Can We Control Addiction Via the Gut? 3 New Insights

For those of us without an addiction, it can be difficult to empathize with others who continue to make bad choices. But this is not just a matter of willpower.

The brain is complex beyond any of our imaginings. The neurotransmitters and hormones that regulate our behaviors can be a driving force second to none. And it is clear that these compounds play a role in addiction as well. Dopamine, in particular, is known to play a role in reward behaviors and addictions. While it’s not that simple, imagine that your brain needs compound B, but to get Compound B, we need enzymes to work on Compound A to convert it to B. If there is a hangup in one of these enzyme systems, our brain will find another way to create or even mimic compound B. Addictions in the brain frequently have this as a component to the problem.

At the root of many neurotransmitter disturbances is inflammation. When the brain is exposed to inflammation, whether produced directly in the brain or initiated elsewhere, havoc occurs. Consider celiac disease, the notorious allergy to the gluten component of grains. Inflammation in the brain that starts in the gut is well accepted in this condition. At the writing of this article, Grain Brain by David Pulmutter, tops the list of self-help medical books. There would be no argument from Dr. Pulmutter that inflammation affects the brain.

In addition to direct food sensitivities and allergies, inflammation from the gut can come from the presence of unwanted bacteria in the gut. I know that you are thinking that this is the beginning of yet ANOTHER rant on how probiotics play a role in controlling inflammation in the body.

And you’d be right.

In this particular study, researchers looked specifically at alcohol addiction and the relationship of alcohol cravings to inflammation coming from the gut. These researchers had, in a previous study, documented the relationship between leaky gut (increased intestinal permeability), elevated blood lipopolysaccharides (LPS) levels (proteins that are released by evil-doing bacteria in the gut) and low-grade systemic inflammation with psychological symptoms of alcohol dependence. While that’s a pretty long sentence, suffice it to say that gut-derived inflammation was a player in the alcoholic process.

To take this information a step further, the researchers looked at how much gut-derived inflammation played a role in alcohol cravings in alcoholic detox. 63 actively-drinking alcoholics were tested at the beginning and end (days 2 and 18) of alcohol detoxification and various compounds and pathways associated with evil bacteria in the gut were assessed. Here’s the details:

1. LPS (the immune-stimulating molecules released by the bad bacteria) as well as that peptidoglycans (PGN) cross the gut barrier and make it into the body. Both of these compounds activate inflammation (as measured by toll-like receptors in PBMCs).
2. Chronic alcohol consumption led to changes in inflammation (specifically, it inhibited the NF-kappa B pathway, but turned on the mitogen-activated protein kinase/activator protein 1 pathway).
3. These inflammatory changes resulted in increased production of interleukin (IL)-8, IL-1β, and IL-18, which were directly related to both alcohol consumption and alcohol-craving scores.

So what does all of this mean? It means that probiotic supplementation as well as lifestyle changes that support a healthy gut may mean the difference between success and failure in alcohol detoxification. And not just for the time period of the actual detoxification, but throughout life. For this reason, the dietary choices we make during alcohol withdrawal may be critical to success, and may explain how some are successful and some destined to fail.

What would be even more interesting is to see if there is a relationship between alcohol addiction and antibiotic use. The problem with this type of study, however, is that it seems like almost everyone has been on antibiotics at some point in his or her lifetimes. Considering that a single course of antibiotics can disrupt the balance of the bacteria in the gut for years to come, this creates an obvious problem.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.