“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
Razi Berry is the founder and publisher of the journal Naturopathic Doctor News & Review, which has been in print since 2005, and the premier consumer-faced website of naturopathic medicine, NaturalPath. She is the host of The Love is Medicine Project docuseries, The Natural Cancer Prevention Summit, The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10-week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and chronic fatigue syndrome and fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. You can follow Razi on social media: Facebook at Razi Berry, Instagram at Razi.Berry and join the Love is Medicine group to explore the convergence of love and health. Look for more, and listen to more Love is Medicine podcast episodes here.