![]() Unfortunately, when the behavior is drinking alcohol, the alcohol drinking behavior is strongly “learned” via pleasure center activation/reinforcement. When the reward center of the brain activates, the organism is more likely to remember and repeat the behavior they are currently performing at the time, without even thinking about it (Ostafin et al., 2008). Human brains have evolved to reward life-sustaining activities to encourage organisms to repeat those behaviors. People with alcohol use disorder experience a euphoric high feeling after drinking alcohol. According to the DSM-5 (American Psychiatric Association, 2013), activation of the brain's reward (pleasure) system is a major source of problems for alcohol users. Alcohol dependence is “a maladaptive pattern of drinking leading to clinically significant impairment, as manifested by a compulsion to drink, a lack of control over urges to drink (craving), a lack of control over the amount of alcohol consumed, and continued drinking despite realization of the associated problems,” (The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, DSM-4 American Psychiatric Association, 2000). According to a recent NIH epidemiological study, the lifetime prevalence of alcohol use disorder in adults 18 and older in the United States is 29% (Grant et al., 2015). Substance use disorders are estimated to affect well over one billion people worldwide.Īlcohol-use disorders, which include both alcohol abuse and dependence, make up one of the most prevalent categories of substance use disorders. Additional fMRI brain scan studies are needed to further explore the neurobiological mechanism of chemical aversion therapy treatment for alcohol use disorder, and other substance use disorders for which chemical aversion therapy is used (e.g., opioid dependence and cocaine dependence). Consistent with a craving reduction mechanism of how chemical aversion therapy facilitates sobriety, results of the UW fMRI brain scans showed significant pre- to post-treatment reductions in craving-related brain activity in the occipital cortex. ![]() Most of the participants (69%) reported being still sober 12 months post-treatment. After treatment (after four SSH chemical aversion treatments, again after five SSH chemical treatments, 30 and 90-days post-discharge), these same patients reported avoidance/aversion to alcohol. Prior to treatment, patients reported craving/desire for alcohol. ![]() Patients were recruited as subjects for the University of Washington (UW) brain scan study following SSH admission but before treatment onset. This is the first fMRI study to measure the effects of chemical aversion therapy on alcohol craving-related brain activity. Craving reduction was one of the primary treatment goals. All patients met DSM4 criteria for alcohol use disorder, were heavy drinkers, and reported craving alcohol pre-treatment. The treatments included five chemical aversion conditioning sessions that associated alcohol cues (and alcohol) with nausea and emesis. In the current study, patients with alcohol use disorder received 10 days of inpatient multi-modal treatments at Schick Shadel Hospital (SSH) of Seattle. Craving was added as one of the defining criteria for alcohol use disorder in DSM5, and craving reduction is becoming an increasingly important treatment goal. Alcohol craving is a powerful desire to drink alcoholic beverages. ![]() Alcohol drinking behavior is strongly “learned” via pleasure center activation/reinforcement. ![]() A recent NIH epidemiology study found the lifetime prevalence of alcohol use disorder in the United States to be 29%. ![]()
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