Alcohol use disorder (AUD) is one of the most serious and common mental health problems in the world. It affects millions of people and causes harm not only to individuals but also to families, communities, and health systems.
According to a 2018 report from the World Health Organization, alcohol is responsible for more than 3 million deaths every year. Harmful drinking also plays a role in over 5% of the total global burden of disease. Despite the huge impact, the root causes of alcohol addiction in the brain are still being uncovered.
Now, scientists from the University of Warwick have made a breakthrough in understanding what might drive alcohol addiction in the brain. Led by Professor Jianfeng Feng, the research team studied brain activity and found a key brain network that may be responsible for the urge to drink. Their findings were published in the journal Science Advances.
The study focuses on how our brain reacts to danger or discomfort. Normally, when something bad happens—like losing a reward or feeling upset—our brain processes this information and decides how we should respond.
A small area in the front of the brain, called the medial orbitofrontal cortex (mOFC), helps us detect negative situations. It then sends signals to another part of the brain, deeper inside, known as the dorsal periaqueductal gray (dPAG). The dPAG decides whether we need to act, like running away or changing our behavior.
To explore how this process relates to alcohol addiction, the researchers studied brain scans from 2,000 people across Europe. The participants were part of the IMAGEN study, a long-term research project involving teens and young adults from the UK, Germany, France, and Ireland.
The team used a special type of brain scan called functional MRI to see how the brain worked while people did tasks designed to trigger negative emotions, such as the disappointment of not receiving a reward.
They discovered that people with a history of alcohol abuse had problems in how the mOFC and dPAG communicated during these negative moments. In people with alcohol addiction, this brain network does not work properly.
This means they may react differently—or not at all—to stress, fear, or disappointment. These reactions are important in helping us avoid harmful behaviors. When that system is broken, people may be more likely to turn to alcohol as a way to cope.
The study also found two main patterns in how this brain system can become unbalanced.
In some people, the dPAG becomes too quiet. Since alcohol can dull the activity of the dPAG, the brain no longer reacts strongly to negative situations. This means the person may not notice or care about the bad effects of drinking—like feeling sick, making poor decisions, or damaging relationships.
Instead, they only feel the good parts, such as relaxation or a brief mood boost. This can lead to compulsive drinking, where someone drinks again and again without thinking of the harm it causes.
In other cases, the dPAG becomes overactive. The person may feel like they are always under pressure or in a stressful situation—even when they’re not. For them, drinking alcohol may feel like the only way to escape those feelings. This can lead to impulsive and repeated drinking, especially in tough moments.
These new findings help explain why some people may struggle with alcohol addiction more than others. It shows that alcohol use disorder isn’t just about willpower—it also involves brain changes that affect how a person experiences stress and reward.
The researchers say that by better understanding this brain network, we can develop new and better ways to treat alcohol addiction. Instead of focusing only on symptoms, future treatments could target the specific brain pathways involved. This might include new types of medication or brain-based therapies designed to restore healthy brain communication.
In short, this study helps us see alcohol addiction in a new light. It shows how deep brain processes can shape our behaviors and responses, especially when it comes to dealing with stress. With more research, this knowledge could help millions of people find safer and more effective ways to recover from alcohol use disorder.
If you care about alcoholism, please read studies that your age may decide whether alcohol is good or bad for you, and people over 40 need to prevent dangerous alcohol/drug interactions.
For more information about alcohol, please see recent studies about moderate alcohol drinking linked to high blood pressure, and results showing this drug combo shows promise for treating alcoholism.
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