The first drink does it!?

Some structural and functional differences in affective circuitry in the brain have been found in adolescents at risk of alcoholism compared to controls, and may precede alcoholism onset and thus constitute markers of  risk.

Thus, it is reasonable to hypothesize that pre-alcoholic differences in the functioning of relevant neural systems will be related to risk for alcoholism.

One aspect of the at risk argument that struck a chord was how difficulties in the regulation of stress in the offspring of alcoholics has a pronounced affect on how alcohol effects them.

This we believe may partly explain that rosy or golden glow of the first drink, which appears to often alter the perception of at risk alcoholics to such a profound effect, especially compared to those not at risk to later alcoholism.

We know that dopamine rises in relation to the “rewarding” properties of drugs and alcohol, rising in a more pronounced way in drugs such as cocaine than in alcohol so perhaps alcohol does something else to alcoholics than to non-alcoholics, perhaps it effects something other than dopamine or natural opioids or other neurochemicals in the brain, perhaps it hits us via our hearts and in reducing heightened stress levels?

For example in terms of inherent stress regulation, offspring of alcoholics tend to have higher baseline heart rates (1,2) and show increased cardiovascular reactivity to aversive stimuli  (3-6).

In simple terms those at risk have inherent difficulties in stress regulation, react more than those not at risk,  studies have shown that cortisol (stress chemical) response to psychosocial stress is significantly increased in offspring with a family history of alcoholism compared to those with no family history of alcoholism (7,8)

Interestingly, this stress dysregulation may potentiate (heighten) the rewarding properties of alcohol as we have also seen in emotion dysregulation. Alcohol appears to not only be rewarding but is doubly so in that it provides a release from stress also.

In fact, offspring from families with alcoholics may be hypersensitive to the effects of alcohol on cardiovascular activity (3,5,9,10)

Alcohol may serve to dampen heart rate and electrodermal reactivity to stress more in young adults with a family history of alcoholism than in offspring without a family history.

Slowing of heart rate may be associated with increased perception of relaxation making alcohol more rewarding to high risk offspring.

In offspring of alcohol dependent individuals, ethanol (alcohol) consumption results in significantly lower stress chemicals like adrenocorticotropic hormone (ACTH) and cortisol levels compared to control subjects and these are  predictive of future alcoholism (11).

Initial alcohol use may have a double whammy effect on alcoholics, possibly right from the first drink. It may be the reason some alcoholics say they were alcoholic from their first drink, that the drink could do for them what they could not do for themselves.

Alcohol may involve a profound a release from self, a self prone to stress difficulties and more susceptible to the releasing, stress reducing properties of alcohol.

References

1. Harden PW, Pihl RO. Cognitive function, cardiovascular reactivity, and behavior in boys at high risk for alcoholism.Journal of Abnormal Psychology. 1995;104(1):94–103.

2. Hill SY. Absence of paternal sociopathy in the etiology of severe alcoholism: is there a type III alcoholism? Journal of Studies Alcohol. 1992;53(2):161–169.

3. Finn PR, Pihl RO. Risk for alcoholism: a comparison between two different groups of sons of alcoholics on cardiovascular reactivity and sensitivity to alcohol. Alcoholism, Clinical and Experimental Research. 1988;12(6):742–747.

4.  Finn PR, Zeitouni NC, Pihl RO. Effects of alcohol on psychophysiological hyperreactivity to nonaversive and aversive stimuli in men at high risk for alcoholism. Journal of Abnormal Psychology. 1990;99(1):79–85.

5.  Peterson JB, Pihl RO, Séguin JR, Finn PR, Stewart SH. Heart-rate reactivity and alcohol consumption among sons of male alcoholics and sons of non-alcoholics. Journal of Psychiatry & Neuroscience. 1993;18(4):190–198. [PMC free article]

6. Stewart SH, Finn PR, Pihl RO. The effects of alcohol on the cardiovascular stress response in men at high risk for alcoholism: a dose response study. Journal of Studies on Alcohol. 1992;53(5):499–506.

7. Uhart M, Oswald L, McCaul ME, Chong R, Wand GS. Hormonal responses to psychological stress and family history of alcoholism. Neuropsychopharmacology. 2006;31(10):2255–2263.

8. Zimmermann U, Spring K, Kunz-Ebrecht SR, Uhr M, Wittchen HU, Holsboer F. Effect of ethanol on hypothalamicpituitary-adrenal system response to psychosocial stress in sons of alcohol-dependent fathers. Neuropsychopharmacology.2004;29(6):1156–1165.