Why Can’t I Stop Drinking Once I Start?
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If you’ve been trying to cut down or moderate your drinking without success, then it’s frustrating to keep letting yourself down and messing up. It’s easy to blame yourself, but there are lots of reasons why someone can’t control the amount of alcohol they drink.
Why you have no off-switch when drinking alcohol
The dorsomedial striatum or DMS receives input from the prefrontal cortex and is involved in goal-directed action control and flexible thinking. Goal-directed behavior is being able to resist instant gratification choices because you know it will be better for future you. There are two types of dopamine neurons in the DMS, D1 and D2.
The D1 neurons are part of the go pathway in the brain and the D2 neurons are part of the no-go pathway. This is part of the decision making process, or the go, no go process. Your brain decides if it should do something or not do it, so continue drinking or stop drinking. When D2 neurons get activated it tells you to wait, stop, or do nothing. When D1 neurons are activated, it tells you to go go go! You can think of the D2 neurons as your off-switch.
A 2016 study published in Biological Psychiatry found that when we drink a lot of the D2 neurons become deactivated, meaning the no-go pathway gets weakened and the off switch disappears. Loss of control is one of the earliest signs of addiction, and the D2 neurons become deactivated even in people who aren’t addicted yet.
Heavy drinking changes the brain
As we drink more and more our brains adapt and change. The loss of your off-switch is one major way and this represents the move from thinking about things and weighing the pros and cons, to just compulsively drinking and needing alcohol no matter what.
If you’re struggling with your off-switch and blaming yourself for it, then please try to stop viewing this as a morality thing. Your off-switch didn’t go away or weaken because you’re a loser with no self-control. It weakened because you drank a ton of alcohol and heavy drinking changes the brain.
Learn more about where your off-switch went in episode 125:
What to listen to next:
E117: Why Sobriety Eventually Just Clicks
E97: Why We Keep Believing it’ll be Different this Time
E99: Why We Can Never Drink Again (Neuroplasticity and Permanent Changes)
Sources
Yifeng Cheng, Cathy C.Y. Huang, Tengfei Ma, Xiaoyan Wei, Xuehua Wang, Jiayi Lu, Jun Wang. Distinct Synaptic Strengthening of the Striatal Direct and Indirect Pathways Drives Alcohol Consumption. Biological Psychiatry, 2016
Volkow, N. Effects of alcohol detoxification on dopamine D2 receptors in alcoholics: a preliminary study. Psychiatry Research: Neuroimaging. 116:3. 163-172. 2002
Ypder, K. Dopamine D2 receptor availability is associated with subjective responses to alcohol. Alcoholism: Clinical and Experimental Research. 29:6. 2005
Bocarsly, M. A mechanism linking two known vulnerability factors for alcohol abuse: heightened alcohol stimulation and low striatal dopamine D2 receptors. Cell Reports. 29:5. 2019.
Cite this episode
Tietz, G. Episode 125: Why Can’t I Stop Drinking Once I Start. Sober Powered. 2022.
