WEDNESDAY, Jan. 25, 2006 (HealthDay News) -- Treatment for alcoholism could change radically as researchers learn more about the interplay between smoking and drinking, and how the two addictions feed each other to devastating effect on the brain.
New evidence suggests that alcohol and nicotine work on the same inhibitory amino acids in the brain, which makes the inclination to do both doubly strong. However, experts think that could mean both addictions could be battled simultaneously, and not separately, in the future.
"While among non-drinkers smoking rates are 20 to 30 percent in the Western world, rates are up to 80 or 90 percent among alcoholic patients," noted Dieter J. Meyerhoff, a professor of radiology at the University of California, San Francisco, and an organizer of a recent symposium on the phenomenon.
"There is research that suggests this is not by chance," he said.
Results of the symposium, which focused on brain injuries caused by smoking and drinking separately and together, appear in the February issue of Alcoholism: Clinical & Experimental Research.
Genetics and environment appear to play a strong part in both addictions.
"Drugs, including alcohol and nicotine, may affect different individuals differently, depending on their genetic makeup," Yousef Tizabi of Howard University, co-author of a paper delivered at the seminar, said in a statement. "Similarly, drug-drug interactions are also influenced by genetic factors."
It appears that alcohol tends to lower IQ and impede other long-term brain functioning, while smoking appears to interfere with short-term cognition. When used with alcohol, nicotine exacerbates the damage by releasing free radicals and reducing blood flow to the brain, the researchers said.
Brain scans showed chronic smokers who are alcoholics had greater brain damage and slower metabolic recovery when compared to nonsmoking alcoholics, said Meyerhoff, though in time and with treatment alcoholics do recover brain tissue.
"So, with the two conditions, the question is what do you do?" said Dr. Adam Bisaga, an addiction psychiatrist at the New York State Psychiatric Institute in New York City. "It's much more difficult for drinkers to quit smoking on their own. And smokers often insist, wrongly, that cigarettes help them think more clearly."
Generally, it has been thought it was too much to ask patients to battle smoking and drinking at the same time, just as it was thought that no one should be asked to quit smoking marijuana when they were recovering from cocaine addition.
"But that is not supported by empirical evidence," Bisaga said. "It's easier to become abstinent from alcohol if you quit smoking at the same time."
The idea now is that when a patient is in treatment and a "captive audience," all conditions should be dealt with, he said. Psychotherapy can be effective in treating multiple addictions, but more work is needed.
Bisaga said that while drugs have been developed to treat alcohol and smoking individually, it's time scientists concentrated on medications that help people beat both.
More information
For more on alcohol's effects on the brain, visit the National Institute on Alcohol Abuse and Alcoholism.
