Saturday, 29 June 2013

Is alcohol really a depressant?

In an attempt to make our lives less complicated, we like to simplify quite complex issues into quick grabs that are easy to understand and don't take too long to communicate to others. It's just human nature - firstly, most people don't have the time or the patience to listen to all of the subtleties that may be involved with the subject, and secondly, most of us wouldn't necessarily understand everything that needs to be said!

In the alcohol and other drug (AOD) field this has always been the case. I've been to scientific conferences where researchers who have spent their life in a laboratory with a pile of mice have tried valiantly to communicate what they have discovered and seriously, not one word has made any sense to me at all. When it comes to how different drugs work on the body, most particularly the brain, there are very few researchers across the world who I have met who can effectively communicate in words of one or two syllables how drugs do the things they do ...

As in other areas of science, messages in the AOD field have been made simpler by the classification of drugs into one of a number of groups. Three main categories are usually identified and these are based on similarities that certain drugs share, particularly in terms of their action on the user. The three are stimulants, depressants and hallucinogens. Put simply (and I mean really simply!) the three can be defined in the following way:
  • stimulants - these stimulate the brain and central nervous system - they 'speed' you up
  • depressants - these slow down the activity of the brain and nervous system - they 'slow' you down
  • hallucinogens - these interfere with the brain and central nervous system in a way that alters the user’s perception of reality - they 'mess you up'
The problem with this classification system is that most drugs don't fit neatly into any of these groups. I was doing a bit of a search on the web for drug classification recently and I found quite a few sites that referred to four drug types, the fourth being 'other', which is really helpful!

If we hope to get effective messages across to young people around alcohol we must make sure that what we say is accurate - unfortunately, one of the key pieces of information we provide to them is not entirely correct and actually conflicts with their own experience - 'alcohol is a depressant'. Try standing in front of a group of Year 11 students and tell them that and all they'll be thinking is that you're drinking something very different to them! It simply doesn't match what happens to them when they drink alcohol - it doesn't slow them down, in fact, it does just the opposite - it speeds them up and charges them. The more they drink (to a point), the more wide awake they are!

Young people are able to drink more, for longer periods of time, than adults due to them being less susceptible to the sedative effect of alcohol. The brain mechanism of this effect are not completely clear, but it is believed to be due to the neurotransmitter GABA. In an adult brain, consuming alcohol increases GABA production, reducing energy levels and calming everything down (a depressant effect). It is now believed that final levels of GABA receptors are not reached in the brain until early adulthood, once the brain is fully developed, and therefore adolescents have fewer GABA receptors on which alcohol can act. There isn't as much of a release of GABA when they drink and they are therefore able to stay awake and unfortunately drink more!

I am sure that many people reading this will be able to remember the night when their brain reached full development (i.e., early 20s), full GABA release was possible and as a result they sat on the end of their bed after a big night of drinking and realized that they could never quite drink the same way again (an oversimplification of a complex process but you know what I'm getting at!)  ….

But why the stimulant effect - why do young people get 'charged up' on alcohol?

Years ago I remember having this effect explained to me as simply the 'depression' or the slowing down of the part of the brain that controlled inhibition, i.e., alcohol turned off your 'on-off' switch, that part of the brain that stops you doing dumb things! Alcohol certainly depresses the behavioural inhibitory centres, making the person less inhibited, but this doesn't really explain the 'buzz' that young people get from alcohol.

Reading through the research that is now available in this area, it appears that the process is quite complicated and to be honest, there aren't any easy answers. What is clear is that alcohol also increases the release of another neurotransmitter in the brain called dopamine. Dopamine helps control the brain's reward and pleasure centres. By raising the levels of dopamine by drinking the first glass or two, alcohol tricks an adult into thinking that he or she is feeling pretty good. However, when you keep drinking to maintain that pleasurable effect, the other brain chemicals start to be released, particularly GABA, and they unfortunately win the battle and the depressant effect kicks in. When you are an adolescent it would appear that GABA release doesn't happen and all they're experiencing is a flood of dopamine ... they are feeling good and more alcohol is going to make them feel better!

If you haven't seen the wonderful ABC documentary - 'The Science of Teens: Binge' - take a look as it does a wonderful job of showing the very different effects, particularly those around sedation, alcohol has on teens and adults. The whole series is fantastic and every parent of an adolescent should take a couple of hours to sit down to watch these to assist them in understanding what is actually happening to their child through this difficult time.

Certainly we need to acknowledge that alcohol works in a very different way on young people than on an adult. The exact processes are still not known as yet but regardless this difference enables them to drink a lot more than many adults and puts them at great risk. Talking about the stimulant effect of alcohol with our young people is important - they may then at least listen to what we tell them and be able to say what we're telling them is credible and meaningful to their own experience.

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