Alcohol Consumption and Changes in the Brain

As Daniel Amen writes in Change Your Brain, Change Your Body: Use Your Brain to Get and Keep the Body You Have Always Wanted, “Your brain is involved in everything you do, every decision you make, every bite of food you take, every cigarette you smoke, every worrisome thought you have, every workout you skip, every alcoholic beverage you drink, and more.”

And yet, the brain is also affected by all of those activities, and it changes based on what we put into our bodies. When it comes to alcohol, these changes can be quite significant, involving everything from temporary shifts to long-term wiring and structural changes, all of which can profoundly affect our experience of the world.

Part 1: What Happens When We Drink

The brain is a bustling hub of activity, with billions of neurons zipping messages around — 24/7! When alcohol enters this dynamic environment, it has immediate effects, as well as ones that linger the following day. Let’s start by exploring these temporary shifts, which involve four types of neurotransmitters, the chemical messengers that keep the brain buzzing with activity and regulate our mood, behavior, and physical experience.

The Immediate Dopamine Buzz

Seconds after that first sip, alcohol travels through our bloodstream and crosses the blood-brain barrier. It starts influencing the brain immediately. It magnifies the release of dopamine, a neurotransmitter responsible for feelings of pleasure and reward. That's why that first sip can sometimes feel so satisfying. 

The initial surge of dopamine is strongest at the onset of alcohol consumption. As we continue to drink, however, the dopamine system doesn’t continue to release at the same heightened level. It means the euphoric feelings tied to dopamine might begin to plateau or even diminish with subsequent drinks. That's why the first drink often feels the most rewarding, and there's a diminishing return of that "high" with more booze.

2: The Depressant Effects of GABA 

While the initial sips of an alcoholic beverage bring a rush of dopamine (and the euphoria that comes with it), alcohol's broader effects on the brain are a bit more intricate. Alcohol is classified as a central nervous system depressant. But what does this mean, and how do GABA and glutamate come into play? 

First things first: the term "depressant" doesn’t imply that it makes one feel depressed emotionally — instead, it refers to the slowing or "depressing" of certain brain functions. Alcohol dampens the speed of neurotransmission, decreases the excitability of neurons, and results in a slowdown of physical and cognitive functions.

Gamma-aminobutyric acid, or GABA as it's more conveniently known, is the chief inhibitory neurotransmitter in the brain. It’s the brain's natural "chill pill,” reducing neuronal excitability and promoting calmness and relaxation. Alcohol boosts the effects of GABA, leading to increased drowsiness, slowed reaction times, and the familiar relaxation associated with drinking.

3: Glutamate Taking a Backseat

On the opposite end of the spectrum from GABA is glutamate, the primary excitatory neurotransmitter: it speeds up transmissions and enhances brain activity. Alcohol inhibits glutamate's excitatory signals, contributing to the overall depressant effects on the central nervous system.

The Combined Influence on Behavior and Cognition

With GABA's effects boosted and glutamate's effects suppressed, the net result is a pronounced slowing down of the brain's activities. This is why consuming alcohol leads to slurred speech, decreased motor coordination, drowsiness, blurry vision, and impaired judgment.

Memory Lapse: The "I Did What?" Effect

Ever had one of those nights where memories are fuzzy, or there are blank patches from the evening? Alcohol also impedes our brain's ability to form new long-term memories. It doesn’t erase them, but it does blur the recording process, making it hard to recall specific events.

4: Dynorphin: The Brain's Reality Check

When discussing alcohol's effects on the brain, the spotlight often shines on neurotransmitters like dopamine, GABA, and glutamate. But there’s another key player: dynorphin. It’s not as commonly known as the others, but understanding dynorphin offers a more comprehensive picture of the brain-alcohol relationship.

Dynorphin is a type of endogenous opioid peptide, which is naturally produced in the brain and binds to opioid receptors, much as endorphins do. But unlike endorphins, which are often associated with feelings of pleasure and euphoria (think of the “runner’s high”), dynorphin produces the opposite effect. It's often linked with feelings of dysphoria or general unease.

How does alcohol act upon dynorphin? When we drink — especially in larger quantities — a dopamine surge creates feelings of pleasure and reward. However, in an effort to maintain equilibrium, the brain releases dynorphin as a countermeasure to dampen and balance the dopamine, ensuring that the euphoria we feel doesn’t go over the top.

Broader Implications of Dynorphin


Beyond its interaction with alcohol, elevated dynorphin levels have implications for mood and mental well-being. Over time, as the brain gets accustomed to regular and high levels of alcohol intake, it produces more and more dynorphin to counteract our heightened dopamine levels. This contributes to a reduced sense of pleasure or reward from alcohol and other activities, leading us to consume even more alcohol in an attempt to chase the diminished highs — a cycle that is a crucial factor in the development of dependence and addiction.

Part 2: Dependence and the Brain's New "Normal"

With regular heavy drinking, the brain adapts to this new alcohol-infused environment. It begins to expect alcohol's presence, leading to increased tolerance and dependence. 

Alcohol dependence isn't just about consuming more drinks or feeling a craving — it signifies a profound adaptation within the brain, which reorganizes itself and adjusts its baseline functioning. This alteration goes beyond behavior; it encompasses structural and chemical changes that redefine the brain's "normal”:

• Altered neurotransmitter balance. Regular alcohol consumption disrupts the brain's delicate balance of neurotransmitters. For instance, the brain may produce more glutamate and less GABA to counteract alcohol's depressant effects, causing anxiety or discomfort when alcohol is absent.

• Dopamine system reconfiguration. Chronic exposure to booze changes the dopamine system's responsiveness. While initial alcohol consumption may lead to dopamine surges, over time and with increased tolerance, more alcohol is required to achieve similar dopamine release levels.
• Changes in brain structures. Certain regions of the brain — especially those linked to judgment, decision-making, and behavior control (associated with the prefrontal cortex) — may change, affecting our ability to resist cravings or make sound decisions around alcohol.
• Enhanced stress response. The brain's stress systems become more sensitive with consistent alcohol use. In the absence of alcohol, a person might feel heightened levels of stress or anxiety, nudging them back towards drinking as a way to alleviate these feelings.
• Shift in reward pathways. The brain associates alcohol with reward more strongly, reinforcing drinking behavior. Other pleasurable activities pale in comparison, further entrenching alcohol as a primary source of reward.
• Cellular adaptations. On a microscopic level, the dendrites — branch-like structures on neurons that receive signals — can undergo morphological changes that alter how they process and transmit information.

What Happens in Withdrawal

When someone who has been drinking heavily for a while reduces or ends alcohol consumption, the brain throws a bit of a "where's my drink?" tantrum. Let's explore this reaction and the brain-related symptoms that arise during withdrawal.

• Anxiety and mood disturbances. Remember how alcohol boosts GABA, the calming neurotransmitter? Without alcohol, the brain is left in an over-excitable state, leading to anxiety and mood swings. 
• Seizures. In extreme cases, the sudden absence of alcohol can lead to seizures resulting from the heightened activity of excitatory neurotransmitters, which can overstimulate the brain to a dangerous degree.
• Cognitive difficulties. Decision-making, memory recall, and attention can all take a hit during withdrawal. 
• Sleep disturbances. Many find it harder to fall asleep or stay asleep during withdrawal due to the imbalance of neurotransmitters that play a role in sleep regulation. 
• Hallucinations. In more severe cases, some people experience visual, auditory, or tactile hallucinations due to the brain's heightened state of arousal and imbalance.
• Headaches. A common symptom, headaches during withdrawal can be linked to the sudden shift in the brain's chemical balance — like a computer operating system rebooting and adjusting to a new normal.

Part 3: Chronic Drinking and Brain Health

Consistent high levels of alcohol intake can lead to some troublesome changes in our brains. Just like how constant sun exposure can affect our skin, chronic drinking has some lasting impacts on our brain's landscape. Let's demystify these changes and their implications:

• Brain structure shrinkage. Believe it or not, heavy and prolonged alcohol consumption can lead to a reduction in brain volume. It's as if the brain, feeling overwhelmed, decides to downsize its operations.
• Disruption of neurotransmitters. Our brain communicates using chemical messengers called neurotransmitters. Chronic alcohol use can disrupt their operations by making them less effective or overly abundant, throwing off our mood, reactions, and overall brain function as a result.
• Impact on memory and learning. Chronic drinking can impair the hippocampus (our brain’s memory hub), leading to difficulties in forming new memories or recalling old ones.
• Brain plasticity problems. Our brain has an amazing ability called plasticity, which allows it to change and adapt throughout our lives. Chronic alcohol use hinders that, making learning and adaptation harder.
• Cognitive decline. From decision-making to problem-solving, chronic drinking can put a dampener on cognitive functions. Tasks that once seemed a breeze might now feel overwhelming.
• Emotional effects. Alcohol can impact brain regions responsible for regulating emotions, such as the amygdala, leading to mood swings, sadness, or reduced emotional responsiveness.
• Wernicke-Korsakoff Syndrome (WKS). This is a big one! WKS is a serious neurological disorder brought on by a deficiency in thiamine (vitamin B1), often associated with chronic alcohol consumption. It has two primary phases:
  
  Wernicke's encephalopathy. Symptoms include confusion, issues with muscle coordination, and vision difficulties, like back-and-forth eye movements or droopy eyelids.
  
  Korsakoff's psychosis. The next stage is even trickier. Memory problems become prominent, especially with forming new memories. Some might even make up stories to fill memory gaps, a condition called confabulation.

The Good News: The Brain's Remarkable Resilience

Despite the negative effects, our brains have an astonishing ability to heal. Reducing alcohol or quitting altogether can lead to improvements in cognitive function and a reduction in structural brain damage over time. Plus, the body is programmed to heal, so when we cut back or quit, it jumps into repair mode, mending the damage.

Steps To Foster Brain Health in Relation to Alcohol

• Know your limits. Understand how much is too much. Aim to stay within recommended guidelines, and if you're unsure what those are, check with a health professional.
• Hydrate. Alcohol dehydrates the body and brain. For every alcoholic drink, have a glass of water. This will keep you hydrated and may also reduce the overall amount of alcohol consumed.
• Sip slowly. If you choose to drink, instead of chugging down, take your time with each drink. This gives your liver time to process the alcohol and reduces the immediate impact on the brain.
• Stay social, sans alcohol. Plan activities that don't revolve around drinking. Movie nights, hikes, or board game evenings can be just as fun, if not more, without alcohol.
• Educate and share. Learn about alcohol's effects on the brain and share this with friends and family. Awareness can lead to informed choices.
• Mindful drinking. Pay attention to why you're reaching for a drink. Is it out of habit? Stress? Social pressure? Recognizing these triggers can help you make mindful decisions.
• Seek support. If you're trying to cut back or quit, reach out for help. Whether it's a friend, family member, or professional, having a support system can make the journey smoother.

Brain Marvels

In the words of Neil deGrasse Tyson, “Everything we do, every thought we've ever had, is produced by the human brain. But exactly how it operates remains one of the biggest unsolved mysteries, and it seems the more we probe its secrets, the more surprises we find.”

Our brains are marvels, constantly working, adapting, and helping us navigate our world, and it’s crucial to be aware of the effects of what we consume on them. With a mindful approach, you can make informed decisions about your alcohol consumption. While it might take a bit of effort at first, it’s worth it in the end — after all, the decisions we make today shape our experiences and memories for years to come!