Study Finds Alcohol Abstinence Changes Brain, May Foster Relapse

Recent research has revealed that abstaining from alcohol might lead to an increased risk of compulsive drinking behaviour, particularly highlighted in a study involving mice. The research team observed that changes in a specific brain region preceded the urge to consume alcohol again, indicating potential screening opportunities to identify individuals who are at higher risk of relapse.

While it is well-documented that abstinence can lead to improved health outcomes, addiction specialists have proposed that alterations in the brain during this period may actually heighten the risk of returning to alcohol use. To test this theory, researchers focused on the behaviour of mice that had been given access to alcohol over a long-term period before undergoing a phase of enforced abstinence.

The findings showed that a subset of the mice developed an inclination to consume alcohol even after it was made unpalatable with the addition of quinine, a bitter compound. Mice subjected to forced abstinence exhibited a marked increase in their alcohol intake, even preferring the more bitter version of the drink, suggesting that there are inherent difficulties associated with abstaining from alcohol that might contribute to relapses in individuals with alcohol use disorder.

To delve deeper, the research team monitored the activity of cells within a specific area of the brain known as the bed nucleus of the stria terminalis (BNST). Previous studies have linked the BNST to symptoms often observed in alcohol use disorder, such as anxiety and depression. The study found that when abstinent mice were placed back in an environment where alcohol was previously available, they attempted to drink from a plain water source — an action linked to increased activity in the BNST.

Interestingly, the abstinent mice who had developed a taste for the bitter alcohol displayed double the BNST activity compared to their counterparts who had not undergone forced abstinence. Even before being given access to the bitter alcohol, heightened BNST activity was observed, which suggests that screening for this brain activity could help identify individuals who are more susceptible to relapse when faced with alcohol.

Alcohol misuse poses a significant challenge to public health in the United States, where rates of related fatalities are alarmingly high. In 2024, deaths linked to alcohol consumption were reported to be 4.5 times greater than those attributed to opioid use. While harm reduction strategies are being explored for alcohol use disorder, abstinence remains a cornerstone of treatment approaches.

Over 80% of Americans aged 12 and older have consumed alcohol at some point in their lives, with around 10%, equating to nearly 30 million individuals, experiencing alcohol use disorder. Despite the existence of FDA-approved treatments, the inability of clinicians to reliably predict who may need assistance remains a pressing issue. Since 1999, the prevalence of diagnosed alcohol use disorder has effectively doubled in the U.S.

Improving identification methods for individuals at risk of developing alcohol use disorder and navigating treatment options could lead to more effective strategies in addressing this growing concern. However, there remain unanswered questions surrounding the specific role of the BNST in alcohol-related behaviours, including the triggers for increased brain activity and the types of cells involved.

Advancements in neuroscience now enable researchers to manipulate the activity of specific neurons within the brains of mice. This innovative approach is helping investigators to comprehend the BNST’s role in the consumption of alcohol despite its associated harms. Additionally, there are ongoing efforts to explore BNST activity in human subjects, particularly among those in early abstinence from alcohol. Should similar patterns be confirmed, the next phase of research would focus on utilising BNST activity as a potential screening tool in clinical settings.

The study was led by Professor Danny G. Winder and supported by funding from the National Institutes of Health, the National Institute of Alcohol Abuse and Alcoholism, and the University of Massachusetts, which is affiliated with The Conversation US.