Alcohol use disorder (AUD) is one of the most widespread and serious mental health problems in the world. It affects millions of people and causes harm not only to those struggling with addiction, but also to families, communities, and healthcare systems.
According to a 2018 report by the World Health Organization (WHO), alcohol is linked to more than 3 million deaths every year and contributes to over 5% of the world’s total disease burden.
Now, researchers at the University of Warwick have uncovered important new information that could help us better understand how alcohol addiction starts in the brain. Their study, led by Professor Jianfeng Feng and published in Science Advances, points to a specific brain circuit that may be at the heart of alcohol addiction.
The team focused on a communication pathway between two parts of the brain: the medial orbitofrontal cortex (mOFC), located at the front of the brain, and the dorsal periaqueductal gray (dPAG), which lies deeper inside. The mOFC is responsible for detecting negative or stressful situations.
When it senses something unpleasant or dangerous, it sends signals to the dPAG, which decides whether we need to act — for example, by avoiding or escaping the situation.
To explore this brain circuit, the researchers looked at brain scans from 2,000 people across Europe, using data from the IMAGEN project. While in MRI machines, participants completed tasks that were designed to trigger mild negative emotions — such as disappointment — by taking away rewards. These situations mimic the types of frustration or stress people might feel in real life.
The study found that people with a history of alcohol abuse showed weaker communication between the mOFC and dPAG when they experienced these negative feelings. In other words, the part of the brain that senses danger and the part that responds to it were not working together properly.
This breakdown in communication may make it harder for the brain to deal with stress in a healthy way, increasing the likelihood of turning to alcohol.
The researchers also found two main patterns in how this brain circuit behaves in people with alcohol addiction:
A dulled or inactive dPAG: Alcohol can reduce the activity in the dPAG, meaning the brain is less responsive to signs of danger or discomfort. People in this state might only feel the “good” effects of alcohol, such as calmness or happiness, without fully noticing the harm. This can lead to compulsive drinking, as they don’t feel the warning signs that usually tell someone to stop.
An overactive dPAG: In contrast, some people with alcohol addiction have an extremely active dPAG. This makes them feel constantly stressed or on edge, as if they’re always in a situation they need to escape from. For these individuals, drinking alcohol becomes a quick way to calm down, which can lead to impulsive or frequent drinking to escape negative feelings.
These findings are a big step forward in our understanding of alcohol addiction. They show that the way the brain handles stress and negative emotions plays a major role in why some people develop AUD. More importantly, they suggest that by focusing on this specific brain circuit, future treatments could be more targeted and effective.
For example, new therapies could aim to balance activity in the mOFC-dPAG network — calming it down in some cases or boosting it in others — to help people regain control over their drinking. This could lead to more personalized and successful approaches to treating AUD, improving lives and reducing the global damage caused by alcohol abuse.
This research highlights how deeply mental health and addiction are tied to brain function. It also offers hope: by better understanding the brain’s role in addiction, we can move closer to solutions that help people heal and thrive.
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