A new study finds that liquor releases pleasure-inducing endorphins into the brain. This has long been suspected, but the new study, for the first time, uses humans and sophisticated brain imaging techniques. Somewhat surprisingly, heavy drinkers are especially influenced. This article contains more details. Also we discuss a Chinese herb that has been used for centuries to reduce the effects of alcohol, such as hangovers, and the addictive inclination.
HOWARD: Welcome to the CNS Podcast I am Howard La Mere here with Dr. Darryl Inaba and we are continuing to talk about things in the news relating to addiction, drug use and abuse. Some stories came out recently about alcohol and its addictive nature. We’ve known it’s one of the most addictive substances for some time, but new information has come out from UC San Francisco, your old stomping grounds, Darryl. What do you know about this?
DARRYL: Yes, it was released actually today, Howard, and it’s surprising in a way, because it sort of reinforces what we’ve always known or strongly believed as reality as to why people get addicted to alcohol and how they react to it. The findings confounded some studies that look at how people who are prone to alcoholism, react to alcohol as opposed to normies or those who aren’t prone towards alcohol addiction. The study was done at Gallo Institute, University of California and at the UCSF medical center by Dr. Howard Fields and a colleague. We've known for a long time through research with animals that alcohol actually releases the brain opioid neurotransmitters, the endorphins. As a matter of fact, there are a lot of studies showing that the brain actually metabolizes alcohol and causes different substrates and things. In certain individuals, chemicals like THIQ, tetrahydroisoquinoline, which isn't mentioned in the article, is very much an opioid receptor agonist which is produced in higher quantities by people prone toward alcoholism than people who aren’t and through PET scans researchers have found that the brains of those with …or who are prone towards alcoholism, actually release a lot more endorphins in two major areas – first, the reward/reinforcement center, the nucleus accumbens area, the go switch, where that survival mechanism is activated, and in the orbital prefrontal cortex, where the stop switch is located. Higher levels of endorphins and enkephalins are released. So these are things that we’ve talked about and shared through our writings with other addictionologists. What might be news here is the fact that the research was done on humans, albeit a small number of human subjects, and the findings are compared to those from animal studies. So maybe that is different, a stronger reason for presenting this data as something new. But it isn’t really that new. Because those who are prone to alcoholism release more endorphins in these two key areas they experience alcohol with much greater intensity which in turn creates a greater addiction. It confounds some other studies which show that when those who may be biologically prone toward alcoholism – either genetically or because of toxic environmental factors that make their brain vulnerable, are given alcohol their cortical levels – their thinking, their feeling, or their awareness of the buzz or the feeling from alcohol – those areas of their brain are actually less active than the brains of those individuals who are normies - given the same amount of alchohol. Normies have a much greater feeling and experience from the effects of alcohol than those who are prone to addiction. This study is reporting the opposite – that addicts and alcoholics consuming the same amount of alcohol release more endorphins in both their subcortical or their reward/reinforcement /survival areas and in their cortical, their orbital frontal cortex area. It gives them much greater feeling and a much greater experience, so they are going to be more prone toward alcoholism than somebody who doesn’t release as much endorphins.
HOWARD: This seems kind of contradictory…
DARRYL: It can be, these things twist and turn as you look more deeply, maybe the reference is to a particular point in time or an experience in time. For instance, when somebody who is an alcoholic or prone toward alcoholism drinks a lot, they develop a more profound tolerance much earlier. After their initial exposure, they probably feel a greater effect from alcohol than a normie, but with subsequent use, they’re going to feel less from the same amount of alcohol because of the tolerance they have developed. So, a normie will experience a greater effect from a shot of Jack Daniels than somebody with alcoholism. This causes the alcoholic to drink more in an effort to get that feeling back again. So that may explain some of that contradiction. It is interesting because we’ve known about this for a long period of time, much longer than the information in that article indicates.
HOWARD: You have interesting material on a Chinese herb that is related to addiction and perhaps alcohol.
DARRYL: Specific to alcohol. A word of caution here or a disclaimer. This kind of herbal or nutritional or spiritual or whatever treatment for addiction and alcoholism - even medical treatments pop up all the time and I would say over 90% of them have absolutely no value once they are empirically studied and after duplication studies are done to determine whether or not they’re positive.
HOWARD: To follow up on our bad science commentary from a couple of weeks ago - alot of times there are studies that completely reverse findings 10 or 20 years later.
DARRYL: And I think there are some podcasts we recorded a few years ago where we talked about Chinese herbs being used in the treatment of addiction, heroin addiction, alcohol addiction, amphetamine addiction - the Chinese have actively incorporated and experimented with traditional herbal medication and acupuncture in treatment for years. Something that hit the news recently - because UCLA did a study of it, was news of an herb that has been used in China since about 600 A.D…so what is that? 1400 years or so? For 1400 years this herb has been used to treat alcohol toxicity or hangovers or the ill effects of alcohol, but UCLA did some recent research on it and they, of course, were able to incorporate neuroscience into the process and the study revealed that the chemical in the herb has some activity at the gamma-aminobutyric acid A receptors, which alcohol and endorphins also interact with. It actually blocks some of the effects on the GABA A receptors, which are sensitive receptors in addicts, and it reverses both the toxic effects of a hangover as well as the overdose potential. The studies were done on rats, even though humans in China have used it for 1400 years - the rats were given massive doses of alcohol until they became comatose - researchers knocked them out, laid them on their back and measured how long it took for them to wake up and right themselves… indicating the negative effects of alcohol had worn off. Then they compared the length of time it took the rats to wake up and turn over after treating them with the chemical found in this herb. The herb is hovenia dulcis and the chemical is a powerful antioxidant known as dihydromyricetin. This antioxidant seems to block alcohol because the rats were not unconscious for as long as they were when given alcohol without dihydromyricetin. They didn’t experience as many negative effects when pretreated with dihydromyricetin, and it took more alcohol to cause their effects. The researchers are claiming that this substance might be a treatment for alcoholism. Later on, when the rats were given access to alcohol, those who were treated with dihydromyricetin didn’t have that compulsion or didn’t have as much of a drive to go back and use it, whereas those who didn’t….
HOWARD: So the chemical actually gets in the way of the absorption in the brain and the positive effects or the rewarding effects?
DARRYL: Exactly - and the craving. Actually it blocks the action at the receptor sites where alcohol creates these effects. So, interest in this is high - people are saying, gee, there might be something to this herb that has been used for 1400 years or so. What we now need to do, is test it on humans - that’s the difficult thing, to try to get human volunteers and safely manage the equivalents….I think they gave the rats the equivalent of 20 beers to knock them out - there is a liability there.
HOWARD: It sounds kind of dicey though!
DARRYL: Yes, it does bring up an interesting question. A lot of this stuff has been out there for a long time and there have been lots of claims made. I saw an article today about some empirical research done on the Prometa treatment protocol. The research looked at methamphetamine addiction pretty rigorously and found that … current new age medication used to treat craving and block craving for a long time, absolutely had no effect in methamphetamine abuse. So, lots of these cures come and go and it's interesting to see what comes of them. It is always exciting to hear of an herb that has been used by humans for a long time with no side effects and is perhaps not as toxic to the body as some of our western medicine is. This might be a really effective treatment for some people with alcoholism.
HOWARD: That is exciting. Side effects are always an issue. Because this is a plant, it might mitigate some of those issues
DARRYL: On a related topic … in late December of 2011, some Dutch researchers followed up on remarks made by Dr. David Nutt…(it's unfortunate that the guy's last name is Nutt) who was the head of the British addiction department - and he lost his job. I think we addressed that in a podcast ....
HOWARD: Yes, we talked about that.
DARRYL: He said marijuana is much less addictive than tobacco or other drugs and created a stir, but David Nutt, in his "observational" research cited what he believed to be the top 10 most addictive drugs. The Dutch scientists followed up on that and they came out with their top 10 list of drugs that were most addictive. But it's actually not about how addictive these substances are - it’s about how difficult it is to gain recovery or kick these drugs, stay off of these drugs and gain recovery. And that list rated alcohol as 6. It was the 6th most addictive substance - heroin was number 1, and the hardest to kick. Crack cocaine number 2, nicotine number 3, meth number 4, then crystal meth, followed by alcohol. But one thing this herb treatment doesn't address is tissue dependence… a physical addiction to alcohol that is very dangerous and is difficult to kick. Alcohol should be even higher, I think, than heroin in terms of physical withdrawal. The benzodiazepines should be higher than crack cocaine or heroin because when you try and physically stop taking alcohol or the benzodiazepines, you run the risk of having a seizure, having a grand mal seizure. When we treat people in our treatment centers, we have to monitor that very closely because a person could die during a seizure. Sometimes they are in treatment for drug use and haven't been honest about the extent of their alcohol use. They say they’re not drinking much and they had their last drink over a week ago and they come into treatment and within 4 hours they’re bouncing up and down on the floor having a seizure … and we’ve got to rush them to the emergency room. I'd have to look at the data on this herb more closely, but I can’t see it reversing or addressing the tissue dependence physical addiction to alcohol creates. I think it addresses the craving and it might address some of the emotional effects, but the physical effects are not addressed. I can’t see it as a safe thing on its own to treat alcohol, it probably should be combined with anti-epileptic or anti-seizure medication just to make sure the patient is safe. So, those are some of the interesting things about alcohol that are coming out. But they’re just sort of…to me, they’re sort of a new sweater on the same person because these are topics that have been around a long time - they are getting renewed attention and a lot more specificity.
HOWARD: Well, it’s more clarity, I’m guessing, because of the sophistication of imaging today - especially as it relates to the brain.
DARRYL: You know, and that is a good connection. I have to keep reminding myself that the first MRI study…the first really good brain study was done on how the brain changes in adolescence - that began in 1980 and rigorously carried on since 1990. To me, that’s very recent.
HOWARD: That’s not very long really.
DARRYL: I guess for kids it might be an eternity - but it’s fairly recent, so it’s an evolving science and diffusion imaging and stuff like that is new. It’s just brand new stuff that has given us an unprecedented look at how things affect the brain. The spec scans that show us the major, major impact that drugs, stress, emotions, trauma, and even nutrition have on the brain - give us a better understanding. A recent National Geographic featured a picture on the front cover of a teenage brain and the lead article focused on the enigma of the teenage brain - which has been, you know, a question from the beginning of time. What is it about…what is the adolescent brain? How can they think the way they do? What’s going on? Brain imaging studies can now show us how the brain develops from the back to the front - two phases of increased gray matter and then a prolonged phase of increased myelination …increasing the brain cells capacities by up to a hundred times. That takes place, prolifically during the ages of about 10 to 20 or so, right at the adolescent period and really explains why they think the way they do and why it’s impossible for them to think any other way, which is not really good news for the rest of us, but at least we know…we have an understanding of it.
HOWARD: Well, I’m sure we’ll get to find out more about that subject. We're out of time for today Darryl - thank you very much, and thanks to you - our listeners for logging on. If you have questions, comment or a suggestion drop us an email. Thanks for visiting the CNS Podcast and check back soon for the next in the series.