PAYING THE TAB
The simple fact is that we may have a drinking problem.
The research community now believes that many people who have two or three drinks a day have a medical problem – that is, if they occasionally drink more than they intended to, wish they could cut down, or spend too much time thinking about drinking.
“If you’re uncomfortable about your drinking, if it’s causing you stress, then you probably need treatment,” says Dr Mark Willenbring, founder of the Alltyr Clinic and former director at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
This field’s terminology is evolving: Alcohol use disorder, or AUD, is the phrase of choice to encompass the range of people in trouble. People like me, and maybe you.
“What most of us think of as an alcohol problem or alcohol dependence is a stereotype that really only applies to the sickest 10 or 15 percent of people,” says Dr Willenbring. The most recent data show that roughly 14 percent of American adults have suffered from AUD in the past year, and that three quarters of those people look more like me than the stereotypical alcoholic. (Think Nicolas Cage in Leaving LasVegas.)
The biology of booze is also coming into sharper focus. Drugs like heroin and marijuana influence dedicated systems of the brain, but alcohol acts as both a stimulant and a depressant, with effects spread over several brain sectors.
Like valium and xanax, it binds to the receptors of a neurotransmitter called Gaba, which makes you relax in a major way. But through a kind of biochemical magic, it also jacks up the release of dopamine in your brain’s pleasure centre, giving you that feeling of euphoria.
It turns out men are twice as likely as women to have AUD. In research from Yale and Columbia universities, the brain scans of male drinkers revealed significantly greater dopamine release than those of women. Over time, a drinker’s brain adapts