People Who Drink to Relieve Craving, Lift Mood Headed Down Path to Alcoholism
Alcohol and Cigarette Use
In the first decade of the 2000s, the National Institute on Alcohol Abuse and Alcoholism conducted a landmark project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Among other things, NESARC gathered data on the number of people in the U.S. who consume both alcohol and cigarettes, as well as the number of people who qualify for a diagnosis of both alcohol use disorder and nicotine addiction (tobacco use disorder). Figures compiled during the survey showed that 46 million Americans used both alcohol and cigarettes (or some other form of tobacco) in the previous year. In addition, roughly 6 million people had problems that would merit a simultaneous diagnosis of nicotine addiction and alcohol use disorder.
The combination of alcohol use and cigarette use is known to create unique risks to physical health. Researchers now know that combined intake of alcohol and nicotine can also pose unique risks for normal mental function. For example, in a study published in 2013 in the British Journal of Psychiatry, researchers from University College London compared the higher-level mental skills of people who only drink alcohol in moderate amounts to the skills of people who drink alcohol in heavier amounts and smoke cigarettes (a fairly common pattern of substance intake). These researchers concluded that people who drink heavily and smoke experience a substantially more rapid decline in their mental skill set over time.
Addiction specialists and public health officials use the term “craving” to identify the presence of an insistent urge to use more of a given substance. Cravings for alcohol and other substances can appear in forms that include substance-related trains of thought, substance-related changes in emotion and substance-related physical reactions. Many affected individuals experience external or internal cues that trigger their cravings or make existing cravings more intense. The recurring presence of alcohol cravings is one of the main symptoms of alcoholism.
Cravings and Negative Mood Changes
In the study published in Addictive Behaviors, the UCLA researchers looked at the levels of negative mood change in a group of 464 adults who drank in heavy amounts and also smoked cigarettes. After determining the extent of this change, they used a detailed statistical analysis to determine if alcohol use or cigarette use plays a more important role in the onset of negative mental states. In addition, they looked at the specific drinking- and smoking-related factors that contribute to damaging mood change. They were especially interested in the role played by alcohol craving.
The researchers concluded that, in people who drink heavily and smoke cigarettes, alcohol use is the critical influence on negative emotional states. In fact, they did not link cigarette use to the presence of these states. When they explored the reasons heavy drinking can have such a harmful effect on mood, the researchers found that alcohol craving is the key factor and has a direct impact on the likelihood of experiencing significantly negative emotions. In fact, without the presence of alcohol craving, heavy drinking would lose essentially all of its clear association with negative mood change.
The study’s authors believe that their findings demonstrate two of the potential reasons some people develop serious problems with alcohol: relief craving and negative reinforcement. Relief craving refers to behavior that satisfies a current craving; in the case of alcohol craving, drinking is the satisfying action. Negative reinforcement refers to behavior that allows a person to avoid an unwanted consequence. In the current context, alcohol consumption is a negative reinforcement consciously or unconsciously intended to help a person avoid experiencing depression, anxiety or other unpleasant mental states. However, this does not mean that heavy alcohol use actually helps a drinker achieve this goal over time; quite the opposite is true.