Node Smith, ND
“One day at a time” is a mantra for recovering alcoholics, for whom each day without a drink builds the strength to go on to the next. A new brain imaging study by Yale researchers shows why the approach works.
“One day at a time”
Imaging scans of those diagnosed with alcohol use disorder (AUD) taken one day to two weeks after their last drink reveal associated disruptions of activity between the ventromedial prefrontal cortex and striatum, a brain network linked to decision making. The more recent the last drink, the more severe the disruption, and the more likely the alcoholics will resume heavy drinking and jeopardize their treatment and recovery, researchers report Aug. 28 in the American Journal of Psychiatry.
Severity of disruption between brain regions diminishes gradually the longer AUD subjects abstain from alcohol
However, the researchers also found that the severity of disruption between these brain regions diminishes gradually the longer AUD subjects abstain from alcohol.
“For people with AUD, the brain takes a long time to normalize, and each day is going to be a struggle,” said Rajita Sinha, the Foundations Fund Professor of Psychiatry and professor in the Child Study Center, professor of neuroscience and senior author of the study. “For these people, it really is ‘one day at a time.'”
Imaging studies can help reveal who is most at risk of relapse
The imaging studies can help reveal who is most at risk of relapse and underscore the importance of extensive early treatment for those in their early days of sobriety, Sinha said.
“When people are struggling, it is not enough for them to say, ‘Okay, I didn’t drink today so I’m good now.'” Sinha said. “It doesn’t work that way.”
The study also suggests it may be possible to develop medications specifically to help those with the greatest brain disruptions during their early days of alcohol treatment. For instance, Sinha and Yale colleagues are currently investigating whether existing high blood pressure medication can help reduce disruptions in the prefrontal-striatal network and improve chances of long-term abstinence in AUD patients.
Former Yale postdoctoral researcher Sarah K. Blaine, now at Auburn University, is lead author of the study.
1. Sara K. Blaine, Stephanie Wemm, Nia Fogelman, Cheryl Lacadie, Dongju Seo, Dustin Scheinost, Rajita Sinha. Association of Prefrontal-Striatal Functional Pathology With Alcohol Abstinence Days at Treatment Initiation and Heavy Drinking After Treatment Initiation. American Journal of Psychiatry, 2020; appi.ajp.2020.1 DOI: 10.1176/appi.ajp.2020.19070703
Node Smith, ND, is a naturopathic physician in Humboldt, Saskatchewan and associate editor and continuing education director for NDNR. His mission is serving relationships that support the process of transformation, and that ultimately lead to healthier people, businesses and communities. His primary therapeutic tools include counselling, homeopathy, diet and the use of cold water combined with exercise. Node considers health to be a reflection of the relationships a person or a business has with themselves, with God and with those around them. In order to cure disease and to heal, these relationships must be specifically considered. Node has worked intimately with many groups and organizations within the naturopathic profession, and helped found the non-profit, Association for Naturopathic Revitalization (ANR), which works to promote and facilitate experiential education in vitalism.
