Comment by tcj_phx | Hacker News Reader

Comment by tcj_phx | Hacker News Reader

When my friend overdosed on heroin she was revived with two doses of naloxone. Her drinking was under control for about 2 weeks. Naltrexone is very similar to Naloxone, and is FDA-approved to help people with opioids and alcohol use.

https://en.wikipedia.org/wiki/Naltrexone

The Sinclair Method uses naltrexone to help people get their alcohol use under control:

  Naltrexone is at the heart of the Sinclair Method (TSM)
  for Alcoholism.   When you take Naltrexone prior to 
  drinking, it blocks endorphins, the naturally occurring 
  opiates in the brain, from being released when alcohol 
  is consumed.

  When the endorphins are blocked, there is no “buzz” or 
  rewarding experience, and the alcohol doesn’t make you 
  feel the pleasure that drives you to drink excessively.

  Over time, your brain learns not to associate alcohol 
  with pleasure, resulting in reduced cravings and 
  improved control over alcohol use.   Naltrexone must be 
  taken at least one hour before your first drink.

https://www.sinclairmethod.org/what-is-the-sinclair-method-2...

Very cool, thanks for sharing. Describing it another way:

The goal is to deassociate alcohol with pleasure. One way to do this is to abstain for a long period of time so that the association gradually weakens, but 1) this requires constant willpower and 2) takes a long time for the association to decay.

If you instead take a pill that blocks the pleasure from alcohol consumption, you can undo the association very quickly and with basically 0 willpower (it’s not like your brain currently has an association between taking the pill and experiencing pain).

I have no experience with alcohol dependence, but this is a great confirmation of the reinforcement patterns of the brain.

I don't understand at all what is this "buzz" that people talk about that causes alcoholism. When I drink too much, I feel dizzy and I hate that feeling of not being fully in control. When I do drink moderately, it's because the drink tastes good, period. Some mocktails taste just as good as the real alcoholic version so I'll opt for that. Wines have a much more complex profile so grape juice isn't a substitute, but still I enjoy the taste and aroma of wines, not that it gives me any pleasurable "buzz" (whatever it is).

You've reinforced the premise of the article!

Your brain has to learn how to be "buzzed", thus the experience is a function of your very complicated physiology and neurochemistry.

If you are susceptible and drink often enough, your brain will begin to associate drinking and its effects with certain activities. The addiction arises when your brain tells you it's a good idea, and you comply.

I tell younger people this, but when you're an alcoholic, you don't realize it until you're not addicted to alcohol. I went through this when I was maybe 20, and when I quit, I was often surprised when and where I suddenly felt the urge to look for a drink. After, I saw it all around me in others. As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended. Most of them never got drunk, and many could drink several drinks before they reached a point where they "felt" it.

It doesn't have to be overtly pleasurable to be felt. Sometimes, it's merely the removal of difficult feelings that drives someone.

> As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended.

Emotional and physical stress increases the brain's use of glucose.

Alcohol has 7 calories per gram. I think the main use of alcohol in the brain is as acetate (vinegar) - that is, Ethanol is transformed by the liver into acetate, which is one of the brain's alternative fuel sources.

For people with broken metabolisms, ethanol also provides calories to allow their brain to function.

Increased brain uptake and oxidation of acetate in heavy drinkers - https://www.jci.org/articles/view/65153

It’s the same feeling you’re reporting, many of us just find it fun to be a bit dizzy. I’m not trying to argue anyone into enjoying drunkenness, but I like spinning around in my chair really fast too.

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