Alcohol Research in the News

Interesting research on the relationship between residence area and alcoholism. In the usual study, alcoholism is treated as the dependent variable, as being affected by the residential surroundings. But this research looks at the effect of alcoholism on where the person is living and proclaims a two-way street rather than a uni-directional relationship. What does this mean for treatment and recovery?

Buu noted that the study's findings show that the damaging effects of alcoholism are much broader than simple health consequences. "The effects also have a long-term impact on quality of life, including where one lives and their quality of life. Social environment appears to play some role in keeping the disorder going, and possibly even making it worse: we can see effects going from community to individual, and from individual to social environment. Preventive efforts therefore may also have effects in both directions."

Trim added that the results have both cautionary and optimistic applications for alcohol misuse. "The findings highlight the far-reaching impact of alcohol problems on the type of neighborhood an individual could reside in as an adult. Thus, high-risk adults who drift into lower-SES neighborhoods will likely face even greater challenges at recovery due to lack of resources and increased environmental stressors. However, adults who successfully treat their alcohol problems early in life are no more likely to experience this downward social drift than non-alcoholics. I would hope these findings provide additional incentive to any individuals who are unsure or unwilling to enter treatment for alcohol-related problems." . . .

Long-term structural brain damage for alcoholics even when they manage to stop drinking? Sadly, yes, according to this research and its conclusions.

"Even though both groups of participants performed similarly on the task, what distinguished them were their brain activation levels while engaged in the memory task," said Sullivan. "The attenuated activations were in brain regions that are known to contribute to goal-directed behaviour, error monitoring, drug-seeking behaviour, and declarative memory, that is, memory for new events."

"We call this phenomenon 'latent lesions' or 'subclinical pathology'," said Kato. "To date, brain damages induced by alcohol are known to cause structural changes such as brain atrophy and shrinkage. Conversely, latent lesions mean brain damages not seen in a structural brain examination. Latent lesions may occur without apparent cognitive impairments, so that people continue drinking alcohol without noticing damage to their brain."

"This functional brain imaging study focused on young to middle-aged adults with a relatively long drinking history and current abstinence period," added Sullivan. "Other studies of brain structure commonly find that this age group has less evidence for structural brain damage than older alcoholics. But this research group has shown that, in spite of the absence of visible brain lesions or other brain dysmorphology, these younger alcoholics showed differences from controls in brain responsivity to their test stimuli. In other words, alcoholics carry untold liability for brain damage, whether functional or structural." . . .

Could those damages have led to the results of this research?

A new study uses functional magnetic imaging (fMRI) to examine emotional processing, finding that alcoholics have stunted abilities to perceive dangerous situations.

"We knew that alcoholics show a deficit in accurate recognition of facial emotions," said Jasmin B. Salloum, research scientist at the National Institute on Alcohol Abuse and Alcoholism and corresponding author for the study. "This can lead to insensitivity to, and overestimation and/or misattribution of, certain facial expressions."

"Relatives and friends of alcoholics often wonder why they continue to drink even though they intellectually know how detrimental this is for them," added Andreas Heinz, director and chair of the department of psychiatry at Charité -- University Medical Center Berlin. "Patients often relapse when entering previous drinking situations, that is, entering a bar or a shop in which you can buy alcoholic drinks. One reason may be that they fail to perceive dangerous situations. This study suggests that there is a neurobiological correlate of this often-reduced ability to perceive dangerous situations."

The implications?

"Alcoholic patients are known to be sensation seekers and are less likely to shy away from signals that suggest danger. Both sensation seeking and avoidance of danger are characteristic of subjects with axes II personality disorders, which many of our subjects had. The findings in this study may shed some light on some of the problematic and psychopathological behaviors that are manifest in this patient group. It remains to be determined if the dysfunction of the anterior cingulate precedes alcoholism or is a result of long term drinking."

There is, however, a silver lining, added Heinz. "Now we can begin to understand why patients have problems avoiding dangerous situations and, particularly, why they may not react to the concerns of their friends and relatives: the brain area that should help them appreciate these concerns is functioning at a reduced level. Furthermore, the authors also observed a normal or even increased brain response to happy faces. Our group recently made a similar observation, in that patients with strong brain responses to pleasant pictures have a reduced relapse risk. So, relatives and friends may want to support alcoholic patients with positive messages that strengthen their self-esteem while being particularly careful, and even repetitive, in pointing out the dangers of alcohol and alcohol-associated environments. Otherwise, the patients may miss the message."