One of the difficulties in treating alcoholism as a disease is that it does not look like a disease. It doesn’t look, sound, smell, and certainly doesn’t act like a disease. Worse, generally speaking, it denies its existence and refuses treatment.
For many years, professional medical institutions have regarded alcoholism as a major, chronic, progressive, and sometimes fatal disease. The National Committee on Alcoholism and Drug Dependence provides a detailed and complete definition of alcoholism, but the simplest way to describe it may be the obsessive-compulsive disorder that causes the body to drink alcohol.
Mental obsessive-compulsive disorder? Do you play a song over and over again in your head when you wake up in the morning? It may be a commercial advertisement you hear on TV or a song on the radio, but it keeps playing… it keeps playing.
Remember what it was like? No matter what you do, that stupid tune keeps playing. You can try to whistle or sing another song, or turn on the radio to listen to another song, but the one in your head keeps playing. think about it.have What’s in your head You didn’t put it there, no matter how hard you tried, you couldn’t get out!
Mental obsession can be defined as a thought process that you cannot control.
This is the essence of alcoholism. When the drunkard started to play drinking “songs” in his mind, he was powerless. He didn’t put the song there, the only way to stop it was to have another drink.
The problem is that the alcoholic’s mental obsession with alcohol is much more subtle than the song playing in his head. In fact, he might not even know it was there. All he knew was that he had a sudden urge to drink–a physical impulse.
Neurobiology of Alcoholism
In 2016, American surgeons released a report, “The United States Faces Addiction: A Surgeon’s Report on Alcohol, Drugs, and Health”, which detailed changes in the brain regions of drug addicts. The section entitled “The Neurobiology of Substance Use, Abuse and Addiction”.
According to the report, substance use disorders are caused by brain changes caused by repeated use of alcohol or drugs. These changes occur in the brain circuits involved in pleasure, learning, stress, decision-making, and self-control.
Reuse affects the reward system
When someone drinks alcohol or takes drugs such as opioids or cocaine, it produces a pleasant surge of dopamine in the basal ganglia of the brain, which is the area of the brain responsible for the ability to control rewards and reward-based learning.
With the continuous use of alcohol or drugs, the nerve cells in the basal ganglia “reduce” their sensitivity to dopamine, thereby reducing the ability of alcohol to produce the same “high” as it once produced. This is known as building tolerance to alcohol, and it causes drinkers to consume more alcohol and thus feel the euphoria they have done before.
Quality of life is affected
These same dopamine neurotransmitters are also involved in the ability to obtain pleasure from daily activities, such as eating, making love, and participating in social activities.
According to a surgeon’s report, when this reward system is disrupted by substance abuse or addiction, even if they don’t drink or take drugs, people’s enjoyment of other aspects of life will become less and less.
Drinking is related to other clues
Another change that may be caused by long-term drinking is to “train” the brain to associate the pleasure of drinking with other “cues” in the life of the drinker. The friends they drink, the places they go, the cups or containers they drink, and any drinking-related rituals they may practice can be linked to their drinking pleasure.
Because many clues in their lives remind them to drink, it becomes increasingly difficult for them not to think about drinking.
Drive to avoid pain
Although the brain’s dopamine transmitter drives us to seek happiness, the stress neurotransmitter found in the expanded amygdala region of the brain drives us to avoid pain and unpleasant experiences. Together they force us to take action.
Studies have found that drug abuse, including alcohol use disorder, can disrupt the normal balance between these two basic driving forces.
Avoid withdrawal pain
As alcohol use disorder changes from mild to moderate to severe, drinkers experience more and more pain when they are not drinking. Alcohol withdrawal symptoms can become very uncomfortable or painful.
At this stage, the person no longer drinks to experience happiness. In fact, drinking alcohol may not even bring any pleasant feelings anymore. Drinkers drink to avoid pain, not for excitement.
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Alcoholics can no longer reach the highs they have experienced because of tolerance, but the lows they experience when they are not drinking will get lower and lower. Other pursuits in life that once brought happiness and balance lows are no longer so at this point.
When drinkers are relatively healthy, they can control their drinking impulses, because the judgment and decision-making circuits of the prefrontal cortex balance these impulses. However, their substance use also disrupted their prefrontal circuits.
Studies have shown that when this happens, alcoholics and addicts have a reduced ability to control their powerful impulses to use, even if they know that stopping is best for them. At this point, their reward system has become morbid, or in other words, morbid.
Explanation of impaired self-control
The surgeon’s report on the neurobiology of drug abuse explains why alcoholics cannot make health decisions in this way:
“This explains why substance use disorders are said to involve impaired self-control,” the report said. “This is not a complete loss of autonomy-addicted people are still responsible for their actions, but they are even less likely to overcome the powerful motivation to seek relief from the withdrawal provided by alcohol or drugs.”
“At every turning point, addicts trying to quit smoking will find their determination challenged. Even if they can resist drug or alcohol abuse for a period of time, at some point, the persistent cravings triggered by many clues in life may erode their Determined to lead to re-use of the drug or relapse,” the report said.
Compounding the problem is the gradual nature of the disease. In the early stages, a drink or two of wine may be enough to stop the “song”. But soon six or seven will be needed, and ten or twelve may be needed later. Somewhere on the road, the only time the song stopped was when he passed out.
The progression of this disease is so subtle and usually lasts so long that even the alcoholics themselves do not notice that he is out of control-alcohol has taken over-moments of his life.
No wonder that denial is almost a common symptom of this disease. For those who have realized that they do have a problem, help may be as close as a white page in a phone book. But for those who need help but don’t want it, there is hope.
Do you have drinking problems? You may want to take the Alcohol Abuse Screening Test to see how you compare.