KEY TAKEAWAYS
Yes, brain damage from alcohol is reversible.
The factors most impairing recoverability are:
Can You Reverse Brain Damage From Alcohol?
After two weeks of full abstinence from alcohol, partial regeneration of both grey and white matter in the brain cells occurs [2].
Kindling, caused by multiple withdrawal attempts, leads to exacerbated withdrawal seizures that inhibit brain damage recoverability.
Repeatedly drinking to 'blackout' causes brain cell death that inhibits the brain from recovering and being able to form new memories.
Brain shrinkage, which inhibits brain recovery, between 31-71 grams is 70% greater in chronic alcoholics than non-drinkers [3].
Factors Influencing Recoverability Of Brain Damage From Alcohol
Duration, Recency, Frequency & Severity Of Alcoholism
There is no specific frequency of drinking alcohol that causes alcohol-related brain damage, but consistent drinking of over 14 drinks per week for men and 7 drinks for women causes alcohol-related brain damage in 1.5% of the world's population [4].
Severe alcoholics have an 80% increased risk of developing Wernicke's encephalopathy, followed by a 90% increased risk of developing Korsakoff's psychosis. Korsakoff's psychosis causes irreversible brain damage [5].
Onset
As the brain fully matures at 21 for women and 28 for men, drinking alcohol before this age can lead to permanent damage to prefrontal cortex brain cells.
Those who drink heavily before the age of 15 are 5 times more likely to abuse alcohol later in life than those who drink heavily after the age of 21, leading to alcoholic dementia or Wernicke's encephalopathy [6].
Type Of Alcohol Consumed
Alcohol ranges in ethanol content from 5.1% in beer to 42.3% in bourbon. Adding 1 extra unit of alcohol to daily intake via higher ethanol content has the same effect on white and grey matter volume as 2 years of ageing [7] [8].
Age And Neuroplasticity
Although neuroplasticity in the brain cells naturally decreases during ageing, alcohol decreases neuroplasticity by 30%, returning to normal results during abstinence [9].
Co-occurring Conditions
During recovery, serotonin neurotransmitters are no longer repressed by alcohol, leading to brain cell recovery and improvement in anxiety and depression.
In our experience at Abbeycare, patients experience an improvement in anxiety and depression symptoms during recovery.
Genetics
Genetics affect the function of Naltrexone in recovery.
Naltrexone users carrying the Asp40 gene experience less reward from drinking than those with alternate Asn40 alleles, fostering greater levels of brain recovery, even in those attempting to achieve abstinence [10].
Learned Behaviours
Learning, practising, and repeating the behaviour of abstaining from alcohol, when feeling triggered, strengthens neural pathways involved in developing these recovery behaviours as long-term habits.
Repeating this behaviour, together with small rewards, helps restore positive dopamine regulation damaged during active addiction.
Sociability
In evolutionary terms, behaviours involving social support and connectivity are positively rewarded in the brain as they foster survival and adaptation.
Social support reduces stress and assists in restoring neurotransmitter levels which incurred deficits during alcohol addiction.
Environmental Circumstances, Living Conditions, & Socio-economic Factors
Active addiction typically entails chaotic living circumstances, incurring additional stress, raised cortisol, and fluctuations of neurotransmitters, beyond those also caused by addiction itself.
This additional environmental stress means abstinence is more difficult to maintain, regardless of personal motivation or success in recovery.
The improved structure, order, and routine of living conditions in recovery reduces cortisol levels in the brain, improves synaptic plasticity, and rebalances neurotransmitter levels which incurred deficits during active addiction.
Those in higher socioeconomic groups can benefit from higher-quality foods, nutrition and supplements, assisting brain healing during recovery.
Studies Indicate How Alcoholic Brain Damage Is Recoverable
Diffusion Tensor Imaging (DTI) Findings In Recovery From Alcoholism
Magnetic Resonance Spectroscopy (MRS) Findings In Recovery From Alcoholism
Dehydration Level Does Not Determine Recoverability
A common theory on the recoverability of alcoholic brain damage is hydration level, however, during 5 weeks of abstinence, CT density did not increase with an increase in water to the brain caused by hydration [12].
Comparing brain cells at the beginning of abstinence to three weeks later, there is an increase in brain volume and brain tissue density due to hydration, but this did not correlate to a return in brain function [13].
How To Reverse Brain Damage From Alcoholism
Abstinence As An Indicator Of Recoverability
After 1 year of abstinence, tests analysing 12 cognitive domains found little to no difference in brain function between those in recovery and not in recovery [14].
63% of patients demonstrated normal levels of cognitive function after 18 days of abstinence [15].
Recovering Alcohol Brain Damage Via Exercise
Exercise replenishes dopamine and other neurotransmitter rewards in place of alcohol, reducing alcohol cravings and improving comorbid effects of alcohol such as anxiety and depression [16].
Thiamine In Brain Recovery
Thiamine deficiency contributes to Wernicke's encephalopathy, with 80-90% developing Korsakoff's psychosis, causing damage to the cerebellum and peripheral nerves [17].
Adding 0.33 mg of thiamine per 1,00 calories consumed, and abstaining from alcohol, raises thiamine levels by 25%, increasing brain function [18].
Socialising As Brain Recovery
Those who spent 3 months living in groups of 7 spent 50% less time completing memory exercises than those who were living in groups of 2 [19].
Supported living in secondary care facilities is typically a 6-12 month programme living with an average of 20 people. It provides peer-led support services overviewed by professionals.
The socialising aspect of supported living allows the brain to be retrained for sociability, fostering recovery.
