Seeing how a drunk person behaves can be striking, or even funny: they do not coordinate their movements, they sweat uncontrollably, they get dizzy and they say things without meaning. Let's imagine this situation every day. With added problems of concentration, attention and memory. Not being able to stop drinking, despite being very aware of the symptoms you will experience. And every day becomes a constant struggle to get alcohol to drink. Well that's the life of an alcoholic. And no, it's not fun at all.
According to the latest report from the World Health Organization (WHO), more than 280 million people in the world suffer from some problem with alcohol. 5% of all deaths are due to the consumption of this substance, with Europe being the most affected region. The worrying thing is that these figures do not stop rising, especially among the youngest, as a consequence of the well-known "botellón" or binge drinking.
Beyond addiction, drinking alcohol increases the risk of developing physical and mental illnesses, such as anxiety and depression.
The coronavirus pandemic was a challenge for all of us, and not all people coped with this virus and its consequences in the same way. Some took to baking bread, others tried to become the family hairdressers and there were also those who took refuge in alcohol.
The fear of what was happening, the doubts, the sadness of not seeing family and friends, having more free time and doing less physical activity changed the way we drank alcohol.
More of this substance was drunk and abused. And those who previously had problems with alcohol saw her situation worsen.
When the alcohol-dependent person tries to stop drinking, they go through a withdrawal phase in which the body responds with tremors, tachycardia or anxiety. How do you prevent the appearance of these symptoms? Drinking again. And that puts alcoholic people in an infinite loop.
Now, a person can overcome withdrawal and still return to drinking after a while. In alcoholism, relapses and recoveries are common throughout life. In fact, 50% of people who suffer from alcoholism relapse into drinking within the first three months after treatment for their addiction.
The main reasons why these relapses occur are stressful life events, returning to places where you used to drink alcohol, or trying small amounts of the substance.
If we want to be served a drink we usually go to a bar or a nightclub. This makes the lights and music in these places become signals that encourage us to consume alcohol.
Our brain is programmed to identify behaviors that are beneficial to the organism or species. And once identified, they generate a chemical reward at the brain level, to increase the probability that the behavior will be repeated in the future. This is known as an operant learning model.
Well, if we apply it to the alcoholic, his brain learns that a context (disco) and signals (lights, music) lead to a reward (alcohol). This reward makes him feel good (joy, fun), so he will try to repeat the behavior (order more drinks), thus maintaining alcohol dependence.
That is why if a person wants to stop drinking, the first thing that is usually recommended is that they avoid the places, the contexts, where they used to consume alcoholic beverages. To avoid being incited.
Beyond avoiding temptation, there are pharmacological strategies to help break alcohol dependence. Specifically, there are three medications that are approved by the US Food and Drug Administration (FDA) as a treatment for alcoholism: disulfiram, acamprosate, and naltrexone. The European Medicines Agency (EMA) has added a fourth to these three medications: nalmefene.
All of them are used to treat negative symptoms that appear in the withdrawal period or to reduce the desire for alcohol. However, they are not usually well tolerated, either because of their side effects or because they fail to prevent relapses. And that leads them to not achieve, in many cases, their therapeutic purpose.
Hence the importance of continuing to search for new treatments to tackle this problem.
In our research group we are studying the effect of a molecule called galanin (1-15) on alcohol consumption in animal models.
To do this, we use accepted tests for the study of the search for and motivation for drugs of abuse in experimental animals, specifically in rats. One of these tests is substance self-administration.
In our study we designed a self-administration box to simulate a context associated with alcohol (like a nightclub for us). This is accompanied by signals that indicate the availability of the substance, such as lighting (for us, colored lights and music). And we record the number of behaviors that the animal performs to obtain the alcohol. In this case, pressing a lever (the equivalent of ordering a drink).
And what did we observe? Well, we saw that the rats that were administered galanin (1-15) decreased their pressing of the lever associated with the delivery of alcohol. That is, “they ordered fewer drinks.” And if they stopped “consuming alcohol” for a while (abstinence) and returned to the context linked to the delivery of alcohol (disco), they relapsed less (drank less alcohol).
Associated with these effects, we identified changes in brain areas related to addiction to substances of abuse, that is, areas of the brain reward system.
In conclusion, galanin (1-15) decreases the motivation to drink alcohol and, in addition, reduces alcohol relapse associated with the context in rodents. A hopeful result, and, although there is still a long way to go, we could be facing a new pharmacological therapy for people affected by alcoholism, who are not few.
This article was originally published on The Conversation website and is written by Noelia Cantero García, Antonio Flores Burgess, Carmelo Millón Peñuela, Juan Pedro Pineda Gómez, Marta Flores Gómez and Zaida Díaz Cabiale.
