Drugs, Brains, and Behavior: The Science of Addiction: Preface
According to a 2021 review published in the journal Trends in Neurosciences, excessive drinking can disrupt gene expression in neurons, a process in which brain cells develop and connect with each other. These adaptations may be a key factor for developing alcohol use disorder, the researchers said. Meanwhile, Americans are drinking more heavily than they have in decades; the average adult now consumes over 500 drinks a year, and some 180,000 lives are lost annually to alcohol-related diseases and injuries. These trends were exacerbated by the stress of the Covid-19 pandemic, yet they began enabling behavior meaning before it, marking a major shift in America’s drinking habits. Drinking moderately if you’re otherwise healthy may be a risk you’re willing to take.
Alcohol use: Weighing risks and benefits
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How does the brain recover?
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Historically, public awareness of such risks, specifically the links to cancer, has been low. A review of 32 studies across 16 countries found that awareness of alcohol as a cancer risk factor was generally low, with some variation across regions. What sets Gen Z apart is that this change appears to be more than a passing trend.
- This was taken to provide support for a need to re-conceptualize addiction as a “disorder of choice”.
- Topiramate has complex molecular mechanisms of action, but because its efficacy appears to be moderated by a polymorphism at the locus encoding the kainate receptor subunit GRIK129, its actions are likely to be mediated through glutamatergic mechanisms.
- This treatment gap is in large part caused by a lack of effective treatments with good patient acceptance.
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- Examples of such features are high rates of spontaneous remission, preserved sensitivity to contingencies, and efficacy of treatments that strengthen cognitive control.
Deciding about drinking
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Alcohol-related deaths are climbing in women, and lifetime risk of breast cancer rises as much as 9 percent with just one daily drink. Particular effects of alcohol on the body make drinking dangerous for drivers. Alcohol affects the brains ‘neurotransmitters’, the chemicals in the brain which carry messages to other parts of the body and tell it what to do.
The great Chinese Shang emperors of the late second millennium B.C.E. are said to have succumbed to too much drink, going crazy and committing suicide. This long and often polarizing history is described in this in-depth collection of articles from the Scientific American archives. Meta-analytic support for efficacy is also present for some medications that lack approval for the treatment of alcohol addiction, but are approved for other indications.
Efficacy of treatment approaches such as contingency management, which provides systematic incentives for abstinence73, certainly supports the notion that behavioral choices in patients with addictions including AUD74 remain sensitive to reward contingencies. It is unclear, however, to what extent this invalidates a “brain disease model of addiction”. The hopes that neuroscience would bring novel treatments to patients with addictive disorders is intimately related to the conceptualization of addiction as a chronic relapsing brain disease70. In recent years, this conceptualization has encountered increasing criticism45.
Finally, scientists explain the dreaded ‘red wine headache’
As a result of methodological advances, the concept of neuronal ensembles postulated by Hebb more than half a century ago99 has returned in full force59. It is rapidly becoming clear that this concept is critical for understanding valuation and decision-making processes that ultimately result in drug or alcohol use. Rather than reflecting activity of entire brain structures, such as the mPFC or the amygdala, these processes seem to reflect the activity of small neuronal populations that are sparsely distributed within the respective structure100,101,102. Functional ensembles are characterized by coordinated spatiotemporal activity and reliable re-activation during specific behavioral tasks. Neuronal ensembles are dynamic, meaning that they are formed and updated throughout the learning of a behavior103.