The role that specific receptors in the brain play in addiction is becoming increasingly documented, and our understanding of how this works in cases of alcoholism is especially interesting. One particular chemical, dopamine, has come to be singled out for its influence on people who display addictive behaviors. In addition to being tied to problems that individuals experience, it is looking to be a likely culprit in some families that display multi-generational histories of issues with alcohol.
A recent study of alcohol use disorder utilized brain scans to identify how reward centers in the brain responded to alcohol. The researchers compared people with family histories of alcoholism against ones who come from families with no indications of trouble, and they compared consumption of real alcoholic mixed drinks served with vodka against the consumption of a placebo that didn’t have vodka. Drinks were served in a random order, so individuals wouldn’t know whether they were receiving an actual hard drink until they consumed it.
All participants displayed levels of dopamine release that were similar to each other when they consumed the actual alcoholic beverages. This is an expected response as people tend to respond to alcohol consumption. The surprise, however, appeared in the group with family histories: They displayed high levels of dopamine in anticipation of receiving a drink. The study did not follow participants to see whether use disorders became more prevalent over time.
What Is Dopamine?
Dopamine is a critical receptor in the human brain that controls a wide array of functions, particularly ones that relate to how the brain interacts with the body. The chemical is a go-between that handles messages sent between brain cells, and its proper operation is essential to virtually everything you think of as part of being a functional person. A shortage of the chemical has been tied to motor function issues displayed by people who have Parkinson’s disease, leading to tremors that become increasingly uncontrolled.
Another function that dopamine serves is inducing animals to act upon the expectation of intakes that are essential to their survival, such as food and drink. The chemical is released and serves as a reinforcement mechanism, ensuring that animals will proactively modify their behavior in order to consume more of what they need to survive. Strong positive relationships are reinforced over time, causing a reward cycle that keeps an animal driven to seek out anything that encourages its well-being.
In humans, this cycle is often tied to a variety of actions that we generally think of as pleasure-seeking behavior. For example, a positive experience while dancing and listening to music will lead to high dopamine levels. This reinforcement of rewards will drive a person to seek out the opportunity to enjoy that experience, often leading to pro-social behavior. Nature has even tied dopamine release to the bonding process that mothers have with their newborn children.`
What’s Bad About It?
The value that dopamine has in producing positive moods and reinforcement mechanisms has an immense potential to backfire, especially in the modern world. Individuals are chemically driven to pursue anything that provides a consistent release, and its role in everything from food to video game addiction has been noted. While a drug itself often provides its own high, for individuals prone to addictive patterns of behavior, there’s also frequently a high that comes with anticipating the consumption of a chemical and another one that comes from actually doing it.
In instances of alcoholism, there can be a number of compounding effects. For most modern societies, there’s a strong relationship between alcohol and social situations. It’s not an accident that alcohol is often served in settings that promote high dopamine levels, such as dancing, friendly conversation and sexualized interactions.
When thinking of how a bar or a club is designed, it’s not dissimilar to the ways rewards are tied up in specific interactions in other addictive situations. Just as an addicting game is constructed to take advantage of reward mechanisms, so is the social experience built around alcohol.
This is particularly concerning because it means that there’s a level of chemical addiction in alcoholism that isn’t inherently tied to any of the chemicals in alcohol itself. As much as alcohol can lead to a whole host of potentially lethal chemical problems, it’s also operating alongside a parallel reward mechanism that’s difficult to confront in its own right. Disentangling these various interactions is a big part of what makes it difficult for many people to quit engaging in problem drinking without a structured program and professional support.
Relationship to Withdrawal
Dopamine also plays a role in the brain after an individual has stopped drinking. While levels tend to drop in the initial period after abstinence from alcohol consumption has begun, they can actually rebound upward in the following weeks to a similarly elevated state. It ends up creating a U-shaped curve as a person travels from an unhealthily elevated reward state due to high dopamine levels down to a depressive state due to low levels and finally back to a high state. At all three points in the process, the individual is in an unhealthy condition, and this may explain the mechanism that leads to relapse.
Our genetics code a great deal of what we think of as brain-related activities, and this appears to be the case with how dopamine-receptive an individual is. A deficit in the chemical can have a variety of adverse effects, ranging from increased risk of high blood pressure to a higher likelihood of ADHD, all known to have genetic components. This relationship is not lost on those who come from families with a history of alcohol use disorder, and it may be one of the reasons why alcoholism seems to run in certain gene pools.
Individuals who are disposed to relatively low dopamine levels compared to the rest of the population may be inclined to remedy the problem by pursuing activities that correct the issue. In some sense, this means that alcoholism may operate as a form of self-medicating behavior for those who experience low levels of the chemical. Beginning from a lower and more depressed starting point, these individuals may receive a particularly strong boost from the process, ultimately leading to a greater reinforcement of the behavior.
One study showed that microinjections of a type of dopamine into animals led to a reduction in voluntary alcohol consumption. In other words, simply getting a bit of the dopamine high may actually serve to stunt the impulse to engage in problem drinking. This offers some hope to individuals suffering from addictions that they may be able to pursue structured activities that ensure they experience high dopamine levels and have a chance at reducing their intakes.
There is a belief among researchers that replacement of dopamine may be used to help people with addiction disorders. It is a chemical, however, that does not easily pass through the blood-brain barrier. Consequently, it’s unlikely that any potential treatment option that’s designed to increase dopamine uptake will be as simple as swallowing a pill loaded with the chemical. Research into how to take advantage of the chemical balance in the brain is ongoing, but it’s not currently close to yielding a feasible solution for those who are coping with alcoholism.
If it sounds like all of this might be a minefield for someone with alcoholism to try to navigate, it is. Dopamine is, after all, an absolutely essential chemical that contributes to your ability to function at all. Individuals suffering from extremely low levels may experience a variety of unusual disorders, including Tourette’s syndrome.
Finding a way to balance something that is a clear necessity against its potentially more negative effects presents a number of challenges. For example, an individual with a genetic disposition to low levels does still need some sort of way to increase their access to the chemical in order to feel happier and be able to function properly. Alcohol offers a cruel mix given its inherently depressive effects that occur alongside the inherently stimulating effects of dopamine.
Making the problem sometimes harder to sort out is the role that positive social interactions related to alcohol often play in promoting uptake of the chemical. Drinking culture is a real thing, and its removal from a person’s life needs to be accompanied by activities that serve the same function in terms of providing rewards for pleasure-seeking behavior. For this reason, we often see that group programs aimed at people with alcoholism are designed to provide a structured and supportive setting. Simply making a few good friends may serve to reward someone in a surprisingly effective fashion.
One of the positive takeaways from recent research about addiction and reward mechanism is that behaviors that pay off pleasure-seeking conduct can be traded off in a fashion that promotes a healthier lifestyle. Simply taking up an exercise regimen may, for example, produce high dopamine levels. Stress-relieving practices like yoga and meditation as well as personal hobbies like art, woodworking and theater may also help boost an individual’s dopamine levels and chances for positive social interaction. Given the large number of activities that can be substituted in order to promote the production of the chemical, everyone who has addiction concerns can hold out a candle of hope that serious alterations to their lifestyle choices may be rewarded with a sense of fulfillment.
Many situations that are generally thought of as negative can push down dopamine levels. Stress is frequently noted as something that can reduce the presence of the chemical. By weeding out sources of stress, individuals might be able to install a higher floor for their levels, ultimately leading to a lower risk of voluntary alcohol consumption.
On the downside, many of these negatives are inherently compounding. Someone who comes from a family that’s prone to lower levels of dopamine production may also experience stresses in early childhood that increase risk factors for alcoholism. This is believed to be one reason why problem drinking is known to appear as a multi-generational issue in some families.
Disentangling this web of various forces that drive dopamine levels one way or the other over a person’s life is critical to the recovery process. For many people, it’s just not as simple as saying goodbye to alcohol. If a suitable reward structure isn’t put in place to serve the role that drinking once did, the risk of relapse is expected to be higher. Instead, individuals prone to alcoholism need opportunities to restructure their lifestyles around new reinforcement mechanisms.