Why do we get drunk?

Drinking alcohol leads to a host of immediate changes in brain chemicals. One of the key brain chemicals involved in mediating the euphoric effects of alcohol is dopamine. Dopamine tells us that something we have ingested is pleasurable and consequently we seek more of it. This is ultimately why some of us will continue to drink to the point of drunkenness. Alcohol hijacks our decision making processes and tells us to continue drinking when we should have stopped long before. The problem with continued drinking is that drunkenness or binge drinking is associated with a range of problems to the self and others. Accidents, illness, injury, assaults and death are all associated with drunkenness.

An important question is: who is most likely to run into difficulties with alcohol - either by getting drunk or becoming addicted? The answer lies in both genetics and the environment. It is clear even on casual observation that alcoholism runs in families in Ireland. Genes determine how quickly we get drunk and how likely we are to want to get drunk again. Certain populations tolerate alcohol poorly, making alcohol intake less pleasurable. It is within these groups that we see less drunkenness and less addiction. Genes alone however do not account for the development of alcohol related problems.

The environment is the other factor clinicians look at when assessing someone's propensity to overuse alcohol. Life has become more demanding through recent recessionary pressures. People are working harder and longer, to the detriment of physical and mental health. Mobile device usage has also increased dramatically in the past ten years, adding to the hectic pace of life. Overall, the environment has become more stressful leading people to seek pleasure and reward from substances. Alcohol is the starting place for many who are stressed as alcohol is ubiquitous in our society - availability of cheap alcohol has increased and marketing remains sophisticated and prominent.

Intoxication with alcohol has long been and remains a part of Irish life. Heavy and binge drinking is rife amongst certain age categories, leaving us near the top of the world statistics. Irish people are however also becoming more informed about the toxic effects of alcohol and its ability to produce negative medical outcomes including poor sleep, depression, liver and stomach disease, anxiety and even cancers. Irish people will need to think more carefully about their relationship with alcohol as modern life becomes even more hectic and demanding. The most sobering data of recent times are within the studies of relative harm which demonstrate of all the drugs used by societies, alcohol is the most harmful to self and others. Yes, more harmful than a long list of illegal drugs including crack cocaine and heroin. This probably comes as a surprise to many readers, but not to those of us who work in the addictions treatment field, who encounter the misery of alcohol overuse on a daily basis.

 Published in the Irish Independent, 22nd April, 2015. Read full article here