The Secrets of AA

by Christopher Paul on July 8, 2010

A Very Good Year

Wired has a long but fantastic piece on Alcoholics Anonymous. It starts off with this history – which I always find fascinating – and moves on to why it works. Ironically, no one really understands why it works so well for some but not others. The author, Brendan Koerner, tries to find reasons for AA’s success beyond the famous 12 steps. But what I find interesting about the piece is where he explains the science behind alcoholism:

Once an alcoholic starts drinking heavily, the mesolimbic pathway responds by cutting down its production of dopamine. Alcohol also messes with the balance between two other neurotransmitters: GABA and glutamate. Alcohol spurs the release of more GABA, which inhibits neural activity, and clamps down on glutamate, which stimulates the brain. Combined with a shortage of dopamine, this makes the reward system increasingly lethargic, so it becomes harder and harder to rouse into action. That’s why long-term boozers must knock back seven or eight whiskeys just to feel “normal.” And why little else in life brings hardcore alcoholics pleasure of any kind.

As dependence grows, alcoholics also lose the ability to properly regulate their behavior. This regulation is the responsibility of the prefrontal cortex, which is charged with keeping the rest of the brain apprised of the consequences of harmful actions. But mind-altering substances slowly rob the cortex of so-called synaptic plasticity, which makes it harder for neurons to communicate with one another. When this happens, alcoholics become less likely to stop drinking, since their prefrontal cortex cannot effectively warn of the dangers of bad habits.

At the conclusion, Koerner notes that just joining AA doesn’t mean success with fighting the addiction but he also highlights research into supplemental therapies that might aid in improving the long term success rate.

Like I said, the piece is long but well worth the read; I highly recommend it. The article was written in June and I would have missed it if it weren’t for BoingBoing covering it.

If you think you or someone you know might struggle with alcohol dependency, contact your local AA meeting place and get help.

Secret of AA: After 75 Years, We Don’t Know How It Works – Wired [via BoingBoing]

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