Ever wonder what binge drinking does to your brain? Chat with Duke University professor of psychiatry and behavioral sciences Scott Swartzwelder to find out.

Dec 08, 2010

The statistic that the majority of binge drinker are college students is rather upsetting. What are the reasons for this - and if the impression that binge drinking is increasing accurate - why has binge drinking increased?

Drinking on the college campus is generally unregulated.  Because it is illegal for most students, colleges are in a very difficult position and often student go 'underground' to drink.  This can lead to more rapid consumption of drinks.  Binge drinking among college students does seem to be on the rise.  There are probably lots of reasons for this.  But largely there seems to be a focus on drinking to get drunk rather than drinking in a more social way.

What are the effects and are they permanent?

There is no magic number in terms of how much drinking, over what period of time will damage the brain.  But we do know that while the brain is still developing (into about the mid-20's) it is likely that it is more susceptible to long-term damage from alcohol.  The best bet for college students who drink is to do so moderately...the fewer drinks per drinkign occasion, the better.

My sons are 21 and 22 but emotionally are still (alas) immature. They appear to love drinking, are proud of how much they can drink, have obvious tolerance. They are fully aware of not driving if they have imbibed. Neither has a DUI yet. Any advice about how to limit their drinking? And is this possible? Thanks!

People who seem to naturally be able to 'hold their liquor' are at greater risk than the general population for subsequent alcohol abuse disorders.  If they are in this category, and also 'love' drinking, as you suggest, it it probably very important that they understand they may be genetically predisposed to alcohol problems.  I would recommend they set limits for themselves, both in terms of how much they drink per occasion, and how often they drink.  Drinking beer, rather than hard liquor is another strategy that can limit the amount of alcohol consumed.

Do teenagers face a greater risk than adults?

Yes, absolutely.  There is now a strong research literature showing that the adolescent brain responds quite differently than the adult brain to alcohol.  Too much is not good for anybody, but teens seem to be more at risk for short-term har m as well as long-term consequence.

Can the brain fully recover from a decade of more of regular drinking to excess , once the drinking has been abandoned? How about with pot usage?

There is always some degree of recovery in the brain after one stops drinking.  But this will depend on how much was consumed, over what period of time, how many drinks per occasion on average, and the age at which the drinking occurred. 

My husband is 62 and drinks hard liquor every night. Both his parents were alcoholics. I don't drink. Is he at risk for dementia? His father died at 67 of heart disease. His mother has dementia, is institutionalized. She is still living at 81. I know I'll be my husband's caregiver if he does have a neurological problem. Just wondering if alcohol plays any role in this terrible disease.

There is no evidence that mild to moderate drinking predisposes someone to dementia.  But if he drinks more than a couple of drinks per night, I bet he'll feel smarter during the day if he cuts back a bit!

what are the effects of smoking pot several times a week throughout the high school years on the developing brain? Are there long-term effects of smoking pot and drinking from the teenage through college age years even if a person cuts down once they " grow-out" of this stage?

Interestingly, both marijuana and alcohol have more powerful effects on lerning and memory systems in the brains of adolescents than in those of adults.  There is no strong evidence for enduring brain damage after mild to moderate pot smoking.  But the studies have not looked convincingly at adolescents, compared to adults.  There are also possible risks for later psychiatric problems in people who smoke pot heavily during adolescence, but this literature is also incomplete.  So my advice is to take it easy on both pot and alcohol during adolescence.  There are enough red flags about adolescent brain sensitivity to warrant lots of caution.

Do any of your studies address the drinking styles practiced in Europe, where wine or is served to young people in a moderate fashion? And does the abstinence of alcohol until the age of majority create conditions in which binge drinking is more probable?

We have not addressed that specifically.  But my view is that when alcohol use is viewed as a culinary event or a social event and not just an opportunity to get drunk, kids learn to use it differently. 

First of all, does limited (college years) binge drinking cause brain damage? If so, does the brain "heal or repair itself" after college when this binge behavior stops?

Heavy drinking at any time of life can damage the brain, and during the college years the brain is still developing and thus is more vulerable.  It is not clear exactly how much drinking will cause damage during those years, so until we get the answer to that question moderation is probably not a bad approach.

How bad is it to drink right after a work out.. say after swimming or running?

Alcohol will cause dehydration.  So drinking after a workout will limit the ability to replenish fluids.  I would avoid alcohol for at least a couple of hours after intensive exercise.

What about the effect on older brains, say, 60, for example?

The older brain is less susceptible to some alcohol effects than the adolescent brain.  But particularly if older folks are startig to have sleep problems or noticing a slip in learning and memory, it is probably wise to limit alcohol intake.

Dr - I'm a successful trial lawyer with a thriving practice on both coasts. I am, however, still partying like the fraternity boy I was circa "81. Long term damage to my noggin ? Just ordered your book on Amazon btw.

I guess it depends on what fraternity you belonged too!!  If you are drinking heavily on a regular basis (nightly or near-nightly) you are probably not doing your brain any favors.  You are still young enough that your native intelligence may be allowing you to compensate for the negative effects that alcohol has on your brain...but that won't last forever.  You might consider going 'independent.'

What are the long term changes in neurochemistry resulting from alcohol abuse?

There are changes (none good) in many neurotransmitter systems - dopamine, serotonin, GABA, glutamate...  Alcohol is a very dirty drug in that it does not interact with just one system.  Many are at risk with abuse.  But those related to learning, mood, and addiction risk are strongly affected.

I have a college junior who attends Central Washington University where the 4Loko incident took place. He told me that this drink is called "black out in a can" and that the goal for many students is to drink to "black." Can you talk about the dangers of blackout drinking to both the drinker and those around them and on the road. What is the science behind it and why do they think they are still in control?

Blackouts are very serious neurological events.  This is when you drink so much that you can't remember some or all of what happened the night before.  If you got hit on the head hard enough to cause memory problems you would take that very seriously (as would your doctor).  But people laugh about blackouts.  They are no laughiing matter.  The brain is sensitive to alcohol and when enough goes in to shut down that level of function, systems are being compromised that should not be. 

Did you engage in binge drinking during periods of your life? Do you drink alcohol now, and if so, how often?

I drink very moderately now, and drank somewhat more when I was in my 20's and 30's.  But I always monitored how much I had consumed because I knew of some of the risks (and we didn't even know back then about the sensitivity of the younger brain).

I drank heavily usually 2-3 nights a week from age 17 to 24. I managed to function well and graduate from college and finish my masters, but my blackouts became more frequent and my mental health began to detoriate. I experienced my first panic attack after a night of drinking and then begin to get more and more (usually after drinking the night before). I no longer drink, but occasionally have panic attacks (albeit much less severe and more controlled). I am convinced that abusing alcohol has helped cause, or allowed, my predisposition to anxiety to manfiest itself. Is there any research on this link? Thank you

Yes, there is a relationship between drinking and anxiety.  First, many people unknowingly 'self-medicate' with alcohol to reduce anxiety.  Second, after a night of heavy drinking, one tends to be more anxious than usual because when the alcohol gets eliminated the brain rebounds into a state that is more likely to produce anxiety and agitation.  It is probably wise for you to avoid alcohol, but if you still have ongoing anxiety problems there are good medicines and behavioral treatments that your doctor can recommend.

Since alcohol can deplete thiamine cofactors of enzymes that are crucial for microvascular function (and dysfunction), to what extent does alcohol cause microvascular dysfunction and regional blood flow changes in adolescents who binge drink?

That's a good question.  Alcohol has broad effects on both cardiac and vascular function, including microvascular funcrtion.  Whether any of these are more or less powerful in adolescents is not know but it is an very important topic to address.  Sounds like a good topic for a dissertation!

I forgot to add: if you believe youthful binge drinking has a negative long-term effect on the brain, do any remedies exist to improve the conditions?

Any activities that promote brain health will help, no matter what a person's history.   Good sleep hygiene, exercise, and a brain-healty diet will help.

we have a 22 year old son in an outpatient detox program and a senior in college. His drinking problems have just come to light in the last 2 months. When talking to him he is coherent most of the time. Every now and then he starts talking about something not based in reality. Is this alcohol psychosis and does this go away after a period of no drinking? He has not been drinking in 2 months (according to the detox program he is currently in).

I'm sorry your son is having such a tough time.  I can't really answer that question - not having seen him - but his doctors should certainly be looking into both alcohol-related and other possible causes for his periodic disordered thinking.  A thorough psychiatric history and work-up should be done to get a clear picture. 

My nephew is 27,as been binge drinking since college. For the past month,he's had numerous tests(MRI.etc) due to fainting episodes. He has spots on brain, possible damage to myeline cover. How is a diagnosis of binging damage reached? Any advice is appreciated.Thanks

It sounds like there is more going on than would be expected from drinking alone.  He needs to have a thorough neurological and neuropsychological work up to accompany the MRI. 

I was appalled by an article in praise of binge drinking on Courtney Cox's TV sit-com "Cougar Town" in the Post. Courtney's character holds a funeral when her 44-ounce favorite drinking glass "dies" (falls off the counter and shatters into smithereens). The adult characters all consume copious quantities without seeming to suffer ill-effects. What can you do to try to educate TV show writers re: the harm such messages send?

I agree with you fully about the ill-advised mixed messages that are so prevalent on our society.  Organizations like Outside The Classroom, MADD, and Choose Responsibility are all working in different ways to combat the effects of such messages.  Check them out, as they may provide you with ways to get involved as well as with valuable information.

Your book is about ten years old. How has the research over the last ten years changed the information you provide in your book?

Actually, the third edition of our book (2008) has lots of updated material.  But you're right the science is evolving rapidly.  You can check one of our websites for periodic updates -- http://dukebrainworks.com/

I'm a recovering alcoholic (binge drinking division) who didn't become "hooked" until his mid-30's. I tell friends that it took about 15 years of increasingly heavy drinking before I sufficiently "rewired my brain," and became alcohol dependent. Is it possible that this is what happened, or is it just my perception?

It is entirely possible.  We know that the earlier one starts drinking regularly, the more likely s/he is to get addicted later in life.  We're not sure of which circuits are getting altered while the early drinkign occurrs, but that is the subject of much current research.  Stay tuned...

Heavy binge-drinking sessions were a de facto rite of passage in our Eastern Shore town starting freshman year of high school. I quickly found that I could hold large quantities of alcohol, that I enjoyed its effects and that I could get away with it. Massive weekend drinking sessions continued throughout high school, college and my pre-fatherhood years. Now I drink moderately and rarely, but I worry about any permanent effects consuming large quantities of alcohol at 14-17 might have done. I am educated, intelligent and happy -- but I have problems with motivation and focus and "purpose," and I often wonder if they are related to early alcohol consumption.

Sounds like you're fine.  But you dodged a bullet.  People who can 'hold their liquor' well from an early age are at risk for addiction, and that may be related to a genetic predisposition.  I would steer clear of much alcohol use (if any) and advise your children that they may be at enhanced risk, and should think very carefully about whether and how much they drink as they get older.

If you know this, how do the effects of pot smoking compare with the effects of binge drinking on brains?

We don't know this yet...but we do know both are more powerful against learning in the adolescent brain compared to the adult brain.

In This Chat
Dr. Scott Swartzwelder
Dr. Scott Swartzwelder is Duke University professor of psychiatry and behavioral sciences who published the book Buzzed: The Straight Facts About the Most Used and Abused Drugs. He also authored a 2006 study of binge drinking among college freshmen. Dr. Swartzwelder's lab is focused on understanding the neuropsychology, neuropharmacology, and neurophysiology of substance abuse. He is particularly interested in adolescence as a developmental period of significance.
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