What happens in alcoholism, exactly?

What is it?

Alcoholism is a broadly used term that refers to any drinking of alcohol that results in problems. This can be expressed as drinking large amounts of alcohol over a long time period, not being able to cut down, spending lots of time drinking and trying to get alcohol, and the drinking resulting in problems with other people and the person’s own health. Long-term use of alcohol seriously damages the body. The brain, liver, heart, pancreas, and immune system are affected in particular. Drunk people are also more likely to take part in dangerous activities, such as drinking and driving or having unsafe sex.

4.1% of people over 15 suffer from alcoholism. In Eastern Europe the rates are as high as 11%. Alcoholism is more common in males and in young adults. Alcohol is thought to cause 5.9% of all deaths, and alcoholism reduces a person’s life expectancy by around 10 years.

What causes it?

The cause of alcoholism is a complex mixture of genetic and environmental factors. Many of the genes associated with the condition regulate the metabolism of alcohol. People in different corners of the world have different genes, which partly explains why alcoholism is much more common in some countries than in others. People who start drinking young are more likely to become alcoholics later in life. Negative childhood experiences, like trauma and a lack of support from family and friends, are known to increase the risk.

What happens during it?

All the functions of our brain – things like our mood, our state of consciousness and our decisions to behave in certain manners – come down to the signals that are transmitted along and between neurons. Neurotransmitters are essential to this process. When a signal reaches the end of one neuron, neurotransmitters are released to the space between the first neuron and the second neuron. The signal continues when the neurotransmitter molecules bind to the second neuron.

This communication process depends on strictly regulated neurotransmitter concentrations. If they are altered in one way or another, there is a change in the way we perceive the world. This is how alcohol works – it alters the balance of neurotransmitters. Normally, we have roughly the same amount of neurotransmitters that speed up the signal and neurotransmitters that slow it down. Drinking alcohol increases the concentration of the slowing ones, which causes us feel things like drowsiness and euphoria.

If you drink alcohol often, your brain will adapt to these new levels of neurotransmitters. Your brain starts expecting them, and the old normal is now deemed abnormal. The brain will start producing more speeding neurotransmitters so that it can function when the alcohol-induced levels of slowing neurotransmitters are around. You might not get drunk as easily as you used to and you probably will start craving alcohol more than ever before.Moreover, stopping drinking causes there to be much more speeding neurotransmitters than slowing ones, and this causes the horrible feelings of withdrawal. One of the big reasons why many alcoholics keep on drinking is because they are very anxious about the painful withdrawal period and this anxiety makes them avoid it at all costs.

How can it be treated?

The treatment of alcoholism varies a lot depending on both the individual case and who is making the decisions about treatment. Alcoholism can, for example, be approached as a medical condition or a social choice, and this fact can often lead to very different treatments.

Most alcoholism treatment focuses on making the patient stop drinking and then helping them get back on their feet in life. There are many reasons why alcoholics drink, and these must all be addressed in order to prevent relapse.

Although ending the alcohol use is necessary, the body of an alcoholic has a hard time coping with this and the withdrawal symptoms can sometimes even lead to death. This is why an abrupt stop should be done in a controlled environment and ideally coupled with drugs that have similar effects and hence reduce the symptoms. Group therapy or psychotherapy can be very helpful in treating the underlying psychological issues.

Recovery from alcoholism is certainly possible and should definitely be encouraged, but returning to the “old normal” is at least statistically unlikely to succeed. It is uncommon for previous alcoholics to be able to lead a life where they drink casually and occasionally. Most either relapse or stop drinking alcohol altogether.



Sources: http://pubs.niaaa.nih.gov/publications/AA77/AA77.htm, https://en.wikipedia.org/wiki/Alcoholism, en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome



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