The Alcohol Trap

Consider your alcohol consumption and answer this question: do you drink as much as you would like, more than you would like, or less than you would like?

There are three possible answers but only two outcomes. If you are honestly drinking as much as you would like, you would be a very occasional drinker with zero dependence. Drinking more, or not enough, are two sides of the same coin whereby a habit or dependence has formed.

How about this relatable scenario? I drink two cups of coffee in the morning. I would happily drink a third but know that I should not. I also know that drinking only one cup of coffee would be better for me. Now this: I drink three pints (scale as appropriate) of beer on a Friday night. That’s more than I need to feel at my peak on a Saturday morning, but I could easily have carried on. In this type of paradox, we consume ‘too much’ for it to be good for our health, but ‘not enough’ to satisfy our cravings. With repeated consumption, our tolerance increases and so must the quantity. Then we are consuming increasingly MORE than is good for us, and increasingly LESS than our cravings demand.

Is this an issue? That depends on you. If you are a regular drinker who after an honest self-appraisal feels that you are fulfilling your potential in terms of your own health, being there for your family, managing your finances and spending your free time in a genuinely rewarding manner, you can stop reading now (assuming you haven’t already). If however you aren’t excited about the pathway you’re on when you imagine life in 6 months, a year, or 5 years’ time, and instead would like things to get a little bit better each day, re-evaluating your relationship with alcohol will have a significant impact on your life.

Why don’t I just drink less?

This sounds like an obvious solution. Have two drinks instead of three, reduce the risk to your health, and just suck up the increased craving gap and hope they fade in time. This leads to the obvious question: Why aren’t I doing this already? The answer is: I tried it, and it doesn’t work. Alcohol is an addictive substance and a one-way street to increased consumption. Statistically, this is proven by 52% of UK adults drinking at least once a week. One presumes that they weren’t drinking every week from their first ever pint. Does your own experience with alcohol show naturally increasing or naturally decreasing trend over time, despite attempts at moderation? For many people, alcohol consumption increases over time without intervention.

The alcohol trap

Figure 1 The alcohol trap. Source: Author's own (2024)

Figure 1 shows how once we make the decision to drink, we are likely to want to drink again be that next week, the day after, or in ten minutes. Alcohol is a highly dopaminergic substance that stimulates the brain’s reward pathways over short and long time-frames. Each time a feedback loop is completed, alcohol-seeking behaviour is reinforced. The initial feedback loop shows how your phasic (short-term) dopamine levels spike soon after taking a drink. This is the first part of the trap. The drink feels good, so you want another. This is also the easiest place to break the entire trap, but if you don’t take another drink you soon enter a phasic dopamine dip (Grace, 2000). This is easily relieved by having another drink and so the second feedback loop is complete.

With repeated exposure to alcohol, loss of grey matter in the pre-frontal cortex (PFC) occurs, reducing brain-volume in the region tasked with impulse control, reasoning, planning and emotional regulation. The shrinking and downregulation of the PFC could lead to the ‘rubber arm’ effect where you are readily tempted, or can easily find a reason to drink. Astonishingly, a long-form UK study found this effect occurs when drinking within government guidelines, i.e. 6 pints of 4% beer or 6 medium glasses of wine a week (Topiwala et al., 2022). The study also found that loss of brain volume was sharply associated with increased consumption.

Dopamine levels are again impacted with chronic (long-term) drinking by drop in dopaminergic tone. This has a two-fold impact. Firstly, changes in tonic dopamine are associated with increased anxiety (Zarrindast and Khakpai, 2015) which could trigger alcohol-seeking behaviour. Secondly, it reduces the reward you get from activities that don’t involve alcohol such as outdoor pursuits, hobbies and socialising. This loss of interest in these activities further compounds the reduction in tonic dopamine which again leads to alcohol-seeking behaviour in an attempt to self-medicate the situation.

A further, reinforcing feedback arising from the loss of interest in sober social and leisure activities, is the reduction in physical health. This negatively impacts interest in other activities, which in turn reduces tonic dopamine, increasing anxiety, leading to alcohol-seeking behaviour which precipitates further drinking and reduction in brain volume, ad infinitum.

The alcohol trap unfolds with time. It’s primed after just one drink and has increasingly compounding one-way check-points the further into it you get. This is why moderation fails; all you have done is return yourself to the start of the trap.  

The way out

Excepting those that need medical detox because of life-threatening physical dependency, quitting alcohol is an instant process. Compare it to a weight-loss journey. Weight loss has a temporal factor, the time you need to make that happen. Say you want to lose 5kg in three months. On day one, you start by making the right decisions, and have to keep making stackable decisions for the next three months so that you can be measured as an individual weighing 5kg less. For everyone that has stopped drinking, they instantly became non-drinkers the moment they put down their last drink. You don’t lose weight by going to sleep overweight and wake up at your target, but you can go to bed drunk and wake up to a life of sobriety.

If you want to get out of the alcohol trap, make a firm decision once and for all to never step back into it. The only things standing in the way are the thousands of excuses we tell ourselves to rationalise why we MUST have another drink. We will look at how to extinguish these in the next blog post.

If you are looking for an integrated approach to re-evaluating your relationship with alcohol, I run a 4-week Firebreak course for individuals. It comprises 4x 30 minute private video chat sessions and 4x one-hour personal training sessions. As far as the rest of the world is concerned you’re just in the gym with me for a regular PT session. I don’t ask you to disclose your drinking habits, or share any medical history with me. I will guide you through the process I used to find effortless freedom from the fear of missing out by not drinking. I offer this for the price of 4x regular one-hour PT sessions, £200.

References:  

Grace, A. (2000) ‘The tonic/phasic model of dopamine system regulation and its implications for understanding alcohol and psychostimulant craving’, Addiction, 95 (2), pp. S119-28. https://doi.org/10.1080/09652140050111690

Noble, E. (1996) ‘Alcoholism and the dopaminergic system: a review’, Addiction Biology, 1. https://doi.org/10.1080/1355621961000124956

Topiwala, A., Ebmeier, K. P., Maullin-Sapey, T., Nichols, T. E. (2022) ‘Alcohol consumption and MRI markers of brain structure and function: Cohort study of 25,378 UK Biobank participants’, NeuroImage: Clinical, 35. https://doi.org/10.1016/j.nicl.2022.103066

Zarrindast M.R., Khakpai F. (2015) ‘The Modulatory Role of Dopamine in Anxiety-like Behaviour’, Arch Iran Med., 18(9), pp. 591-603. PMID: 26317601