Have you ever wondered why people continue using drugs or alcohol despite all the negative effects it has on their lives? You might have a friend or family member who has lost their job or custody of a child and still continues to abuse their substance of choice, and you think, why isn’t that enough for them to stop? Part of the answer, of course, has to do with the way our bodies and brains build up a tolerance to these substances and begin to view them as rewards that we need more and more of to feel pleasure. Another reason is that withdrawal can be so unpleasant that many people keep using just to avoid its symptoms. Now, scientists may have discovered another explanation: certain wiring in the brain that they refer to as a compulsivity circuit.

A study was performed by researchers at the National Institute on Alcohol Abuse and Alcoholism, Brown University, and Linköping University in Sweden and published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. It was focused on compulsive behaviors in drinkers. Compulsive behaviors are things people do over and over again, despite them not having any benefits and possibly having negative effects. Eating breakfast every morning, for example, is a habit. It’s something people need to do to function properly. Eating two pieces of toast and a half cup of milk at exactly 7:05 every morning is a compulsion, albeit a harmless one. In the case of drinking, people feel compelled to keep doing it despite all of the risks to their health, livelihood, and relationships. Compulsive alcohol use, or the tendency to keep seeking and consuming alcohol despite the negative effects, is one of the key identifiers of alcohol use disorder.

The researchers came up with a task to assess the compulsive behavior of both light and heavy drinkers. The participants had to earn points to receive either alcohol or food, and to get a point they would face various threat levels, including potentially being subjected to a painful electric shock. Light drinkers generally didn’t take the risk, but heavy drinkers tried to earn the points despite the possibility of being shocked. Brain images were taken during the task, and the results showed that heavy drinkers had more activity in brain regions called the anterior insula and prefrontal cortex, which are associated with decision-making under conflict, and the striatum, which is associated with habit and reward.

COMPULSIVITY CIRCUIT IN HEAVY DRINKERS

According to the researchers, this shows that complex rewiring takes place in the brains of heavy drinkers. The circuits that are normally associated with conflict, risk, and aversion instead become associated with those that process rewarding experiences. This tells the brain that making choices that lead to risky behavior will lead to a reward.

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