In this month's Wired Magazine, Brendan Koerner takes a look at the neuroscience behind Alcoholics Anonymous— and the neuroscience of alcoholism. More than a million people belong to AA. The "peer to peer" recovery system has been in existence for more than 75 years, founded during the Great Depression by a drunk stockbroker.
How does it work? Nobody really knows. *
As for the steps themselves, there is evidence that the act of public confession–enshrined in the fifth step–plays an especially crucial role in the recovery process. When AA members stand up and share their emotionally searing tales of lost weekends, ruined relationships, and other liquor-fueled low points, they develop new levels of self-awareness. And that process may help reinvigorate the prefrontal cortex, a part of the brain that is gravely weakened by alcohol abuse.
To understand the prefrontal cortex's role in both addiction and recovery, you first need to understand how alcohol affects the brain. Booze works its magic in an area called the mesolimbic pathway–the reward system. When we experience something pleasurable, like a fine meal or good sex, this pathway squirts out dopamine, a neurotransmitter that creates a feeling of bliss. This is how we learn to pursue behaviors that benefit us, our families, and our species.
When alcohol hits the mesolimbic pathway, it triggers the rapid release of dopamine, thereby creating a pleasurable high. For most people, that buzz simply isn't momentous enough to become the focal point of their lives. Or if it is, they are able to control their desire to chase it with reckless abandon. But others aren't so fortunate: Whether by virtue of genes that make them unusually sensitive to dopamine's effects, or circumstances that lead them to seek chemical solace, they cannot resist the siren call of booze.
* Just keep coming back, because it does work.