By David Joel Miller
How are alcohol and other drugs connected to mental and emotional problems?
There are clearly a large number of connections between drug and alcohol use and abuse and mental, emotional and behavioral illness. The recognition of these connections has resulted in a growing emphasis on the relationships between drugs and alcohol and those conditions that we call Mental Illnesses.
This overlap, those times when someone has both a substance use disorder and a mental illness, was called first dual-diagnosis and more recently co-occurring disorders. The overlap is common but not total.
There are people with a mental illness that do not have a substance use disorder. There are also those with a substance use disorder that do not have a mental illness. Over time we have come to see that the overlap is so large that it is more common to see someone with both of these problems than not. The professionals in the field have come to think of co-occurring disorders as an expectation and not an exception.
This understanding that there are reasons for the overlap, or co-occurrence, of these two different disorders has spawned a lot of efforts to find effective treatments for people with multiple disorders. The advances in brain studies have resulted in a lot of research studies on the effects of various drugs and the brain. We now know more than ever before about how drugs and alcohol are affecting people’s thinking, feeling, and behavior.
Alcohol, the drinkable kind, has been around and in use longer than any other drug. We know more about this particular substance and its effect on the brain than probably any other chemical. I recently did a literature search for current scientific articles on the effects of Alcohol on the brain and the search returned 28,834 articles. Other searches would, of course, have returned even more.
Given this huge and growing body of research, I thought I should spend some time and some blog posts reviewing some of this new knowledge. While I can’t read every study and surely will only be able to report on a few highlights, I want to tell you about some of the things we know and some of the things I think about the effects of drugs on the brain and on those things we call mental illness.
There are several sources of this new knowledge. These studies, beginning with the ones focused on alcohol come from the following areas.
1. Fetal Alcohol Spectrum Disorders.
Studies of children who have been exposed to Alcohol before birth show changes in the body, brain, learning, and behavior of those children. We used to think that only those children who were exposed to large amounts of alcohol developed problems. The more the research progressed the more we have concluded that any amount of alcohol consumed during pregnancy increased the risks to the child.
Just because a woman drank during pregnancy does not automatically mean that any problems her child has are the result of her drinking. Still, the link is so strong that most authorities now believe that there is no safe level of alcohol consumption for a woman who is or may become pregnant.
One result of the large overlap between substance use disorders and other mental illness is that a lot of people with a diagnosed disorder are at extra risk for risky sexual behavior and unplanned pregnancy. Parents with a disorder or two are more likely than others to produce an unplanned child.
2. Binge drinking.
The amount of damage drinking does to the body is correlated with the blood alcohol level. As a society, we have been looking at how much alcohol in the bloodstream is a safe level for someone to have and still drive.
Studies of the effects of various levels of alcohol on brain function have taught us a lot about the way in which increasing the level affects the person.
It looks certain that the higher the blood alcohol content the more the damage to the body and the brain. One drink a day all month may be theoretically safe but 30 drinks on one day is a very hazardous way to drink.
3. Alcohol affects structure and functioning of the brain.
We have known for a long time that chronic alcoholics have a reduced brain volume. We are now seeing studies of the effects of alcohol on brain regions and on the production of neurotransmitters. One treatment for depression is to increase the levels of serotonin in the brain. This is done by slowing the natural breakdown of serotonin which is one way many antidepressants work.
We know that alcohol is altering these neurochemicals and so may be increasing the risk of developing a mental illness, may make one worse or may mimic a disorder.
4. Chronic Alcoholics.
Studies of chronic alcoholics, how their brain works and the changes that brain undergoes have added to our understandings of what the alcohol may be doing to the other parts of the body and brain. Because alcohol totally mixes with water, and blood contains a lot of water, no part of the body avoids being damaged by drinking.
5. Developmental studies.
Studies of teens have suggested ways in which alcohol consumption may be affecting the development of the brain. The correlations between the amount that a teen drinks and the results of the rest of their lives, while not a proof of cause and effect, makes us think there are more connections than we previously realized.
We know that “F” students typically drink at least twice as much per week as the “A” students.
We also know that heavy drinkers take longer to heal from injuries than nondrinkers.
6. Brain scans and mice studies of the effects of alcohol.
Brain scans typically capture only a moment in time. Mice studies are not proof that what we see in mice is what is happening in humans. But when the two agree it lends credence to the concept that alcohol is fundamentally altering the way in which brains and the nervous systems function.
7. Learning studies and functional studies.
There have been a lot of studies on how alcohol and other drugs have been affecting people’s memory, behavior, visual and special recognition, learning and other specific brain functions.
Now that you know where the information is coming from let’s begin in future posts to look at why we think mental illness and substance use disorders so often occur together and then what are some of the specific effects of alcohol and other drugs on the body and the brain.
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