People who drink to “chill out” may have structurally different brains from those who drink to “catch a buzz.”
A fascinating study recently conducted at the University of Eastern Finland examined the post-mortem brain tissue of alcoholics. The brains were divided based on their Cloninger’s typology, and the results may help in the creation of more individualized treatments for those addicted to alcohol.
Types of alcoholics
- Robert Cloninger, M.D., studied the genetic and environmental determinants of alcoholism in a Swedish population. In doing so, he developed a simplified way to categorize the behavioral characteristic of alcoholics. Cloninger’s typology of alcoholism is briefly summarized as follows:
- Type I: Drinks to relieve anxiety; onset after age 25; affects men and women; genetic and environmental etiology; progressive
- Type II: Drinks to induce euphoria; onset before age 25; affects mainly men; genetic etiology; not progressive but associated with fighting and arrests
First, all of the alcoholics’ brains had increased increased levels of the steroid hormone dehydroepiandrosterone, which was reportedly related to the development of alcohol tolerance.
Next, all the alcoholics’ brains also showed decreased levels of serotonin transporters in the brain regions associated with social cognition, a finding that reportedly is consist with social anxiety.
Type I alcoholics were unique in that there were abnormalities in the areas of the brain that modulate stress responses, which could explain the anxiety prone nature of Type I alcoholics. Specifically, they had changes in the endocannabinoid system and the amygdala.
Type II alcoholics had extra receptors that modify how the synapses between neurons function. This specific type of receptor plays a role in learning and regulation of behavior, which might help explain why Type II alcoholics are so impulsive.
Implications for the future
The study findings describe physical correlates of behavioral patterns of alcoholics. It remains unclear the extent to which the brain changes made the alcoholics susceptible to alcoholism and how much the changes were due to long-term alcohol use. These findings will hopefully lead to interventions that can prevent the development of alcoholism in at-risk individuals and potential treatments as well.
American brains on alcohol
Although this study was conducted in Finland, most Americans can no doubt easily think of a Type I and a Type II alcoholic they know. Alcoholism does not confine itself to any particular nation, race, gender or socioeconomic status.
According to a recent epidemiological study, nearly 30 percent of Americans have met criteria for an alcohol use disorder in their lifetimes, and about 14 percent at any given time. Another 30 percent do not drink at all. That leaves only 40 percent, or less than half, of Americans who drink in moderation. Even those who drink in moderation are at risk for developing an alcohol use disorder.
Of those who require treatment for alcohol use disorders, only a small percentage actually receive it, despite the fact that the majority of Americans have insurance that will cover mental health and substance use treatment on par with physical disorders. Rather than experience a safe and comfortable withdrawal followed by residential care and therapy, many are forced to detoxify in a jail cell, intensive care unit or on the street. Still others continue drink until their last breath.
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About the author
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. Sovereign Health is a health information resource, and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.