Your Brain on Alcohol
A new understanding of how alcohol alters brain chemistry may transform treatment of the disease
Ask any alcoholic trying to take it just one day at a time, and he'll tell you that compulsive drinking is a disease--period. That's what the Big Book said, after all, the groundbreaking tome by Alcoholics Anonymous that came out way back in 1939. And that's what just about everyone has believed ever since.
But hold on. Technology, not for the first time, is forcing doctors and therapists to see things in a new light. With the aid of sophisticated new imaging techniques, scientists can look inside the brains of alcoholics at the very moment they're being tempted by thoughts of cold beers, crisp martinis, or fully ripened cabernet francs. The new science shows just how alcohol can rewire the circuitry of the brain, eroding its ability to feel p arms. Mark had five wives, and five divorces. Betty polished off a pint of vodka, then carpooled fourth graders from soccer practice. Jeffrey committed strong-armed robbery. April, once shy, took off her clothes and danced for money. Martha threatened her husband with a carving knife. Paula slipped into the kitchen during dinner parties to swill down the last drops of wine left in dirty goblets. All are recovering alcoholics and they are ashamed of these recollections.
For active alcoholics, drinking trumps reason. It distorts judgment. It severs the connection between behavior and consequence. It lays waste to marriages, friendships, and careers. It leaves children stranded. For alcoholics, love and logic can't hold a candle to liquor.
And the damage is not limited to others. Over time, addiction becomes an enervating trial for the drinker. "I would always drink out of glasses that were opaque so my husband couldn't tell what I was drinking," says Jackie Clarke, sober for 16 years. "I would put vodka in my wine because wine seemed more acceptable. I was always thinking about what I was going to drink, when I was going to drink, hiding bottles so my husband wouldn't know how much I drank. It was exhausting."
Just where alcohol abuse crosses the line into addiction remains blurry. John Schwarzlose, president of the Betty Ford Center, has his own simple criterion: An alcohol abuser might get stopped once while driving under the influence, and the experience will be mortifying--and sobering. For an alcoholic, how- ever, the embarrassment is not enough. "Two or more DUIs--that is an alcoholic," says Schwarzlose. But it is often a meaningless distinction to family members, loved ones, and employers. They know that excessive drinking can ruin lives through betrayal, broken promises, lost jobs, car accidents, and a host of other personal tragedies.
Pure pleasure. Alcoholism is a disease that can start with a first drink. With that drink, one fork in the road appears, leading some to a future of alcoholism and others to a lifetime of enjoyable, moderate drinking. The brains of people genetically predisposed to alcoholism may be unable to naturally produce adequate dopamine--one of the brain chemicals that make us feel pleasure. For them, the first drink is a hit of dopamine, and of pleasure, they haven't felt as strongly before. And then, it's love at first tther feel-good chemicals, including serotonin. It disturbs levels of glutamate, which can make people feel high, and then it interferes with other chemicals that can make people feel tired. Enoch Gordis, director of the National Institute on Alcohol Abuse and Alcoholism, calls alcohol "the most widespread and damaging substance we have in society."
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