Swedish scientists have discovered a way of reducing cravings in alcoholics – by countering the down-regulated dopamine response that they have upon taking a drink. The effect of a dopamine-stabilizing drug was very promising, with even those who were highly addicted craving less alcohol as a result. But fixing dopamine levels may not be the cure-all for cravings as other researchers found that another brain chemical — glutamate — could also be linked to alcohol cravings.
Doctoring Dopamine Levels
In a study published in European Neuropsychopharmacology¸ Swedish researchers dosed alcoholics with either a placebo or the dopamine-stabilizer OSU6162 for two weeks. Those who had been given OSU6162 reported fewer cravings both in trigger situations when they didn’t drink and after drinking one glass of alcohol. The OSU6162 group even admitted to not enjoying the first sip of alcohol as much as the placebo group.
“One interesting secondary finding was that those with the poorest impulse control, that is those thought to be most at risk of relapse after a period of abstinence, were those who responded best to the OSU6162 treatment,” study co-author Professor Pia Steensland said.
The normal human response to drinking alcohol is a surge of the neurotransmitter dopamine, a reward chemical. But alcoholics drink so much that it is thought that their brains’ reward systems become desensitized over time, leading to lower levels of dopamine. OSU6162 is believed to counteract the problem by returning the down-regulated levels of dopamine to normal, explaining why alcoholics don’t feel the need to drink as much when they take it.
A Glut of Glutamate
However, what happens to someone’s brain chemicals when they are addicted to alcohol is not fully understood. There appears to be more to cravings than dopamine alone.
Just as the Swedish scientists were celebrating their findings, the Research Society on Alcoholism reported that they had discovered increased glutamate levels in the brains of people who suffered from alcohol cravings. Published in Alcoholism: Clinical and Experimental Research, the Society’s study found that the more glutamate in the left dorsolateral part of the prefrontal cortex, the stronger alcohol cravings were.
Although Professor Steensland noted the “promising” results of the Swedish study, she did concede that “a marketable drug” formed from OSU6162 to stop alcohol cravings was still a long way off.
Indeed, there seem to be many neural systems involved in addiction and several types of craving triggered by different states and involving differing neurotransmitters. Only targeting one brain chemical seems unlikely to provide a solution to all the cravings that alcoholics encounter.
Types of Craving
There is a difference, for example, between the craving to drink alcohol before an alcoholic has actually had a drink and the craving to continue once a session of drinking has started. Subjectively, the cravings feel different, making it likely that different levels or types of neurotransmitter or different parts of the brain are involved in each case.
Cravings come about for varying reasons as well. Too much stress, sadness or emotional turmoil can cause an alcoholic to want to turn to the bottle in order to blot out their feelings or raise their mood. It could well be that the alcoholic is dealing with a lack of serotonin. If the addict has not learned many coping skills or healthier ways of raising their serotonin levels, such as exercise, they may well start to crave alcohol, recalling the short-term comfort it previously brought them when they felt negative emotions. Trying to fix their dopamine levels in this case would most likely just lead to frustration.
Fellowship groups warn recovering alcoholics not to get too hungry, angry, lonely or tired. In this advice we can see not only the risk of poor decision-making when in these states, but also the likelihood of upsetting delicate balances of brain chemicals, which could cause cravings.
Alcoholics suffer from a sort of Pavlovian craving, too, when exposed to environmental triggers that remind them of drinking. Even if they don’t want a drink and are determined not to have one, they cannot stop their brain from telling them otherwise. Years of drinking have conditioned their brain to think of drinking as rewarding, even if it no longer is. So even the sight of a bottle or bar can release anticipatory dopamine in the brain of an alcoholic. If this little taste of dopamine is not followed up by a real reward, the craving for a drink can escalate, sometimes becoming unbearable.
While Scientists Fall Short, Alcoholics Can Take Action
Any or all types of alcohol cravings might, according to the research, be strengthened by an excess of glutamate, which can be caused by diet as well as natural states and processes in the brain. The Research Society on Alcoholism only noted the correlation between higher glutamate levels and strength of craving in their small study — they did not establish a cause-and-effect relationship.
Sometimes cravings for alcohol seem to come from nowhere, and even scientists can’t explain them all, because we don’t yet understand everything about the complex disorder of alcoholism. It is possible that the alcoholic’s brain will always be susceptible to certain levels or combinations of chemicals that make dopamine hits seem excessively attractive. Whether or not this is partly genetic is something researchers are keen to discover.
While researchers are still struggling to formulate the perfect craving-killer, alcoholics can take action by finding effective cognitive and behavioral help. Rehabilitation centers can teach addicts techniques to cope with cravings, no matter how they are caused. Treatment programs can help alcoholics find the strength to overcome urges to drink and build rewarding lives where alcohol is far less of a temptation.
Written by Beth Burgess
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