Alcoholism: When should one put the bottle down?

Published in

Cognitive NeuroEconomics @ UCSD

5 min readFeb 26, 2024

You’ve all seen it before, the iconic cartoon character who’s so drunk, their facial expression reflects it, often with one eye half closed while the other wonders where to look. Sometimes, they’ll even include a first-person-perspective of this character, who seems to have their vision so blurry and “wobbly”-feeling that they’re unable to walk in a curved line, much less a straight line. We can all laugh at these characters and their alcoholism when viewing them from the comfort of our televisions and computer screens, but there is a very real reflection of how these characters act to real-world alcoholics. Sure, perhaps these characters’ livers can stomach as much alcohol as they want, but the underlying issues, especially the reliance of alcohol in their day-to-day lives, is a parallel to the real-world issue of alcoholism many adults face today.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 2022, 11.2% of all adults ages 18 and older suffer from alcohol use disorder (AUD). To put in other words, if every single person in Texas alone were an alcoholic, that would be the sum total of people who suffer from AUD across the entire United States. This number also includes a good portion of people who aren’t legally allowed to buy or consume alcohol, yet still suffer from AUD nonetheless.

So why are young adults, much less fully developed adults, so addicted to alcohol? There’s the obvious answer, where alcohol acts as a depressant to help people feel “less,” whether that be less sad, less restricted. While there is certainly a good portion of young adults drinking in college parties that could lead to AUD, it’s not the only reason why young adults are suffering from alcohol addiction. There’s a rise in depression among teens as the years progress, at an increase of roughly 2–3% per year. As a good majority of these teens do not get the mental health treatment they need, a lot of them are unable to properly face their issues, which could be a contributing factor as to why a lot young adults turn to drinking instead.

There’s an old saying, where if you’re too nervous to do something, take a shot and you’ll feel more confident. The reason behind this is that alcohol depresses the inhibitors in our brain. In other words, the part of your brain that prevents you from thinking of the consequences of your actions, and to make error corrections, is now being depressed and effectively, ignored.

While being able to think without considering the consequences of actions might sound appealing, especially for those who suffer from anxiety or overthink in situations, it’s not the only part of the brain which alcohol depresses. For example, the limbic system, or the part of the brain responsible for behavioral and emotional responses: In the moment of drinking, your brain releases more dopamine than usual, which gives one the feeling of happiness that a lot of people want from drinking. However, consistent heavy alcohol usage can damage the brain to the point where the amount of overall dopamine in the brain decreases to a below average level. This causes addiction, which further plummets the dopamine levels as well as causes a reliance on alcohol, to get the little amount of dopamine that someone who suffers from addiction needs.

Okay, so your dopamine levels are lowered from drinking. Is that all? Turns out, the answer is a hard no. The cerebellum, or part of your brain which is responsible for balance and movement, is also impaired, which is much more noticeable compared to parts of the brain responsible for speech. It’s why often times, police sobriety tests consist of the classic test, where you have to walk in a straight line, touching each toe to heel and maintaining balance. Anyone with a depressed cerebellum will suffer from balance issues, and likely fall over, or just be clumsier in general.

Additionally, another crucial part of the brain that is impaired is the hippocampus, which is responsible for memory control. Wrapping back to the cartoon analogy, it’s why often times there will be a moment in a cartoon where the drunk character wakes up the next morning, completely unaware of their actions after a heavy night of drinking. It’s also why sometimes when people make a drunk purchase, they wake up the next morning, dazed and confused as to what they bought. When the hippocampus is impaired, it’s unable to register short term memories as long-term memories, and as someone drinks more and more, the hippocampus will become damaged to the point where they will have difficulty with any sort of short-term memory.

So, say you have someone who extensively drinks, and you want them to quit by throwing out all of their alcohol. How does the brain react to this sudden change? As with most drug addictions, it’s inherently difficult for anyone to quit cold turkey, and they will likely “crave” alcohol for many nights on end. Some reported symptoms include anxiety and depression, along with a myriad of physical issues such as damage to their heart, liver, and digestive system.

If we look deeper into these symptoms, we can break down the cause of each, and why it’s so difficult for people with AUD to quit. For depression, it’s oftentimes that someone who drinks heavily on a consistent basis has a depleted dopamine level, which is due to their reliance on alcohol for dopamine and their body producing less of it as a result. Therefore, someone who were to quit alcohol has to slowly phase back into producing dopamine on their own, which can be difficult considering their body barely produces any to begin with.

As for anxiety, due to alcohol depressing the need for you to think about the consequences of your actions, it’s easy to get used that feeling. The feeling where you don’t need to think about why what you’re doing is wrong. However, when you take away someone’s sudden boost in confidence, it turns to anxiety as they now suddenly have to think about the consequences of their actions, and the sudden shift from not worrying to needing to worry about one’s actions can be overwhelming for some.

So, when you sit down to watch a sitcom or cartoon, observe the actions of average “town drunk” in your show. Why is this person drinking to begin with? And what are the consequences that they will face as a result of it? If you have friends or family who suffer from alcohol use disorder, think about the long term brain damage they suffer from alcohol use. Will there reach a point when one should put the bottle down?

Citations:

Alcoholism: When should one put the bottle down?

Written by Alpha Zan