family and friends to understand. It is defined as drinking five or more drinks for men and four for women on the same occasion for at least one day in the past 30 days.
Binge drinking is a disease. It happens through no fault of the individual who is affected by the comparatively malfunction of the pleasure circles in the brain. This leads to the fact that the drinker wants more and more alcohol. Binge drinker brains have a disease recognized by the American Medical Association since the 1950s, but binge drinkers are often vilified.
Americans usually want to know and are willing to make some lifestyle changes out of fear and common sense when it comes to diseases like heart disease, obesity, and cancer. We're not quite at the same point as a society with substance abuse disorders, but researchers are desperately trying to achieve the same readiness for substance disorder prevention and treatment.
Science understands the cause well enough to explain and treat it so that lives can be saved and their families and communities spared the devastating consequences for the millions who suffer from these conditions. This has become a pressing matter of national concern to scientists and doctors.
The three stages of addiction
The process of alcohol addiction involves a three-step cycle: binge intoxication, withdrawal-negative affect, and worry-anticipation.
It starts in the neurons, the basic type of brain cell. The brain has an estimated 86 billion of these cells that communicate using chemical messengers known as neurotransmitters.
Neurons can organize themselves in clusters and form networks or circuits to perform certain functions such as thinking, learning, emotions, and memory. The addiction cycle disrupts the normal functioning of some of these networks in three areas of the brain - the basal ganglia, the enlarged amygdala, and the prefrontal cortex.
The disorders have various causes for continued drinking. They enable alcohol or drink-associated triggers (clues) that lead to the search for alcohol. They also decrease the sensitivity of the brain systems, resulting in a decreased experience of pleasure or reward, and increase the activation of brain stress systems. Ultimately, they reduce the functioning of the brain's executive control systems, the part of the brain that normally helps make decisions and regulate one's actions, emotions, and impulses.
These networks are critical to human survival. Unfortunately for the binge drinker, they are "kidnapped" and bingeing continues even after the deleterious effects begin.
Since binge drinkers' brains get a great deal of pleasure from alcohol, there is a strong motivation to keep drinking binge drinks. What can begin as recreational social alcohol excess at parties can lead to progressive neuroadaptive changes in brain structure and function. The brain is no longer good enough to function normally. It gets sick. Continued parties can lead to a chronic and uncontrollable daily pattern of alcohol use. These maladaptive neurological changes can persist long after you stop drinking.
Your brain on alcohol
During the binge intoxication phase, a part of the brain called the basal ganglia rewards the drinker with pleasurable effects by releasing dopamine, the neurotransmitter responsible for the rewarding effects of alcohol, and creating a desire for more.
If bingeing persists, the "habit cycle" is repeatedly activated in another part of the basal ganglia, the dorsal striatum. It contributes to the compulsive search for more alcohol. This explains the intense cravings (cravings) triggered while a binge drinker drives past a favorite bar and cannot resist, even after promising to go straight home after work.
During the withdrawal negative affect phase, there is a break from drinking. Because the reward circuit has a reduced ability to deliver a dopamine reward, the enjoyment of natural (safe) experiences - like eating and sex - is far less than that of alcohol.
During abstinence from alcohol, stress neurotransmitters such as corticotropin-releasing factor (FRC) and dynorphin are released. These powerful neurochemicals cause negative emotional states associated with alcohol withdrawal. This pushes the drinker back to alcohol for relief and to try to restore the rewards of the poisoning.
Regions of the brain are affected differently by alcohol. Surgeon's Report on Addiction
After a period of alcohol abstinence that can last only hours, the drinker enters the phase of anxiety-anticipation. This affects the prefrontal cortex, where executive decisions are made about whether or not to override the strong urge to drink. This part of the brain works with a "go system" and a "stop system".
When the Go circuits stimulate the habitual response system of the dorsal striatum, the drinker becomes impulsive and searches for a drink, perhaps subconsciously. The stop system can inhibit the activity of the go system and is especially important in preventing relapse after it is triggered by stressful life events.
Studies on brain imaging show that excessive alcohol can disrupt function in both the Go and Stop circuits. This interferes with proper decision-making and behavioral inhibition. The drinker is both impulsive and compulsive.
A disease that can be treated
There is good news as scientific evidence shows that this disorder can be treated.
The FDA has approved three drugs for treatment that should be offered as appropriate. There is well-established scientific evidence that behavior therapy can be an effective treatment. This includes recovery support services like Alcoholic Anonymous.
Most importantly, it is important to know that alcohol use disorder is a brain disorder that causes a chronic disease. It is no different from diabetes, asthma, or high blood pressure. When comprehensive continuous care is provided, recovery outcomes improve and excess alcohol drinks hopes of staying sober as long as lifelong treatment and sobriety become a committed lifestyle choice.
This article was republished by The Conversation, a non-profit news site dedicated to exchanging ideas from academic experts.
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Jamie Smolen does not work for any company or organization that would benefit from this article, does not consult any stocks or companies that would benefit from this article, and has not disclosed any relevant links beyond her academic appointment.
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