Reverse Alcohol Tolerance: What It Is And How It Occurs
Alcohol is a substance included in the category of central nervous system depressants Its consumption is widely accepted in society and is part of very diverse moments of celebration or leisure.
For this reason, its use among the population extends to the point that almost all adults have tried it at least once throughout their lives, and a non-negligible percentage consumes it frequently.
As is the case with other substances with depressant properties, alcohol can generate symptoms typical of addictive processes, among which the appearance of tolerance and withdrawal syndrome stands out.
In this article we will review these last two concepts, which are essential to define the behavior associated with substance dependence, and we will delve into the phenomenon of inverse alcohol tolerance
Before addressing the phenomenon of inverse tolerance to alcohol, which will be the core of this article, it is important to know the basic elements that constitute addiction to any substance: tolerance and withdrawal syndrome The presence of both in an individual represents the clinical criterion from which abuse (understood as the use of the substance in contexts where it causes serious harm) exceeds the limits of dependence.
1. Tolerance
Tolerance is the result of changes that occur in the central nervous system as a result of the introduction of a substance that is not naturally found in it. Through the mediation of specific receptors that the brain has, and the alteration in the levels of certain neurotransmitters (GABA and glutamate in the case of alcohol), an adaptation process is generated that involves both physiology and morphology.
Strictly speaking, tolerance describes the need for increasing consumption of a specific substance to obtain the same effects that were achieved in the initial shots; that is, a notable reduction in the effect of the substance (at multiple levels) that precipitates the increase in dose. This phenomenon is one of those that end up eroding the personal lives of those who suffer from an addictive disorder, since it implies very deep economic and social losses. In addition, it provides us with clues about what inverse alcohol tolerance is.
Withdrawal syndrome is a phenomenon that usually co-occurs with tolerance, and describes a severe feeling of discomfort when the person does not have access to the substance with which they maintain a dependent relationship.
In general terms, withdrawal triggers the opposite effects to those observed during intoxication For example, if a drug depresses the central nervous system (as alcohol does), in this phase the person will feel irritable or agitated.
The case of alcohol presents a peculiarity regarding the withdrawal syndrome: the possibility of the appearance of delirium tremens. Its symptoms usually occur between the second and third day (48 to 72 hours) after the last consumption; and include alteration of consciousness, hallucinations, delusions, feelings of fear, tremor, restlessness, irritability and hyperesthesia in the different sensory modalities (photophobia or light hypersensitivity, perceptual sharpening of sounds and touch, etc.).
3. Addictive behavior
It is understood as addictive behavior all behavioral changes that take place in the context of dependency, which are attributable to it and which end up deteriorating the quality of social relationships and even the ability to achieve or maintain an active working life. This phenomenon is due to a series of alterations in the brain reward system, which are common to the mechanism of action of multiple substances.
To correctly understand addictive behavior we must understand the function of the aforementioned system, which is made up of a set of structures (the ventral tegmental nucleus and the accumbens area) that also project to the prefrontal cortex. What we observe after acute consumption of the drug is a sharp increase in dopamine level (pleasure neurotransmitter) in this region, higher than that produced as a consequence of natural reinforcers.
As a result of this intense sensation of pleasure, the person will seek to use the substance in order to experience it again, progressively abandoning those things in life that previously generated joy or enjoyment. Abandonment can include both personal relationships and hobbies reducing everyday life to a compulsive search for alcohol and the associated sensations (which means investing large amounts of time in its acquisition and consumption).
As a direct consequence of the loss of motivation with respect to natural reinforcers, the person simultaneously experiences a pressing desire to consume that increases proportionally when faced with stimuli that are associated with it. For example, he will feel the need to drink when he goes to the establishment where he has done so for many years, since he is exposed to people and environmental cues with whom he has forged a close association with drinking.
On the other hand, multiple studies suggest that The deprivation of social incentives is a fundamental element for consumption to evolve from sporadic use to addiction itself The lack of solid support or environments in which marginality and isolation predominate contribute to the formation of addictive disorders, which is why the design of therapeutic programs that incorporate the reinforcement of this component is absolutely necessary.
What is reverse alcohol tolerance?
Once we have reviewed the basic principles of addiction, we can delve into a more exhaustive knowledge of the phenomenon of inverse tolerance to alcohol, also known as alcohol sensitization
As noted, chronic alcohol consumption increases tolerance to it, as well as to other chemicals with a depressive effect on the central nervous system (cross tolerance). This would be the case of benzodiazepines, which under no circumstances should be combined with alcohol, as they substantially increase the risk of overdose (coma and ultimately death). It is for this reason that People tend to drink more and more as time goes by
However, after many years of consumption in which an addiction may have developed, many people develop an inverse tolerance to alcohol. In this case the effect of the substance on the brain takes place even at very small doses, showing signs and symptoms characteristic of drunkenness with reduced consumption This effect is diametrically opposite to that observed in general tolerance.
Although conventional tolerance and inverse tolerance may seem like two antagonistic phenomena, in reality they maintain a close relationship. In people who consume alcohol, it is most common for a common chemical tolerance to develop first As time passes and continued use of this drug is maintained, specific damage would occur to kidney function that would reduce ethyl metabolism and increase its levels in the blood.
Fortunately, the effect of reverse tolerance extends only to the initial symptoms of alcohol poisoning (behavioral disinhibition and euphoria), but does not precipitate an earlier onset of dyspnea (respiratory effort) and coma that characterize more advanced stages.
Behaviors that promote the development of alcohol dependence
The feeling of euphoria that accompanies the consumption (in low doses) of alcohol is deceptive, and can lead certain people to use this drug as a self-medication strategy for anxiety or depressive disorders. Scientific evidence indicates that this produces the opposite effect, facilitating a series of alterations on emotions and behavior (as well as on brain neurochemistry) that accentuate the problem why the person decided to start drinking
On the other hand, binge drinking, popularly known as drinking (in which more than 100 grams are ingested in a very short period of time), also represents a risk behavior for the development of addictive behaviors, even in the case of that no other substances be consumed during the course of the week.
It is not at all advisable to drink alcohol to reduce the hangover from the previous day, nor combine it with other substances. The simultaneous use of alcohol and cocaine, to cite a common example, produces cocaine ethylene. The result of this chemical reaction increases the toxicity of both drugs separately, and has been systematically linked to episodes of interpersonal violence.
Alcohol is a widely used drug, especially because it is a socially accepted substance and even integrated into traditions and festivals. The most common thing is that the beginning of its consumption occurs in recreational and leisure contexts, in the company of other people, but the evolution towards addiction implies that it is progressively reserved for spaces of solitude. Information about its effects is key to preventing addictive disorders in the population
