Boozing and Brain Function: New Concerns about Alcohol Related Brain Damage

While full-blown “wet brain” – the rather crude layman’s term once commonly used to describe significant cognitive impairment associated with chronic alcohol abuse – is now relatively uncommon in the U.S., health professionals warn that regular, heightened alcohol use is increasingly being observed as a primary cause of dramatic losses in memory, decision-making skills, and emotional stability.

What’s more, experts say it can happen earlier in life than most would expect and in individuals who don’t necessarily drink to excess or to get drunk.

Recent brain imaging studies are showing more clearly just how long-term alcohol abuse can change the brain’s structure, shrinking gray-matter cells in areas that govern learning, memory, decision-making, and social behavior, and damaging white-matter fibers that connect one part of the brain with others.

The impact is so profound in some that this alcohol-related brain damage is often confused with early-onset Alzheimer’s disease and forms of dementia.

Premature Mental Aging and Dysfunction

As part of the aging process, we all start to lose some brain cells and tissues that aid in memory, judgment, and the regulation of emotions. But scientists and physicians studying the neurological impact of long-term alcohol use say these areas break down far more quickly in alcoholics and those who drink with regularity. Essentially, the brains of these individuals look “old” and damaged far before their time.

 Wernicke-Korsakoff Syndrome, or “wet brain,” which is observed when chronic alcohol consumption causes a deficiency in thiamine that leads to hallucinations, amnesia, psychosis, and difficulty walking is rarely seen today in the U.S., experts say because alcoholics are routinely given thiamine to prevent it.

But what many physicians and neurological experts are seeing in consistently heavier drinkers with some regularity is a decline in executive function, decision-making, and memory that are similar to cerebral-vascular dementia, the second most common form of dementia, which reduces blood flow to the brain. Alzheimer’s disease does much the same thing but is usually observed in older adults.

These same patterns of cognitive degeneration have been noted with heightened frequency, and attendant concern, in the United Kingdom where a report recently suggested that alcohol-related brain damage is vastly underdiagnosed and a real problem in Britain and Wales.

 Emotional Instability and Heightened Anxiety

Long-term alcohol abuse also changes how the brain regulates emotion and anxiety and disrupts sleep systems, causing wide-ranging and negative impacts on our ability to calm and restore our bodies and minds. Increasingly, clinicians are diagnosing such cases as “alcohol-induced neurocognitive disorder” and “alcohol-related dementia.” And they have been observed more regularly in people in their 30s and 40s. It seems that, while drinking may make many feel youthfully exuberant at the moment, it can put your body and brain on a course to age and degenerate quickly.

Dr. George Koob, director of the National Institute for Alcohol Abuse and Alcoholism, and other researchers have shown that heavy alcohol use dramatically reduces the ability of the frontal cortex to control the amygdala, the center of emotions—which explains why drinkers often have mood swings and outbursts. With long-term heavy drinking, the amygdala also becomes increasingly over-sensitized to stress.

This can leave chronic drinkers “stuck” in states of high anxiety and fear, very similar to those who suffer from post-traumatic stress disorder. Studies conducted at the Bowles Center for Alcohol Studies at the University of North Carolina at Chapel Hill support this decline in the ability of heavy drinkers to benefit from normal “fear-based learning.”

In experiments conducted there, mice that weren’t exposed to alcohol could be trained to freeze when a light cue is followed by a mild shock and learn to relax again if the shock is discontinued.

But when mice were given the equivalent of six drinks a day for weeks, they were never able to feel safe again and were constantly fearful. Regular heavy drinkers can essentially be frozen in states of anxiety and “fight or flight” states typically associated with exposure to outside threats.

 No “Safe” Amount when it comes to Alcohol

The new studies on alcohol-related cognitive impairment raise some concerns about what was once a fairly consistent promotion of the health benefits of moderate alcohol consumption. While it is true that some research has shown lower risks of cardiovascular disease, depression, and some cognitive issues in moderate (1 drink a day for women, 2 for men) drinkers, some take this guidance as a license to simply overconsume – and the brain impacts of alcohol consumption vary highly among individuals.

The National Institute of Alcohol Abuse and Alcoholism (NIAAA) says the probability of serious health and brain degeneration issues is generally low for men who have no more than 14 drinks a week, or 4 on a single day, and women who have no more than 7 drinks a week or 3 on a single day.

Some people, though, experience negative alcohol-related impacts at lower levels. And the possibility of long-term addiction and dependence on alcohol may originate from regular drinking at moderate levels, depending on a variety of factors such as genetics, environment, and the way in which alcohol may be used as a reward or coping mechanism.

In short, there is no blanket safe or threshold amount that people can drink. Some individuals who begin drinking in their teens and twenties – when brain connections are still forming – may experience lasting impacts later in life.

And the older we get, the more profound smaller amounts of alcohol tend to compromise memory and mental function. This is of particular concern given the fact that many older Americans can slip into patterns of heavier drinking after life-changing events like the passing of a spouse or retirement from a long-standing job.

We must all have a healthy level of caution when it comes to consuming alcohol, the most readily available and most commonly abused drug in the U.S. These new brain imaging studies highlight a critical aspect of the health risks associated with regular alcohol use.

If you suspect a friend or loved one exhibits signs of excessive alcohol use or abuse, engage them in a conversation about the risks to their health and well-being. And help them to help themselves with treatment if necessary.

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