A new study from the University of Chicago Medicine shows that people with both alcohol use disorder (AUD) and depression feel high levels of pleasure and stimulation when they are intoxicated, just like those without depression.
This finding challenges the belief that the enjoyment of alcohol decreases with addiction and that people drink mainly to relieve negative feelings.
Andrea King, PhD, the lead author of the study, explained that even those with depression and AUD reported feeling positive and rewarding effects from alcohol, similar to those without depression.
The research suggests that treatment for alcohol use disorder (AUD) and depression should focus more on the pleasure and reward pathways in the brain rather than just on stress and depression symptoms. Currently, treatment often aims to reduce stress and depression. Still, it is also important to address the heightened stimulation and desire for alcohol experienced by both depressed and non-depressed individuals with AUD.
Andrea King, PhD, who has studied alcohol responses for decades, emphasizes the need to consider the complex effects of alcohol on the brain. Understanding factors that contribute to vulnerability to AUD and depression is crucial for early and effective treatment.
However, there are limited studies on how people with AUD respond to alcohol in both controlled and natural settings, and including those with additional diagnoses adds to the complexity.
The research observed 232 individuals aged 21 to 35, a period known for heavy drinking. Half of the participants had alcohol use disorder (AUD) in the past year, with an even split between those who had or had not experienced significant depression. To ensure safety, the study excluded individuals with suicidal thoughts and severe alcohol withdrawal symptoms.
Participants used their smartphones to answer questions every half hour for three hours during both an alcohol-drinking session and a non-alcohol session. The study found that alcohol consumption slightly reduced negative feelings, regardless of depression or AUD status.
However, the positive effects of alcohol were significantly higher in individuals with AUD, and these effects were similar for those with and without depression.
Study co-author Daniel Friedberg, PhD, Associate Professor of Psychiatry and Behavioral Neuroscience at UChicago, said, “For nearly a decade, our group has been improving methods to use mobile technologies to measure real-time clinically meaningful outcomes in people with AUD and those at risk for alcohol-related problems. These approaches allow us to bridge the gap between the lab and real life and have led to new insights that could one day result in better treatments.”
The study challenges the idea that alcohol addiction is solely about the brain’s attempt to maintain stability. This theory, known as the “dark side of addiction,” suggests that heavy drinking changes the brain’s stress and reward systems, leading individuals to drink to avoid withdrawal and stress rather than for pleasure.
However, Andrea King argues that this theory doesn’t explain the high levels of stimulation and pleasure observed in people with AUD and depression. She compares these effects to an accelerator pedal that fuels dependency.
King points out that treatment providers are often taught that people with AUD drink to self-medicate. However, according to her study, individuals experience high levels of stimulation and pleasure, with only a modest decrease in negative states.
King’s next study will explore whether adults aged 40 to 65 who have had AUD for decades also experience heightened pleasure when drinking compared to older drinkers without AUD. The prevailing theory would suggest that these individuals would show blunted positive responses and high tolerance to alcohol.
King aims to investigate whether they still have a long-term sensitivity to alcohol’s enjoyable effects, similar to the findings in depressed drinkers.
Journal Reference:
- Daniel Fridberg, Andrea King et al. Real-Time Assessment of Positive and Negative Alcohol Effects in Individuals With and Without Alcohol Use Disorder and Depressive Disorders. American Journal of Psychiatry. DOI: 10.1176/appi.ajp.20240069
Source: Tech Explorist
