This post was originally published on August 1, 2016.
Back in my drinking days, I was extremely talented at getting sad head-shakes and eye-rolls. Right after I’d done something spectacularly stupid, somebody would look and me and ask, “What goes through that head of yours?” I’d just laugh off the question. Now, in recovery, nobody asks me that question anymore—but they should. According to a new study, there’s a world of fascinating change going on upstairs in my head. Researchers believe brain scans will “signal [alcoholic]patients’ heightened risk and lead to targeted drug treatments that reduce the compulsion to drink.” In other words, the more closely researchers examine the changes in a recovering alcoholic’s brain, the more precise alcoholism treatment will become. By thinking ahead, we’ll be able to get ahead of relapses—and, potentially, alcoholism altogether.
When I’d confess to my sponsor that I still thought about drinking, he’d just nod and say, “There’s always going to be some part of your brain that is trying to kill you.” I agree. But thanks to this study, I’m convinced there’s a large part of my brain that’s actually trying to save me, too. The study results, presented at the annual meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), revealed that a sober brain is constantly rewiring, arming and defending itself against…well, itself.
Through brain scans, researchers discovered that as the brain got more and more used to sobriety, a receptor responsible for cravings and relapse got switched off. “Images of the brain lit up like fireworks as people experience pleasure and reward are a familiar sight, but sometimes the reward needs to be taken away,” a ScienceDaily article noted. When that reward (in this case, alcohol) vanishes, many alcoholic brains suddenly compensate and adjust.
The receptor’s name doesn’t exactly roll off the tongue (metabotropic glutamate receptor subtype 5—or “mGluR5,” for short), but it’s responsible for cognition, memory and anxiety, among other things. More importantly, the receptor “plays a role in intense cravings,” a UPI article said. Found in both the brain and the body’s nervous systems, mGluR5 appears to be something of a linchpin when it comes to addiction. By zeroing in on this receptor and tracking its behavior, researchers believe they can tailor treatments for specific patients. “Understanding this relationship between mGluR5 and the compulsion to drink could be the key to long-term sobriety by allowing doctors to predict if patients are liable to relapse,” a press release on the study said. The result would be a new wave of targeted drugs for patients whose brains don’t naturally adjust and compensate to sobriety. In short, we’d be able to not only predict who’s prone to relapse, but start treating them before it’s even an issue.
Compare and Contrast
Researchers compared and contrasted two groups of people in the study. The first group was comprised of 16 alcoholics (between 32 and 57 years old) who’d recently gotten sober. Researchers “[determined]patterns of alcohol consumption using questionnaires and hair analysis for verification,” the article noted. The second group had twice as many people between the ages of 27 and 65 who had no history of alcoholism at all. Researchers then used PET/CT scans—a process using radioactive dyes—to image the brains of both groups. The scans confirmed that “patients who were dependent on alcohol had lower levels of mGluR5 receptors available, suggesting their brains had adapted to addiction, with the reduction acting to reduce cravings.”
The study’s findings go a long way toward demonstrating not just how devastating alcoholism is—they show how alcoholics like me are truly at the mercy of our bodies. “Alcohol addiction is a complex, chronic brain disorder associated with enormous physical, social and financial consequences worldwide, and yet current therapies remain unsatisfactory,” one of the study’s lead researchers said of the findings. “Our team was able to investigate, for the first time, these marked changes in the brain circuitry of alcohol-dependent humans.” It’s a landmark study for a number of reasons, but it’s most compelling in what it reveals about the structure and behavior of the newly sober brain. In many ways, that brain acts exactly like I did when I first got sober: on high alert, instantly defensive and desperately trying to find a way to survive.
Taming the Brain
Groundbreaking study or not, it’s what is done with the findings that matters the most when it comes to the future of addiction treatment. “Collectively, these findings strongly substantiate the development of mGluR5-targeted therapies that heal or protect against the dysfunctional brain circuitry that characterizes alcohol addiction,” one of the study’s researchers said. If you think of the brain as a basic wiring diagram, you’d see all the same electrical circuits, terminals and signal connections that power, say, a lightswitch. In sobriety, the diagram sort of comes alive on its own, suddenly reconnecting itself to different posts and terminals. It’s no longer about whether you’re dealing a lightswitch or a brain at that point. You’re simply dealing with a complex work in progress. Knowing that mGluR5 plays a role in both alcoholic bad decisions and recovery, it’s now easier to anticipate which direction the brain is going to take itself.
The Science Daily piece cites 2016 statistics from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which state that “almost 7 percent of adults over the age of 18 had a drinking disorder in 2014.” The article also notes that “alcohol-related deaths were deemed the fourth leading cause of preventable death, accounting for nearly 88,000 deaths in the same year.” In short, with grim numbers like these continuing to climb while the number of alcoholism treatment options remain flat, it’s worth exploring narrower patient populations. To that end, developing mGluR5-specific treatments would help the people who researchers know are the most likely to relapse. While specialists certainly can’t help the entire population of suffering alcoholics all at once, research could help prevent one specific group—chronic relapsers—from being forever doomed to the sad cycle of alcoholism.