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Binge drinking is a growing public health crisis − a neurobiologist explains how research on alcohol use disorder has shifted
The Conversation ^ | May 13, 2024 | Nikki Crowley

Posted on 05/14/2024 7:01:03 PM PDT by DoodleBob

With the new Amy Winehouse biopic “Back to Black” in U.S. theaters as of May 17, 2024, the late singer’s relationship with alcohol and drugs is under scrutiny again. In July 2011, Winehouse was found dead in her flat in north London from “death by misadventure” at the age of 27. That’s the official British term used for accidental death caused by a voluntary risk.

Her blood alcohol concentration was 0.416%, more than five times the legal intoxication limit in the U.S. – leading her cause of death to be later adjusted to include “alcohol toxicity” following a second coroner’s inquest.

Nearly 13 years later, alcohol consumption and binge drinking remain a major public health crisis, not just in the U.K. but also in the U.S.

Roughly 1 in 5 U.S. adults report binge drinking at least once a week, with an average of seven drinks per binge episode. This is well over the amount of alcohol thought to produce legal intoxication, commonly defined as a blood alcohol concentration over 0.08% – on average, four drinks in two hours for women, five drinks in two hours for men.

Among women, days of “heavy drinking” increased 41% during the COVID-19 pandemic compared with pre-pandemic levels, and adult women in their 30s and 40s are rapidly increasing their rates of binge drinking, with no evidence of these trends slowing down. Despite efforts to comprehend the overall biology of substance use disorders, scientists’ and physicians’ understanding of the relationship between women’s health and binge drinking has lagged behind.

I am a neurobiologist focused on understanding the chemicals and brain regions that underlie addiction to alcohol. I study how neuropeptides – unique signaling molecules in the prefrontal cortex, one of the key brain regions in decision-making, risk-taking and reward – are altered by repeated exposure to binge alcohol consumption in animal models.

My lab focuses on understanding how things like alcohol alter these brain systems before diagnosable addiction, so that we can better inform efforts toward both prevention and treatment.

The biology of addiction

While problematic alcohol consumption has likely occurred as long as alcohol has existed, it wasn’t until 2011 that the American Society of Addiction Medicine recognized substance addiction as a brain disorder – the same year as Winehouse’s death. A diagnosis of an alcohol use disorder is now used over outdated terms such as labeling an individual as an alcoholic or having alcoholism.

Researchers and clinicians have made great strides in understanding how and why drugs – including alcohol, a drug – alter the brain. Often, people consume a drug like alcohol because of the rewarding and positive feelings it creates, such as enjoying drinks with friends or celebrating a milestone with a loved one. But what starts off as manageable consumption of alcohol can quickly devolve into cycles of excessive alcohol consumption followed by drug withdrawal.

While all forms of alcohol consumption come with health risks, binge drinking appears to be particularly dangerous due to how repeated cycling between a high state and a withdrawal state affect the brain. For example, for some people, alcohol use can lead to “hangxiety,” the feeling of anxiety that can accompany a hangover.

Repeated episodes of drinking and drunkenness, coupled with withdrawal, can spiral, leading to relapse and reuse of alcohol. In other words, alcohol use shifts from being rewarding to just trying to prevent feeling bad.

It makes sense. With repeated alcohol use over time, the areas of the brain engaged by alcohol can shift away from those traditionally associated with drug use and reward or pleasure to brain regions more typically engaged during stress and anxiety.

All of these stages of drinking, from the enjoyment of alcohol to withdrawal to the cycles of craving, continuously alter the brain and its communication pathways. Alcohol can affect several dozen neurotransmitters and receptors, making understanding its mechanism of action in the brain complicated.

Work in my lab focuses on understanding how alcohol consumption changes the way neurons within the prefrontal cortex communicate with each other. Neurons are the brain’s key communicator, sending both electrical and chemical signals within the brain and to the rest of your body.

What we’ve found in animal models of binge drinking is that certain subtypes of neurons lose the ability to talk to each other appropriately. In some cases, binge drinking can permanently remodel the brain. Even after a prolonged period of abstinence, conversations between the neurons don’t return to normal.

These changes in the brain can appear even before there are noticeable changes in behavior. This could mean that the neurobiological underpinnings of addiction may take root well before an individual or their loved ones suspect a problem with alcohol.

Researchers like us don’t yet fully understand why some people may be more susceptible to this shift, but it likely has to do with genetic and biological factors, as well as the patterns and circumstances under which alcohol is consumed.

Women are forgotten

While researchers are increasingly understanding the medley of biological factors that underlie addiction, there’s one population that’s been largely overlooked until now: women.

Women may be more likely than men to have some of the most catastrophic health effects caused by alcohol use, such as liver issues, cardiovascular disease and cancer. Middle-aged women are now at the highest risk for binge drinking compared with other populations.

When women consume even moderate levels of alcohol, their risk for various cancers goes up, including digestive, breast and pancreatic cancer, among other health problems – and even death. So the worsening rates of alcohol use disorder in women prompt the need for a greater focus on women in the research and the search for treatments.

Yet, women have long been underrepresented in biomedical research.

It wasn’t until 1993 that clinical research funded by the National Institutes of Health was required to include women as research subjects. In fact, the NIH did not even require sex as a biological variable to be considered by federally funded researchers until 2016. When women are excluded from biomedical research, it leaves doctors and researchers with an incomplete understanding of health and disease, including alcohol addiction.

There is also increasing evidence that addictive substances can interact with cycling sex hormones such as estrogen and progesterone. For instance, research has shown that when estrogen levels are high, like before ovulation, alcohol might feel more rewarding, which could drive higher levels of binge drinking. Currently, researchers don’t know the full extent of the interaction between these natural biological rhythms or other unique biological factors involved in women’s health and propensity for alcohol addiction.

Looking ahead

Researchers and lawmakers are recognizing the vital need for increased research on women’s health. Major federal investments into women’s health research are a vital step toward developing better prevention and treatment options for women.

While women like Amy Winehouse may have been forced to struggle both privately and publicly with substance use disorders and alcohol, the increasing focus of research on addiction to alcohol and other substances as a brain disorder will open new treatment avenues for those suffering from the consequences.

For more information on alcohol use disorder, causes, prevention and treatments, visit the National Institute on Alcohol Abuse and Alcoholism.


TOPICS: Health/Medicine; Society
KEYWORDS: alcohol; bingedrinking; drinking; drugs; drunk; intoxicated; intoxication
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To: ClearCase_guy

Correct.


21 posted on 05/14/2024 7:43:30 PM PDT by drwoof
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To: DoodleBob

The statistic about 1 in 5 adults in the US does binge drinking at least once a week.... That seems like it must be very high, or the people I know are mostly not drinking like that. Not 1 in 5, for sure.


22 posted on 05/14/2024 7:44:31 PM PDT by NEMDF
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To: redfreedom
24 beers to a case, twenty four hours in a day…

That is why a buddy is in an assisted living center (plus his heavy smoking).

Did a job for a Cossack a few years ago outside Lipan (Texas y’all). Got there at 0700 and he was already drinking beer.

Finished the job around 1200 and he had already finished his morning 12 pack and rode his bike into town to buy more beer.

23 posted on 05/14/2024 7:48:54 PM PDT by Deaf Smith (When a Texan takes his chances, chances will be taken that's for sure.)
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To: DoodleBob

And a lot of people become desensitized to the feeling of alcohol consumption and their bodies defenses against it also decline - and even believe how they “feel” is how drunk they are. Wrong.

Then some people drink 2 24 oz. beer bottles and claim “I only had 2 beers.” No, you had 4. Or a mixed drink with several servings of alcohol all in one. “I only had one drink.” No, you had several.


24 posted on 05/14/2024 7:53:02 PM PDT by Republican Wildcat
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To: DoodleBob
Her blood alcohol concentration was 0.416%, more than five times the legal intoxication limit in the U.S.

Amy Winehouse was a special case, an outlier - not the norm!

25 posted on 05/14/2024 8:00:26 PM PDT by Right_Wing_Madman
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To: ClearCase_guy

society. Women are especially unhappy.

If my wife doesn’t have a good pour of a dry red wine, i’m not going to be anything near happy.

Sanity in a glass bottle.


26 posted on 05/14/2024 8:26:51 PM PDT by drSteve78 ( Older Je suis Deplorable. Even more so)
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To: DoodleBob
"A diagnosis of an alcohol use disorder is now used over outdated terms such as labeling an individual as an alcoholic or having alcoholism."

Ahhh...alcoholism feels sad, lonely and outdated, and has chosen to identify as an "alcohol use disorder".

Sorry, my "identity-identifier" gizmo is broken, so I think I'll stick to alcoholism.

27 posted on 05/14/2024 8:27:55 PM PDT by moovova ("The NEXT ELECTION is the most important election of our lifetimes!“ LOL...)
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To: redfreedom

Alcohol use/abuse lead to 178,000 deaths each year. It’s safe to assume 170,000 of those suffered and perished for many years. Leaves a long trail of tears for families and friends.


28 posted on 05/14/2024 8:35:26 PM PDT by cornfedcowboy ( )
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To: posterchild

“”Genetics do play a part and can lead to susceptibility. One uncle used to drink whiskey all day until his 70s and then toned it down to just evenings. He was robbed of his youth at 94.
Another uncle with a Strohs in his hand died at the tender age of 96.””

Alcohol kills brain cells, but only the weak ones.


29 posted on 05/14/2024 8:46:16 PM PDT by Ronaldus Magnus III (Do, or do not, there is no try)
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To: cornfedcowboy

Alcohol is a Western Tradition, with all its joys and horrors all in one.

The only thing worse is prohibition, which didn’t work, was hated, costly, and created a huge black market run by really bad criminals.

Pot smokers try to make the argument that it is no worse than alcohol, which even if true does not mean that we should establish a second huge drug problem as a Western Tradition. Alcohol is quite enough!


30 posted on 05/14/2024 8:47:35 PM PDT by Uncle Miltie (Biden <3 Hamas!)
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To: DoodleBob
George Thorogood and the Delaware Destroyers - If You Don't Start Drinkin' (I'm gonna leave) [youtube video link]
31 posted on 05/14/2024 9:00:44 PM PDT by FLNittany (Autotune is jealous of Karen Carpenter)
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To: DoodleBob

Days of Wine and Roses

Staring Jack Lemon

https://www.bing.com/videos/search?q=jack+lemmon+days+of+wine+and+roses&&view=detail&mid=44A6F427AFD440DC3DA844A6F427AFD440DC3DA8&&FORM=VRDGAR


32 posted on 05/14/2024 9:02:34 PM PDT by Varsity Flight ( "War by 🙏 the prophesies set before you." I Timothy 1:18. Nazarite warriors. 10.5.6.5 These Days)
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To: DoodleBob

She said she’s gonna quit me,
If I didn’t quit the booze.
So I just started drinkin’ more,
To see if she would really choose.
And I have to hand it to that girl
She meant every breath.
An’ I’m glad she did, ‘cause I was about,
To drink myself to death.
Because my drinkin’ problem left today

My Drinkin’ Problem-Hank Williams III


33 posted on 05/14/2024 9:15:32 PM PDT by Round Earther
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To: DoodleBob

Human alcohol consumption has never changed and never will. Genesis 9:21. Proverbs 31:6


34 posted on 05/14/2024 9:20:15 PM PDT by know.your.why (<>)
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To: DIRTYSECRET
Bacon won in Nebraska 2. Does binge drinking matter?

Bacon appeared to win handily. Not a surprise for an incumbent to fend off a challenger.

35 posted on 05/14/2024 10:21:48 PM PDT by rexthecat
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To: DoodleBob

Women and minorities hardest hit.


36 posted on 05/15/2024 12:57:25 AM PDT by ModelBreaker
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To: DoodleBob
A diagnosis of an alcohol use disorder is now used over outdated terms such as labeling an individual as an alcoholic or having alcoholism.

Sigh. Another woke-ist.

37 posted on 05/15/2024 1:27:06 AM PDT by metmom (He who testifies to these things says, “Surely I am coming soon.” Amen. Come, Lord Jesus…)
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To: DoodleBob

Last night was the first time in almost two months where I didn’t have at least one drink. I don’t consider myself an alcoholic as I do not drink during the day, nor do I drink to get drunk, fall down and pass out. I’m the guy with the bottle in my desk drawer and when my long day is done, I like to take a shot or two to unwind.

Yet, for some reason, I am thinking of attending an AA meeting.


38 posted on 05/15/2024 3:23:19 AM PDT by EQAndyBuzz (Give the Anti-Israel Protesters a one way ticket to fight with Hamas. )
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To: EQAndyBuzz

EQAndy, I think it is a good idea that you should look into going to an AA meeting.

The fact that you keep a bottle hidden in the desk drawer, and that it is a fairly recent buy daily habit.... sounds like you are at a choice point for turning things around.

My mother died of alcoholism issues at 64, and my first husband died at 54. They had each fallen, and their organs just shut down. It is very painful to watch people go through the years of suffering, as they did.

Good luck to you.


39 posted on 05/15/2024 11:39:07 AM PDT by NEMDF
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To: NEMDF

NEMDF, Thank you for your feedback. The bottle in the desk draw is not meant for me secretly drinking. Needless to say, I’m proud to say today is day 3 without a drink. I believe it is more out of boredom than anything else. I’m still going to look for a meeting close to me and keep it in my pocket should I lapse.

Again, thank you.


40 posted on 05/16/2024 3:20:03 AM PDT by EQAndyBuzz (Give the Anti-Israel Protesters a one way ticket to fight with Hamas. )
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