Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

Underage drinking is often considered a right of passage; something most teens and young adults under 21 go through. As such, the focus is often on keeping young people safe, whether that be parents hosting a party with alcohol and taking away all car keys or offering to drive, no questions asked. Yet, young adults, ages 18-20, have the highest rate of alcohol dependence (alcoholism) in the United States, according to the U.S. Surgeon General’s “2007 Call to Action to Prevent and Reduce Underage Drinking” report.

New and/or advances in brain imaging technologies (e.g., fMRI, SPECT, PET) of the past 1o – 15 years and the resulting research is shedding new light on this issue. Neuroscientists, doctors and other medical professionals are now able to observe how the brain develops and the impact of alcohol on the developing brain.

The image below is a time-lapse of brain imaging studies reprinted with permission from Dr. Paul Thompson of UCLA’s Laboratory of Neuro Imaging. This image study shows brain development, ages 5 through 20 and beyond. It was thought (until these new brain imaging capabilities) that the brain was fully developed by adolescence. We now know it’s not. There is a critical developmental stage identified as pruning and strengthening that goes on during the teen years — often through age 25 (explained in more detail at The Partnership for a Drug-Free America® website, A Parent’s Guide to the Teen Brain). Pruning is when neural connections (called gray matter) that are not used or are redundant fall away (get “pruned”), and those that are used get strengthened, which makes the remaining neural connections more efficient (similar to the way an insulted cable wire works more efficiently than a non-insulated one).

Image: Thompson, Paul. Ph.D., Time-Lapse Imaging Tracks Brain Developing from ages 5 to 20, UCLA Lab of Neuro-Imaging and Brain Mapping Division, Dept. Neurology and Brain Research Institute, http://www.loni.ucla.edu/~thompson/DEVEL/PR.html Permission: Dr. Paul Thompson 5.7.09

About Neural Connections
We are born with about 100 billion brain cells — billions of them — also known as neurons but only a relatively small fraction are ‘wired.’ From birth to around puberty, our brains are ‘wiring’ neural networks like crazy — a wiring process that allows neurons to “talk” to one another via neural connections.

A neural connection requires brain cells (neurons), synapses (the gap between the branchlike extensions of a brain cell) and neurotransmitters (the chemical messenger that takes a message from one brain cell, across the synapse, to receptors on the receiving brain cell). There is an expression sometimes used for this process — “neurons that fire together, wire together“ and this wiring together is sometimes called a “brain map.”  (Norman Doidge, M.D. The Brain That Changes Itself)

Over the course of our lives, we create neural connections (brain maps) for all of the functions our bodies and brains do. In other words, we create neural connections for riding a bike or typing on a computer or talking on the phone or reading a book or running, breathing, reciting multiplication tables, eating, talking with our hands — everything!

Alcohol works on neural connections in many parts of the brain. When it comes to alcohol abuse and/or addiction (alcoholism), the neural connections most effected are those in the Limbic System (the pleasure/reward/pain center of the brain) because those connections require the neurotransmitter, dopamine. Dopamine is our “feel good” neurotransmitter — without it, we have a hard time feeling pleasure. Thus, when we drink, it’s these neural networks that “tell” the brain that drinking makes us feel good. We develop a memory of that feeling (thanks to other neural networks), which is why people want to drink, again. Think about it — if there were no feel good feelings from drinking alcohol, we likely wouldn’t drink it.

About Alcohol Use / Abuse / Addiction — Why It Matters How Much A Person Drinks
It’s important to understand there are three stages of drinking — use / abuse / addiction. It’s common to assume that drinking is either normal or alcoholic. With this assumption, it’s common to excuse some rotten drinking behaviors (e.g., fights, DUIs, arguments) because we don’t want to think of our loved on as an alcoholic. Understanding the differences and the consequences can help us want to intervene earlier rather than later in order to help young people stop their abusive drinking before they cross the invisible line to addiction.

• Alcohol use is defined as moderate drinking — 7 standard drinks per week, with no more than 3 of those 7 drinks in a day, for women, and 14 standard drinks per week, with no more than 4 of those drinks in a day, for men. A standard drink is either 5 ounces of wine OR 12 ounces of beer OR 1.5 ounces of spirits (vodka, for example). [Note: 35% of American adults do not drink any alcohol -- none.]

• Alcohol abuse is when a person exceeds these drinking limits and has problems related to their drinking, such as arguments with family and friends about their drinking, binge drinking (defined as 4 or more drinks for women and 5 or more drinks for men), blackouts, lying about how much they’re drinking, driving while under the influence, work or school performance problems, arrests, unplanned or unprotected sex — in other words, doing things they just would not do if they hadn’t been drinking.

• Alcohol addiction (aka alcoholism) is a chronic, relapsing brain disease caused by biological, environmental and developmental factors. It occurs when a person’s alcohol abuse causes chemical and structural changes in their brain (by interrupting normal neural connections), which sets up the characteristics of alcoholism:  tolerance, cravings, loss of control and physical dependence, in addition to the behaviors just described under alcohol abuse.

According to the World Health Organization’s AUDIT, all alcoholics go through the alcohol abuse stage but not all alcohol abusers become alcoholics. Alcoholism cannot be cured (meaning you can not go back to drinking after a period of time of abstinence), but it can be treated. Alcohol abuse drinking patterns, on the other hand, can be changed.

The Impact of Alcohol Use on the Developing Brain
As you look the time-lapse image, again, notice how the brain develops from back to front (yellow/green to purple/fushia). This means that the portions of the brain that deal with emotion, memory, learning, motivation and judgment are the last to develop and, as such, are the most deeply affected by alcohol (or drug abuse) during ages 12 through 20, often through age 25.

For example, if a young adult repeatedly abuses alcohol (or drugs), the neural connections associated with memories and experiences related to alcohol abuse are the ones that are strengthened and thus embedded. By the same token, neural connections damaged by or not used because of alcohol abuse (those related to learning or judgment, for example) are pruned or not strengthened. This late stage brain development also explains why teens don’t know why they do some of the things they do, and why they take risks they likely would not engage in if they had a fully developed brain and the hindsight (memories and experiences) that go with it. Because the brain is NOT fully developed, adolescents are more vulnerable than adults to many of the effects of alcohol (e.g., memory, long-term cognitive deficits), and less vulnerable to others (e.g., sleepiness, loss of balance).

Facts About Alcohol Abuse During Brain Developmental Ages 12 – 25

• According to NIAAA, nearly half of all people who ever met the diagnostic criteria for alcoholism in their lifetime were addicted (aka alcoholics) by age 21 and two-thirds were addicted by age 25. Thus, alcoholism is really a young person’s disease, but it often takes a person another 10 – 15 years before they seek treatment, which is why we generally think of alcoholism as something that happens to older adults.

• Age of first use is the most significant risk factor for a person becoming alcohol dependent (an alcoholic).

• Teens who start drinking before age 15 are 5 times more likely to develop alcohol problems as adults.

Understanding the impact of alcohol on the brain — especially during its critical developmental stage of ages 12 through 20 and beyond — is shedding a whole new light on the issue of underage drinking. In closing, it may also be helpful to know that the BRAIN CAN CHANGE and go back to “normal” if alcohol abuse is stopped.

For article sources and additional information:

• To learn more about addiction: www.hbo.com/addiction
• To assess your own or someone else’s drinking: www.rethinkingdrinking.niaaa.nih.gov
• To learn more about the teen brain and alcohol/drugs: www.drugfree.org/TeenBrain/science/
• For a variety of information about alcohol abuse and alcoholism: www.niaaa.nih.gov/AboutNIAAA/
• For a statistical snapshot of underage drinking: http://www.niaaa.nih.gov/AboutNIAAA/NIAAASponsoredPrograms/StatisticalSnapshotUnderageDrinking.htm
• For a variety of posts and comments on a variety of alcohol related topics, especially those that can help the family and friends of someone who drinks too much: www.breakingthecycles.com

NOTE: This post was revised October 14, 2009.

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For this kind of information, as well as the latest research and information on brain development and the disease of alcoholism, facts about alcohol abuse not commonly known, hope for the more than fifty percent of American adults and one in four children who have a family member who drinks too much, as well as research and information on the related issues of co-addictions, underage drinking dual diagnoses, codependency and more, please consider buying my book, If You Loved Me, You’d Stop!

©Lisa Frederiksen, www.breakingthecycles.com. The information contained in this post may be freely used and copied for education and other non-commercial and non-promotional purposes, provided any use or reproduction of the information be accompanied by an acknowledgement of Lisa Frederiksen, Breaking the Cycles.com, as the source

This entry was posted on Thursday, May 28th, 2009 at 9:01 am and is filed under Alcohol-Related Public Policy, Alcoholism, Brain Scans, Odds & Ends, Underage Drinking. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.