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A Question Of Chicken Versus Egg

Doctor Domenic Ciraulo’s interest in addictions first stemmed while he was in college. In medical school, he was involved in a study investigating the effects of psychedelic drugs on the pain levels of cancer patients. Since then, he has been primarily interested in studying alcohol tolerance, predisposition to alcoholism, and how alcoholism ties in with anxiety and depression.

“I wondered, what leads to alcoholism?” he says. “The first thing you notice is anxiety and depression, but I had it backwards. Depression doesn’t cause drinking; drinking causes depression,” said Ciraulo.

He argues that the frontal lobe of the brain – the part of the brain responsible for self-control – controls both dependency on alcohol, as well as the ability to stop drinking. Further, he believes that the desire to drink is a function of the chemical imbalanced alcohol causes in the brain, which ultimately over-sensitizes the brain’s reward system. While one or two drinks leads to an increase in dopamine – which is associated with pleasure and a sense of well-being – chronic usage eventually causes dopamine levels to drop significantly. This requires higher levels of consumption in order to produce the same effects.

This has major implications for patients seeking alcohol rehab, even in Winnipeg. While 12-step programs, such as Alcoholic Anonymous, are widely respected, they also have a high level of drop-outs, particularly within the first month. In fact, long-term abstinence is very difficult to achieve and is becoming increasingly costly to the nation’s healthcare system.

Ciraulo believes that the issue with achieving abstinence is that there are still so many misconceptions in terms of how alcohol dependence works – the most common of which is believing that overcoming alcoholism is simply a matter of willpower. According to Ciraulo, the medical reasoning behind why people start drink and are unable to stop is hugely under-recognized and under-explored.

“And the genetic influence that interacts with environmental stresses is a complex model that very few people understand fully,” he added. “We’re just beginning to figure it out.”

At Ciraulo’s clinic, researchers use a machine to track brain activity in alcohol-dependent individuals who are craving a drink or drinking alcohol, and to compare changes in the patients’ brains overtime. The machine uses a special camera to map frontal love activity, as well as stimulate the brain electromagnetically. The researchers believe that if the prefrontal lobe is the key to alcohol and drug addiction, stimulating the area artificially may help control cravings in the way a non-addicted brain does.

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