How Do Alcoholics Respond to Conflicting Brain Effects of Drinking?

Alcohol consumption triggers both pleasurable brain effects (in the form of euphoria) and unpleasant brain effects (in the form of a negative reaction to other symptoms of intoxication). Any person who develops the symptoms of alcohol abuse and/or alcoholism must somehow withstand the unpleasant effects of drinking while attempting to access the pleasurable effects. In a study published in August 2014 in the journal Drug and Alcohol Dependence, a team of South Korean researchers used real-time brain scans to determine how people affected by alcoholism deal with the conflicting incentives to continue and discontinue drinking.

Alcohol’s Effects

When consumed above moderate levels, alcohol has a poisonous impact inside the brain and body. Somewhat paradoxically, significant alcohol consumption can also sharply increase pleasure levels inside the brain. In fact, people who eventually develop alcoholism commonly start out by repeatedly trying to re-create the euphoric experiences they associate with drinking. Some of the toxic effect of drinking is directly related to the amount of unprocessed alcohol circulating in the brain and body. Additional toxic effects kick in when the liver starts to break down alcohol and triggers the accumulation of a poisonous alcohol byproduct called acetaldehyde. If a person drinks enough to overwhelm the body’s alcohol processing abilities, he or she will start to experience a range of negative effects inside organ systems throughout the body. Ultimately, some of these effects can cascade into a dire state called alcohol poisoning. However, long before alcohol poisoning sets in, a drinker will experience a number of unpleasant alcohol-related side effects. In addition, the aftermath of heavy drinking is frequently marked by the presence of a dysfunctional state known as a hangover.

Pros and Cons Inside the Brain

When a person repeatedly experiences pleasure as a result of alcohol use, he or she can develop a susceptibility to conscious or unconscious cues that favor further alcohol intake. These cues can appear in the form of changes in an individual’s mental state or in the form of specific settings or environments linked with drinking in the past. Under the influence of these internally or externally generated cues, a drinker can develop an increased urge or craving for alcohol. Conversely, when a person repeatedly experiences the negative physical or social consequences of drinking, he or she can develop a susceptibility to internal or external cues that disfavor the continued consumption of alcohol. The relative number of negative and positive cues helps determine the likelihood that a person will drink in any given set of circumstances.

How Do Alcoholics Handle the Brain Conflict?

In the study published in Drug and Alcohol Dependence, researchers from three South Korean universities used real-time fMRI (functional magnetic resonance imaging) scans to examine the conflicting alcohol-related cues that occur inside the brains of people affected by alcoholism. Some of these cues arise in the part of the brain that produces pleasure and increases the urgency of substance cravings, while others arise in a part of the brain that helps register the negative or harmful impact of past behaviors. A total of 64 people took part in the study. Thirty-eight of these individuals had diagnosable symptoms of alcoholism, while a comparison group of 26 individuals did not. All of the participants in both groups underwent fMRI exams while being exposed to external cues designed to produce positive or negative reactions to drinking inside the brain. After comparing the fMRI results of the participants affected by alcoholism to the results of the participants unaffected by the condition, the researchers concluded that, compared to their counterparts, the people in the alcoholism-impacted group were substantially more sensitive to the cues that favor the establishment of strong cravings. Conversely, they also concluded that the people in the alcoholism-impacted group were substantially less sensitive than the counterpart group to the cues that help the brain register negative behavioral consequences. In addition, the researchers determined that these changes in brain function are more pronounced in people more seriously affected by alcoholism. The study’s authors concluded that people with alcoholism grow less susceptible to the cues that would normally stop a person from engaging in harmful behavior, and simultaneously grow more susceptible to the cues that support alcohol cravings and make a relapse more likely in individuals who stop drinking and enter treatment. Together, these findings help explain how people affected by alcoholism deal with the inherent brain conflicts associated with consuming large amounts of alcohol.

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