Alcoholism: The Brain and The Beast

By Bill P.

The human body is a wondrous thing. When a foreign substance, such as alcohol, a toxic chemical, is ingested in large amounts over a considerable period of time, the body “adapts” to the substance, developing tolerance and becoming physically dependent upon it. This changes our brain chemistry. These take place in the neurons’ receptor sites, altering the balance of glutamate and gamma-aminobutyric acid (GABA), and in transmitters such as dopamine, serotonin, acetylcholine, and norepinephrine.

Neurotransmitters are substances that convey data from one neuron to another. Neuromodulators resemble neurotransmitters but differ from them in that they tend to remain in the synaptic gap between neurons at levels depending on receptor uptake. For example, serotonin levels are increased by medications which inhibit uptake. They are frequently used to combat depression. Dopamine levels are increased to lessen the effects of Parkinson’s Disease. An excessive increase in dopamine, however, may result in hallucinations.

Deep in the lower recesses of the brain, close to its junction with the brain stem and the spinal cord, lie the more primitive areas (nucleus accumbens) such as the amygdala in the limbic system, sometimes colloquially referred to as the “lizard” brain. This, a product of an earlier evolutionary phase of brain development, responds to physical needs like hunger and thirst, and stimuli that produce fear, anger, and sexual appetite. It is pleasure seeking, demands immediate gratification (“I want what I want when I want it and I want it right now!”), and, when denied what it wants responds with child-like rage.

The ingestion of alcohol over a protracted period leads to physical and chemical changes that foster dependency and addiction. When the alcohol supply diminishes, the primitive brain seeks to distort the more rational thought processes of other brain areas. For the addict, this conflict within the brain results in a divided self. One part craves the alcohol that will satisfy the addicted part of the brain and tries to override the rational areas of the brain that are now increasingly numbed or anesthetized by long-term alcohol use. The other part knows the damage that the addiction is doing and wants to break free of the alcohol.

Programs such as Rational Recovery offer techniques to enable a person to listen to the “inner voice” (referred to as “The Beast”), disabling it and preventing its influence over the normally rational self. This “inner voice,” called the AV (addictive voice) by Rational Recovery, responds to alcohol-induced changes in brain chemistry and neurology by sending crude messages to a numbed and underdeveloped cerebral cortex such as “it’s fine to have just one more,” and “that first drink did no harm, so I guess I can drink like everybody else at this party.”

Rational Recovery claims that once The Beast has been recognized, brought under control, and successfully caged the urge to drink will disappear.

Recent findings indicate that the amygdala, which forms part of the primitive portion of the brain, develops more rapidly in adolescents than the more rational areas of the cerebral cortex. The amygdala deals with sensitivity, our response to fear, and our reactions to risky situations. Adolescents are more prone to experience fear, for example in certain social situations, and have greater difficulty unlearning automatic fear responses. For a further discussion of this see “Why Teenagers Act Crazy,” by Richard A. Friedman, a Professor of Clinical Psychology at Weill Cornell Medical Center, in New York (New York Times, June 29, 2014).

Teenagers are also prone to be risk takers. If in addition, they are socially awkward, shy, withdrawn, and lonely they are even more vulnerable. When they experience uneasiness, again, such as in social gatherings, they may respond by self-medicating with alcohol or with pharmaceutical psychostimulants like Ritalin and Adderall, the sales of which increased more than five-fold in the decade from 2002 to 2012. To make matters worse, the drinking culture at many high schools and colleges poses a challenge to vulnerable students. They may graduate from college not only with debt but with the beginnings of serious addiction.

Scientific research also indicates that alcoholics may have inherited genetic characteristics that cause their bodies to react to or metabolize alcohol in atypical ways. These people may have inherited a marked sensitivity or allergy to alcohol. Studies in England have revealed that single base-pair point mutations in a particular gene (Gabrb1), an important part of the GABAA receptor in the brain, have a particularly strong effect on the brain’s pleasure center (the nucleus accumbens) of laboratory mice, causing them to prefer alcohol containing liquid (primarily wine) over water at least 85% of the time.

Other research suggests that persons prone to addiction may have abnormalities in an area of the brain known as the medial forebrain pleasure circuit, where the neuromodulator dopamine plays a crucial role. On this see a recent study by Neuroscience professor David J. Linden of the Johns Hopkins University School of Medicine entitled The Compass of Pleasure (New York: Viking Press, 2011). You can also see the book by the well-known scientist-writer Marc Lewis called Memoirs of An Addicted Brain- A Neuroscientist Examines His Former Life on Drugs (New York: Public Affairs, 2012).

I was responsible for my alcoholism since it happened “on my watch.” When I became alcoholic, it was also my responsibility to do something about it, to get myself into recovery, and that took me too long because I was a slow learner. In denial, I thought I could drink moderately. Eventually, I learned I was wrong. I wish I had had the help of others on the internet, but that didn’t exist in those days. I should have sought the support of other recovering alcoholics in AA or elsewhere. That would have been the “higher power” which could have speeded my recovery. But that’s all in the past. I must live in the “Now.” I am old now, and the future is uncertain. So “now” I hope to help others. That’s why I have written this.


About the Author, Bill P.

Bill P. has had a long and successful career as a law professor, retiring in 1997. Since then he has focused on helping others with alcoholism and drug addiction. He has a web-site, Alcoholism, and the Higher Power, that offers guidance on how to utilize AA despite its “god stuff.” He also routinely posts on soberrecovery.com. Bill does not believe himself to be an agnostic, much less an atheist, but he appreciates what agnostic AA meetings have to offer. He lives on the east coast with his wife and an exceptionally wise and loving English Cocker Spaniel.

Audio Story:

The audio story was narrated and recorded by Len R. from Jasper, Georgia. Len is interested in starting a secular AA meeting in his area. If you would like to join him, please send an email to lenr.secularsobriety@gmail.com

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  1. Galen T. February 15, 2017 at 7:14 pm - Reply

    Bill- Thank you for your informative and well-researched article.  I notice that despite all the evidence you cite about the effect of alcohol on the brain you don’t label alcoholism a brain disease.  In fact, in the final paragraph you count yourself as responsible for your addiction.

    As you know, the debate is fervid and ongoing.  Is alcoholism an inherited disease entity, a learned behavior, a product of personality twists and psychiatric ailments, a consequence of socio-economic factors, or a predictable outcome  of childhood trauma?  Probably all four, with one or two others thrown into the mix.  For any one person, one or two causative  factors may predominate.

    But when it comes to getting better the big debate is irrelevant.  I know what I need to do to stay sober and continue recovering.

     

     

  2. Tommy H February 13, 2017 at 8:16 am - Reply

    Well said, Bill.

  3. Victoria February 12, 2017 at 8:39 pm - Reply

    Hi Bill,

    Great to see you doing your thing amongst the broader church 🙂

    For any here wondering: I know Bill from his wonderfully eccentric and very wise posts over at soberrecovery (itself, a very broad ‘church’, encompassing large sub-sets of people travelling many different journeys to recovery from addictions). Many of which are neither fish nor fowl, or both.

    Thanks for contributing here too at AA BB, Bill.

    Warm regards, and a big paw-pat from Bessie (blue heeler – border collie) to your doggie.

    Vic

     

  4. Grimpeur February 12, 2017 at 3:22 pm - Reply

    Perhaps the greatest asset AA has is revealed when a member says “in my experience…”. Anything beyond that is mere conjuncture or opinion, and is usually worth what it costs.

    If I wished to consider pronouncements about addiction and legal matters, I would pay attention to a lawyer. If I wished to hear about addiction and the burgeoning discipline of neuroscience, I would rather hear from one active in that ever changing and ever more relevant  field.

    It’s sometimes amusing, sometimes alarming, this tendency for AA members to rush in where angels and mental health professionals fear to tread.

    • Bill P. February 13, 2017 at 1:24 am Reply

      P.S. Many of the citations to the source material relied upon by me in discussing neurological research were deleted in the editorial stage of preparing this article. The deleted citations were to the New York Times. Despite the misgivings of some politicians and others, it largely succeeds in printing “all the news that’s fit to print”. I respect the Times and believe I did not act improperly in passing this information on. I found it interesting- neither “amusing” nor “alarming”.  When posting on Soberrecovery I carefully follow their rule that members should not give medical advice. I follow this rule on my website. In doing so I act merely as a journalist. If I have any skills  they probably exceed what remains of any I may have had as a lawyer.

    • Bill P. February 13, 2017 at 12:49 am Reply

      Grampeur:

      I stand corrected by you! Although I am not a full fledged “member” of AA,  I should only opine on matters which have fallen within my “experience”. Thus all the work I did on this article has been presumptuous if only physicians and medical health professionals are qualified to enter the realm where “angels fear to tread”. We laymen (lay persons?) must meekly accept AA’s doctrine that alcoholism is “caused” by “character defects” which can only be “removed” by surrendering to a “Higher Power…which is God”. Since I question whether this has really been my “experience” it follows that all the effort I have put on this article (depending largely on physicians and medical health professionals whom I respect) as well as what I have put on my website to help other sufferers has been a presumptuous intrusion into matters on which I am unqualified. In view of this AA would consider that my 28 plus years of sobriety have been spent as merely a “dry drunk”. I retired from the law 20 years ago and am no longer qualified to speak of “legal matters”. I do know something about dogs, but then again I’m not a breeder or professional show handler.  I think the better option is to retreat to the silence of Daoism and eventually the even greater serenity of the graveyard.

      W.

      • life-j February 13, 2017 at 1:10 am Reply

        Hmm, Bill, you said it with more nuance than me 🙂

        thanks

    • life-j February 12, 2017 at 4:48 pm Reply

      Grimpeur

      We have a complicated problem on our hands. AA does not want to hear about any science from after 1939. But AA is all too happy to lecture the professional community of doctors, lawyers and neuroscientists about how god can fix anything.

      To the point where AA is indirectly in control of the workings of the whole recovery “industry”. Yes make no mistake about it it, it’s a $500m  industry.

      So how do we help alcoholics when god doesn’t work, and shelling out $5000+ for a month at a recovery center in most cases does not work? And when mental health professionals fear to tread on the korns of AA?

      We start talking about it, whether we, strictly speaking, are the best qualified or not to write an article on the science of recovery, wouldn’t you say? Change gots to come from somewhere. If we don’t do it, and no-one else does it, then who?

       

      • life-j February 12, 2017 at 4:51 pm Reply

        OOps, I forgot to add “In my experience”.

        • Kit G February 13, 2017 at 10:14 am Reply

          Hilarious!  thank you

  5. Bill P. February 12, 2017 at 2:41 pm - Reply

    P.P.S. Dr. Johnson’s third cat was named “Oscar” not “Casper”. Not too many folks know this and I got it all mixed up  Sorry! I guess my “Beast” was confusing me. If in doubt blame the “Beast”.

     

    Bill.

  6. life-j February 12, 2017 at 11:16 am - Reply

    Bill, thanks.

    It is important that we start bringing in science into our recovery, and that we acknowledge the other secular programs’ contribution to recovery as well.

    It must only be because there is such a strong sentiment in favor of religion in the US that religious members of alcoholics anonymous has been allowed to practice medicine without a license for so long.

    Given the generally conservative trend over the last 30 years it remains to be seen how successful we will be in altering the course of this supertanker which is AA, but I’m glad we’re giving it one hell of a try.

  7. Bill P. February 12, 2017 at 11:07 am - Reply

    P.S. As might be apparent, I’m neither fish nor fowl. A bit of an outsider, like Woody Allen  who joked that he would never join any club that would admit him as a member. So sometimes I’m a “God” believer, sometimes a Buddhist, Daoist. You name it, I got it! Am reaching 90. Watch out! Certainly not a “lawyer”! Dr. Johnson hated lawyers and Americans. And what did he think about American Lawyers! And just to make sure I’ve named my dog “Boswell”. Johnson was a cat lover- “Hodge”, “Lily”, and their dad, “Casper.”

    For more of this extraneous comment see my website, under a pseudonym http://hmcclay.org.

    Seriously thanks for your kind and helpful comments.

     

    Bill

     

  8. Joe C. February 12, 2017 at 10:06 am - Reply

    Bill,

    First, this is great. AA isn’t the Big Book (only). While some prefer the reified repetitive strains of allergy analogies and the hetro-patriarchal-normative narrative of the problem and the solution, many of us are adapting to the “more” that is being revealed. Just speculating here, but the term “alcoholic” may grow out of fashion in our lifetime and how much more old-fashioned would our age-old literature sound, then? Great essay, Bill. I learned a few thing, here.

    Are you involved with ILAA (International Lawyers in AA)?

    Our agnostic/atheist home group has more than our fair share of lawyers. It’s probable that that Secular AA has a timely role to play in the work that ILAA does and AA’s cooperation with the professional community in general. There is a growing appetite for secular (non-religious) peer-to-peer options and while SMART, Life Ring, SOS et al are legit solutions, none of them are ubiquitous in the way AA is.

    I wonder if it’s not time if SAA, as part of AA, start doing our own outreach/public info and cooperation with the professional community. It seems by circuit court rulings, secular AA is the best kept secret in the corrections and institutions world. Does this really have to be the case?

    • Pat N. February 12, 2017 at 10:51 am Reply

      Re the word “alcoholic” becoming outdated: That’s my feeling-it’s too emotionally loaded and has too many interpretations. At meetings, I introduce myself as “I used to be addicted to alcohol” for two reasons: I’m not addicted now, thanks to the fellowship’s help; and I’m brother to those who were addicted to other drugs-I’m not special just because my drug was alcohol.

      Good article. I’ll print it out & use it. My current sponsee is a lawyer, btw.

  9. Tommy H February 12, 2017 at 6:56 am - Reply

    Good article.

    Is there a way to subscribe to comments w/o making one?

    • John S February 12, 2017 at 9:22 am Reply

      I don’t think there is a way as of now Tommy to subscribe to comments without actually commenting, but I will look into an option.

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