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Neurobiology of Alcoholism

Advances in neuroscience have sharpened our understanding of how alcohol affects the brain. This explosion of knowledge enables therapists to move their understanding and ways of talking about alcohol abuse with their clients away from the subjective values and fuzzy measurements that often fail to break through their denial. By bringing the latest scientific knowledge and clarity into their discussions, therapists can explain to clients and their families not only how alcohol affects behavior and relationships, but also how it alters and damages the most basic architecture and functioning of the human brain. Changes occur on every level, from regions of the brain, to neurotransmitters such as dopamine and serotonin, and down to the most basic cellular level, where the manufacture of neurotransmitters and the brain cells which transmit and receive them are affected.

This new knowledge helps therapists more accurately diagnose and differentiate between alcohol use and abuse. It can better inform therapists’ treatment decisions and recommendations. As the research grows, aided by sophisticated new brain imaging techniques, some of the long-standing questions about alcohol’s effects on the brain are finally being answered.

Here’s a quick recap:

  • alcohol’s chronic effects are determined by gender, age, amount of alcohol, length of time drinking, physical health, level of education, genetic background, and nutrition
  • alcoholic women are more prone to develop cirrhosis, alcohol-induced damage of the heart muscle, and nerve damage after fewer years of heavy drinking than are alcoholic men
  • chronic alcohol use primarily affects the higher functioning, rather than the more primitive functioning levels of the brain
  • much of the brain damage caused by alcohol can be reversible with abstinence, depending primarily upon the person’s age and years of drinking
  • by affecting both the excitatory neurotransmitters and the inhibitory neurotransmitters–not just during drinking but in between drinking episodes– alcohol throws the brain off balance, creating increased craving and withdrawal difficulties
  • brains of alcoholics are similar to brains of significantly older nondrinking people
  • comorbid conditions can aggravate alcohol’s effect on the brain including malnutrition, liver and cardiovascular system diseases, head injury, depression, anxiety, post-traumatic stress disorder, schizophrenia, and the use of other drugs

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