Family members of people who are alcohol dependent have high rates of psychiatric morbidity, and growing up with someone who misuses alcohol increases the likelihood of teenagers taking up alcohol early and developing alcohol problems themselves (Latendresse et al., 2010). The dependence-producing properties of alcohol have been studied extensively in the last 20 years. Alcohol affects a wide range of neurotransmitter systems in the brain, leading to the features of alcohol dependence. The main neurotransmitter systems affected by alcohol are gamma-aminobutyric acid (GABA), glutamate, dopamine and opioid (Nutt, 1999). The action of alcohol on GABA is similar to the effects of other sedatives such as benzodiazepines and is responsible for alcohol’s sedating and anxiolytic properties (Krystal et al., 2006).
Can People With Alcohol Use Disorder Recover?
This complex condition is influenced by a person’s genes and their environment and is often considered a brain disease. As we drink more, our bodies adapt, requiring higher quantities to achieve the same effects, pushing us deeper into the pitcher plant. The basal ganglia, a part of our brain involved in habit formation, strengthens the association between drinking and the context in which it occurs. With enough repetition and strong enough rewarding experiences, alcohol use becomes more and more automatic over time. This is when a person depends on a substance or behavior emotionally, such as when stressed. “Specifically, when you’re younger, your brain is going through a lot of changes.
Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet].
Consistent with this hypothesis is the finding that severity of alcohol and drug withdrawal symptoms may be a powerful marker of neuropsychological impairments in detoxified older human adolescents and young adults (Brown et al. 2000; Tapert and Brown 1999; Tapert et al. 2002). Juvenile rats exposed to heavy bingelike episodes of ethanol have greater damage than adults in frontal-anterior cortical regions, including the olfactory frontal cortex, anterior perirhinal, and piriform cortex (Crews et al. 2000). Thus, the immature brain may be more susceptible to binge ethanol-induced neurotoxicity, although the mechanisms are unknown. The idea that physiological dependence on alcohol a particular ‘addictive personality’ leads to the development of alcohol dependence is popular with some addiction counsellors, but does not have strong support from research. Often with patients in treatment for alcohol dependence, it is difficult to disentangle the effects of alcohol on the expression of personality and behaviour from those personality factors that preceded alcohol dependence. Nevertheless, people who are alcohol dependent have a 21-fold higher risk of also having antisocial personality disorder (ASPD; Regier et al., 1990), and people with ASPD have a higher risk of severe alcohol dependence (Goldstein et al., 2007).
- Like the fly that was drawn to the pitcher plant by its sweet smell and vibrant color, our curiosity for alcohol begins with a harmless, even glamorous, impression of what the liquid in the bottle represents.
- Figure 1 illustrates the changing role of positive and negative reinforcement circuits during the transition from the nondependent to the dependent state.
- Nevertheless, numerous pharmacotherapies have been employed to treat alcoholism, guided principally by advancing knowledge about alcohol’s interactions with various components of the brain’s reward and stress pathways (Heilig and Egli 2006; Litten et al. 2005; Spanagel and Kiefer 2008).
Addiction treatment and recovery
The study of the anatomy, function, and diseases of the brain and nervous system. 5One mechanism by which electrochemical signal transmission between neurons is terminated is by reuptake of the neurotransmitter into the signal-transmitting cell. When excess neurotransmitter remains in the synapse, receptors on the presynaptic terminal are activated to prevent the release of more neurotransmitter into the synapse. Some drugs target these presynaptic receptors by blocking this “termination” signal.
Compulsive substance seeking is a key characteristic of addiction, as is the loss of control over use. Compulsivity helps to explain why many people with addiction experience relapses after attempting to abstain from or reduce use. The function of GABAA receptors also is regulated by molecules known as neuroactive steroids (Lambert et al. 2001) that are produced both in the brain and in other organs (i.e., in the periphery). Alcohol increases the brain levels of many neuroactive steroids (Van Doren et al. 2000).
The damage that long-term heavy alcohol consumption can do to the health of adults is well documented. Some research suggests that, even over the shorter time frame of adolescence, drinking alcohol can harm the liver, bones, endocrine system, and brain, and interfere with growth. Adolescence is a period of rapid growth and physical change; a central question is whether consuming alcohol during this stage can disrupt development in ways that have long-term consequences. Naltrexone is available for oral or intramuscular administration to reduce the craving for alcohol.
Why Should We Be Concerned About AUD and Alcohol Addiction?
In Summary: The Binge/Intoxication Stage and the Basal Ganglia
