Alcoholism differs from virtually every other disease process in that it begins with symptoms indicating an improvement in functioning.
In the earlier stages of the disease, the symptoms make sense only when you understand that the disease is characterized by neurological adaptations, enhancing the pleasurable sensations of drinking while mitigating the unpleasant effects. These adaptations only lead to later physical and mental deterioration (typically years or decades).
- Intense pleasure associated with drinking
- Lower intensity reaction (metabolic tolerance)
- Acquired (central nervous system) tolerance
- Preoccupation with alcohol
Most people who drink alcohol feel good after the first glass of beer, wine, or hard liquor. Alcohol creates a warm glow, a melting, freezing sensation captured in an ecstatic phrase often muttered after a few drinks, “Ah, isn’t life good?”.
Underlying this feel-good response is alcohol’s ability to raise, through a series of complex neurological interactions, the levels of dopamine, serotonin, norepinephrine, GABA, and other neurotransmitters in the brain. When alcohol opens the neurotransmitter faucets, the drinker is flooded with pleasurable sensations. Many alcoholics describe the experience back in their early drinking: “So this is what’s been missing all my life!”.
In a ten-year study conducted by the Alcohol Research Center at San Diego Veterans Affairs Medical Centre, USA, the researchers evaluated the effect of three to five drinks (the amount depended on the subject’s weight) on the behavioural and perceptual reactions of 453 college-age men. Half of the men had severely impaired alcoholic fathers, while the other half (the control group) had no known biological relatives.
Subjective feelings of intoxication measured reactions, measures of brain activity, hormone levels, and standing steadiness tests that calculated body sway when under the influence. As compared to 10 per cent of the control group, 40 per cent of the men with a positive family history of alcoholism demonstrated “remarkably” low levels of reaction to alcohol. This leads to the conclusion that “reduced sensitivity to lower doses of alcohol makes it more likely that excessive alcohol consumption and subsequent alcohol-related difficulties will occur in about half of the children of alcoholics.” These speculative conclusions have been confirmed in several studies conducted subsequently.
Acquired (Central Nervous System) Tolerance
The ability to drink a lot of alcohol without feeling or showing the effects is a common symptom of early- and early-middle-stage alcoholism. “I could drink everybody under the table. I took everyone else home,” recalled Marty Mann, the first woman to remain sober in Alcoholics Anonymous. Author Jack London had the same experience. In John Barleycorn, he describes the “pride” he felt when, at age fourteen, he drank with a seventeen-year-old sailor and a nineteen-year-old harpooner and was able to stand upright after his comrades had fallen into drunken stupors.
Not all alcoholics share the same early experiences with alcohol. Still, many report a remarkably high tolerance for alcohol and a marked absence of aftereffects following a night of heavy drinking. It is perhaps ironic that many alcoholics in their early drinking careers report fewer adverse side effects to alcohol than normal drinkers. High tolerance for alcohol is a clear sign of the brain’s early, adaptive responses to alcohol. For the individual genetically predisposed to alcoholism, alcohol literally fills the gap, latching on to the neurotransmitter receptors to create a feel-good rush that, in truth, is a sign of addiction.
Preoccupation with Alcohol
Alcoholics Anonymous defines alcoholism as a two-fold disease – physical craving and mental obsession. Alcoholics feel that everything is so good and right when drinking that the desire to repeat the experience seems perfectly sensible. Since drinking is so much fun and makes them feel on top of the world, how can it possibly be bad for them?
In the early stages of the disease, it is not hard to imagine why alcoholics like that feeling or why they want to experience that again and again. Alcohol makes them feel authentic, warm, confident, open, and alive. With so much intense pleasure and so little pain, there is no wonder they seek to get drunk at every chance or occasion.
As alcohol is a physically addictive substance, the cycle of addiction takes over the alcoholic’s life, and their brains crave it all the time.
If you or a loved one is struggling with addiction, call Freephone 0800 140 4044