Social lubricant. Addictive evil. Between these extremes there’s a sea of alcohol.
This week’s episode features two experts in Alcohol Use Disorder. Dr. George Koob, Director of the National Institute on Alcohol Abuse and Alcoholism, and Dr. Tom Parkman, Research Fellow at King’s College London, both join Jesse to discuss what we know, what we don’t know, and what current research is trying to find out about alcohol use and abuse.
Considering how common alcohol use (and abuse) is, what’s really interesting is how little we know about how alcohol acts on the brain.
In low doses, there are a number of neurotransmitter systems that alcohol affects, including GABA.
But researchers still don’t entirely understand what changes in the brain you engage in excessive alcohol consumption. We don’t know what causes alcohol addiction, how exactly it affects the prefrontal cortex, and how it changes the adolescent brain.
Is Alcohol Healthy in Moderation?
We’ve all see the headlines that alcohol can be good for you. But in reality the question is still somewhat unresolved. There is good data out there suggesting the health benefits of one drink per day on including improved cardiovascular health and diabetes.
The problem is that the research is post hoc, meaning it consists of surveying people about their past alcohol use and current health status.
Dr. Koob is working on an exciting new study, the Moderate Drinking Study, that will actually follow individuals as they restrict themselves to one drink a day going forward. Hopefully this new line of research will provide some more definitive answers on the health benefits of moderate alcohol consumption.
Alcohol and Addiction
Many people can consume alcohol moderately without any problem. Many people cannot. Approximately 30% of people will have a problem with alcohol over the course of their lifetime, and about 6% of the population will have one at any given time.
And who becomes addicted to alcohol? There are some predictors, including a family history of drinking or drug abuse and friend who drink heavily. But ultimately we can’t predict who will have a problem and who won’t.
Fortunately, quite a few new therapies to treat Alcohol Use Disorder are becoming available, including psychedelics. Unfortunately, there’s never going to be a magic pill that can completely cure alcohol addiction.
For example, one of the new prescription pills is Disulfiram, which makes you very sick if you drink alcohol while on it. For users of the pill, it’s very effective. Problem is, very few people actually still with taking it consistently.
When you regularly binge drink, your reward systems become desensitized, resulting in less pleasure from alcohol. At the same time, your stress systems are overly activated when you stop drinking. More alcohol brings temporary relief, but just perpetuates the cycle.
Dr. Koob is looking into a treatment something that would reverse the rewards deficit activation. This may be the future of alcohol addiction therapy.