What is Alcoholism? In “Pleasure Unwoven” a DVD by Kevin McCauley (The Institute for Addiction Study), the neuroscience of the whole process of addiction and the reason why it is now treated as a disease of the brain, is eloquently explained. He describes the physiology of alcoholism, the stages of alcoholism and the effects of alcoholism.
The bad behaviour of an alcoholic is the symptom of their disease. They are not alcoholics because they are intrinsically bad people or from bad homes or a bad environment or because they have suffered bad experiences. We all know alcoholics who but for their disease, are the kindest, cleverest, wittiest people we know and have had normal upbringings. Bad behaviour is a symptom of alcoholism.
There are a distinct set of factors that cause the brain to malfunction and the areas of the brain that malfunction are the frontal cortex and the midbrain. This is fairly complicated and the brain’s processing mechanisms are monumentally awe inspiring in more ways than I can begin to discuss here. I’ll stick to alcohol addiction and if you want to see this more beautifully explained then see the above mentioned DVD.
Addiction is a defect in the brain’s ability to perceive, process and act upon pleasurable experiences in a normal way. Genetics creates a blueprint and some people have a higher genetic tolerance for alcohol than others. This makes them more susceptible to alcoholism. They need more of the toxin to have an effect; they can stay out drinking longer, drinking much more than other people before alcohol effects show up, all the time building up the brain damage that continued use of alcohol brings with it.
Some people have a genetic proclivity towards addiction but it does not mean they will become addicted. Just as people who have no such proclivity can also become addicted. It is a matter of coming into contact with the toxin over a period of time. It is the quantity of the toxin and time over which it is taken before addiction takes place, that varies between people with a genetic proclivity and those without. Like people who are addicted to food, humans were not designed to have too much over long periods of time. That’s why the saying “everything in moderation” is so true.
Addiction starts and drugs work, in the midbrain – it is the ancient survival part of the brain that we share with animals. The midbrain doesn’t think or make choices or understand consequences, it has no conscience. It is the part of the brain that ensures survival of the species by getting us to eat, procreate, rest, defend ourselves, even kill if necessary and it does that by making those things feel pleasurable.
It is perhaps those people who are most highly driven by survival mechanisms and would have been the key survivors in previous predatory environments, who are more susceptible in the current modern environment of excess. That’s natural selection, in the present time of excess with unprecedented choice (for good and bad), a different type of human animal is required, one driven by the frontal cortex at all times.
That will need a re-shaping of the values and education of the society we live in, ensuring the protection of those who are vulnerable to alcoholism or any other form of addiction, through self knowledge. The wonderful part is that many alcoholics do recover by re-wiring their brain (called neuroplasticity) through their own concerted efforts over time, perhaps augmented by alcohol treatment programs or alcohol rehab programs. Those recovering alcoholics are fabulous examples of adaptation to the environment through adversity.