Boffins on Booz

Does alcohol abuse lead to mental health problems?

According to research published on the 7th November most Australians believe that it does. The Salvation Army in Australia has released a survey by Roy Morgan Associates finding that 15.1 million people (81%) say drinking alcohol can worsen a person’s mental health.

This came as no surprise to Mr Glenn Whittaker of the Salvation Army who told the Sydney Morning Herald that:
"All too often we are seeing the damage alcohol is doing to people and families ... we see huge numbers of people who have anxiety disorders, depression, schizophrenia and bi-polar disorders ... too often this is linked to alcohol issues. It is predicted that by 2020 depression will be one of the world’s largest health problems."
Can so many Australians be wrong? Not according to research by the Foundation Recovery Network published in March which followed up patients from four US treatment facilities. Their research confirmed that
'more than 50% of patients who have been diagnosed with substance abuse disorders also suffer from a diagnosable mental illness. It appears that relapse rates of alcohol abuse correlated with mental health concerns. '.
Interestingly the same study found that this correlation was true for alcohol but not for other drugs - 'abstinence rates for drug use appear unrelated to mental health outcomes'.

And does alcohol use cause mental health problems in the first place? The UK Mental Health Foundation report 'Cheers' is very sure it does. 'There is much research that indicates that people who consume high amounts of alcohol are vulnerable to higher levels of mental ill health.  According to the World Health Organisation: “Sufficient evidence now exists to assume alcohol’s contributory role in depression”

The idea that people
"‘self-medicate’ their mental health problems using alcohol is also very well known and documented. The prevalence of alcohol dependence among people with psychiatric disorders is almost twice as high as in the general population. People with severe and enduring mental illnesses such as schizophrenia, are at least three times as likely to be alcohol dependant as the general population... As many as 65% of suicides have been linked to excessive drinking".
As Gerard Byrne from The Salvation Army says, "We strongly encourage people to think about and talk about alcohol issues among their family and friends, and find ways so they can look out for each other when life is not a bed of roses. We encourage people to engage in healthy ways of dealing with difficult emotions and to avoid using alcohol for this purpose."


Genetic theories of alcohol addiction get another airing

Alcohol research is often being led away from the inherent dangers of the product and onto the weaknesses of the user. This mirrors the tactic that served the tobacco industry so well for years to deflect from the eventual banning of advertising of its product. Much alcohol research is going in a similar direction, and a popular target is genetics. The theory goes that alcohol is absolutely fine if you can simply identify the weaknesses of the few who are 'genetically pre-disposed' to become alcoholics. The rest of us can then be safe in the knowledge that our superior genes will protect us.

And so it is with another study published this week by the University of California, San Diego School of Medicine which looks at "Genetically Influenced Responses to Alcohol Affect Brain Activation". The researchers find that 'differences in brain activation in individuals with a low level of response to alcohol may contribute to their inability to recognize modest levels of alcohol intoxication'.

But the research is full of qualifications. The findings 'could' provide 'the potential' to identify individuals who are 'at risk for developing an alcohol-use disorder before it develops – in essence, providing a marker for this vulnerability'. But looking at the small print, Marc A. Schuckit, MD, Distinguished Professor of Psychiatry at UC San Diego, who headed the study, admits that “While some genes that contribute to LR [a low level of response to alcohol] have been provisionally identified, the mechanism through which the low LR operates in the brain has not been extensively studied.” In other words, a link between those who don't feel pissed as quickly as others and those who become alcoholics has not been traced.

Of course all sound science is worthwhile, and any understanding of alcohol and genetics has value. But Ireland has already provided the prefect model to test the genetic weakness theory of alcholism. Science rarely gets such a chance to study a large enough cohort to demonstrate or investigate a hypothesis in the real world. The Irish population in 1992 had only 10% alcohol abusers and 39% abstainers. By 2011 it had 74% alcohol abusers and only 11% who had not actually binged on alcohol in the past twelve months. Two possible explanations. If the genetic theorists are right then the population's genes must have changed over the space of twenty years. The alternative is that the deregulation of sales and marketing of alcohol by the 1992 government which led to mass advertising, a 70% growth in outlets and 150% increase in sales of alcohol has led to more drinking, and hence more alcoholism.

If you take enough of an addictive substance then you will sooner or later get addicted, whatever your genetics. The timing is all.

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