Why booze leads to woe

Why booze leads to woe

Maeve Haldane | Robert Pihl has been experimenting with booze since the early '70s. That is, conducting experiments in his professional capacity as a psychologist, of course.

Psychology professor Robert Pihl PHOTO: Owen Egan

Pihl researches alcohol's relationship to aggression. It's a topic of great relevance, Pihl says, but it is often ignored. Despite the sobering fact that fully "half of all murders, rapes, assaults occur while individuals are intoxicated. And it's almost the same percentage for victims."

It's too easy to assume this is because acts of violence can occur in booze-filled dens of iniquity. There are other factors, such as alcohol's ability to weaken the perception of threat or punitive consequences in some drinkers. Pihl says alcohol "disinhibits our normal control mechanism." His studies have shown certain intoxicated subjects to be fully aware of the consequences of their actions, yet "it's like they know it, but they're not computing it, they're not putting it into the appropriate context." He adds, "It's the same reason why victims get involved. Because they put themselves in harm's way."

One renowned study in California looked at rats in a closed alleyway with a cat sitting at the other end. "When they're sober, they're plastered in their little corners, you can't find 'em. But get 'em drunk and they waltz out... and woomph! They get eaten! And we're no different."

Not only can alcohol reduce the self-protective threat mechanism for some, but it also can produce a stimulating effect on others. "Simply by producing more of a stimulatory response, you're likely to put yourself in situations that are more provocative and more likely to cause trouble.

"We find that certain kinds of individuals will demonstrate this accelerated response to alcohol. They're much more likely to have histories of delinquency, theft, destruction of property, gambling. They show personality characteristics of sensation seeking. They're easily bored."

Also, the level of functioning of the prefrontal cortex can have an impact on alcohol's effects. This part of the brain is at least twice as large in people as in other primates and "makes us human." Pihl explains it "basically provides a context for our behaviour, melds the present, past and future." If this part of the brain is low functioning, controlling the response to provocative behaviour becomes difficult, whether sober or intoxicated.

To top it all off, there's the social factor. "In societies where alcohol is viewed as a food, people drink just as much, if not more. The level of social problems related to the drug is far less... Whereas in our society, the drug is a social lubricant. It's a mixture of this kind of psychological cultural concept, along with the physiological activity of the drug -- what it does -- that leads to the increased likelihood of aggression."

Pihl is keen on rethinking standard assumptions about alcohol abuse.

Ultimately, "the word 'alcoholic' means nothing. Zero, zilch, nothing."

Neither does the term alcohol dependence. "It's simply an operationalized term for people who are using too much alcohol, which seems to affect aspects of their life. Duh. It doesn't tell you what to do, it doesn't tell you how they got there. It doesn't tell you why they're drinking too much."

There's also hype around discovering an "alcoholism" gene. "Genes are involved in everything. Well, are they going to isolate the alcohol gene? Never. Are they going to isolate the schizophrenia gene? Never. The disorders are not defined on the genetic level. We might find there are genes in individuals who have this hypersensitivity to arousal, that need this kind of stimulation. That in turn might explain a whole series of disorders."

To illustrate how researchers should approach treatments of alcohol abuse, Pihl compares alcohol to anemia in which "there's a lack of red blood cells. But you deal with it totally differently depending on etiology. There are 30 different etiologies for anemia, why should alcohol problems be any different?

"It would be totally inappropriate to use certain kinds of treatments with people who are threat sensitive, and it would be totally inappropriate to use certain kinds of treatments with those people who are arousal sensitive."

For the first group, alcohol dampens the threat system, "particularly for people who tend to be highly anxious, shy, introverted, panic prone, phobic prone. In that case alcohol is producing an anxiolytic effect. When they drink, their response to stress dramatically decreases.

"Being anxious and upset and nervous is an unwanted condition. Blocking that makes you feel better! And alcohol does it. But so do benzodiazepines, which operate exactly the same way for these individuals. So they might abuse Valium. Or they might abuse alcohol, or they might abuse both of them together!" Basically, these people are self-medicating and the results are often dire.

The arousal-sensitive group, who tend to be extreme extroverts, have a positive "feel-good" response to alcohol, and are "at risk for abusing drugs that stimulate these systems, like alcohol, cocaine, amphetamines, Ritalin -- these kinds of drugs."

But all too often, "the kind of treatment people get for drugs and alcohol depends on the bloody door they walk through. Not their problem." Different doctors and rehabilitation centres tend to have their own pet treatment approaches. Pihl argues that what's needed are therapies that are very specific to the reasons why different people abuse alcohol.

"Jonathan Swift wrote that 'what is drinking but a mere pause from thinking?' But it's not true for everybody. Some people can control their behaviour -- not everybody engages in stupid intoxicated behaviour."

But for those who do, it is crucial to gather more information to help understand the different reasons why.

"We're simply trying to understand why we've got these populations and who they are. We want to understand what variables we can control in this alcohol-aggression relationship. That's a broad way of raising a whole series of small experimental questions."