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Drinkin’ and “Stinkin’ Thinkin’”

Why do people who drink make bad decisions?

There has long been an accepted link between alcohol abuse and impulse control problems

: people with alcohol problems have difficulty choosing large, delayed rewards over smaller but more immediate ones. Most people immediately attribute this to the instant effect of drinking - alcohol lowers inhibition and thus negatively affects peoples' ability to make good decisions in the moment.

There has long been an accepted link between alcohol abuse and impulse control problems

However, in a study to be published in the July 2011 issue of Alcoholism: Clinical & Experimental Research, Eric D. Claus and his colleagues used brain imaging to study people with alcohol use disorders as they made decisions and tried to delay rewards. What the researchers found was that people with alcohol use disorders have anomalies in brain regions associated with emotional and cognitive processing and control - the area of the brain where the ability to delay rewards lies. The researchers also found that the more severe the alcohol problem, the more dysfunction there is in that area of the brain.

What could not be determined is which came first: the neural dysfunction related to impulsivity or the alcohol abuse. In other words, did people first have brain anomalies which lead to impulsive disorders and alcohol abuse, or does the alcohol abuse cause the brain to malfunction? This would be an important area for future research. But whichever came first, they happen together, and that's important and useful information to have in the treatment of alcohol use disorders as well as impulse disorders.

It seems that part of why people who abuse alcohol impulsively make decisions because their brain has difficulty delaying gratification, not simply because it is more rewarding to do so. In this way, it is not just a matter of an individual with alcohol abuse/impulse control problems learning to see and account for the rewards of delayed gratification, but also a matter of training the brain to do work that is difficult for them. This brain work could be helped by specific psychotherapy or medication, but there is research that it could also be helped with alternative therapies, such as meditation, yoga, or acupuncture.

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