Brain changes during abstinence from alcohol may increase the risk of compulsive drinking, a new study suggests.
Recent research has revealed that abstaining from alcohol may lead to an increased risk of compulsive drinking behavior, which was particularly highlighted in a study conducted on mice. The research team noted that changes in a specific area of the brain preceded the desire to consume alcohol again, suggesting potential screening opportunities to identify individuals most at risk of relapse.
While it is well-documented that abstinence can lead to better health outcomes, addiction specialists have suggested that changes in the brain during this period may actually increase the risk of returning to alcohol use. To test this theory, the researchers focused on the behavior of mice that were given access to alcohol over a long period before undergoing forced abstinence.
The results showed that a subset of mice developed a tendency to consume alcohol even after it was made unpalatable with the addition of quinine, a bitter compound. Rats subjected to forced abstinence showed a significant increase in alcohol intake, even preferring the more bitter version of the drink, suggesting that there are inherent difficulties associated with abstinence that may contribute to relapses in individuals with alcohol use disorder.
To delve deeper, the research team monitored the activity of cells within a specific region 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 abstaining mice were placed in an environment where alcohol was previously available, they attempted to drink from a regular water source — an action associated with increased BNST activity.
Interestingly, abstinent rats who developed a taste for bitter alcohol showed impaired BNST activity compared to their counterparts who did not undergo forced abstinence. Even before access to bitter alcohol was made available, increased BNST activity was observed, suggesting that examining this brain activity could help identify individuals most vulnerable to relapse when confronted with alcohol.
Alcohol abuse poses a major public health challenge in the United States, with related mortality rates alarmingly high. In 2024, it was reported that deaths associated with alcohol consumption were 4.5 times greater than those attributable to opioid use. While harm reduction strategies for alcohol use disorders are being explored, abstinence remains a cornerstone of treatment approaches.
More than 80% of Americans ages 12 and older have consumed alcohol at some point in their lives, and about 10%, about 30 million individuals, have an alcohol use disorder. Although there are FDA-approved treatments, the inability of doctors to reliably predict who might need help remains a pressing problem. Since 1999, the prevalence of diagnosed alcohol use disorder has effectively doubled in the United States
Improving methods for identifying individuals at risk for 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 behaviors, including the stimuli for increased brain activity and the cell types involved.
Advances in neuroscience now enable researchers to manipulate the activity of specific neurons within the brains of mice. This innovative approach helps researchers understand the role of the BNST in alcohol consumption despite its associated harms. In addition, there are ongoing efforts to explore BNST activity in humans, especially among those who have early abstinence from alcohol. If similar patterns are confirmed, the next phase of research will focus on using BNST activity as a potential screening tool in clinical settings.
The study was directed by Professor Danny J. Wender is supported by funding from the National Institutes of Health, the National Institute on Alcohol Abuse and Alcoholism, and the University of Massachusetts, affiliated with The Conversation US.
