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Neurochemical and behavioral studieson ethanol and nicotine interactions.Neurosci Biobehav Rev. 2004 January;27(8):713-20.
Larsson A, Engel JA.
Department of Pharmacology, Goteborg University, Box 431, Goteborg SE-405 30, Sweden.
The most commonly abused drugs, alcohol and nicotine, are likely also the most costly drugs in terms of health and societal costs. A large body of evidence from epidemiological studies indicate that smoking and alcohol-intake are positively correlated. The mesocorticolimbic dopamine system has been implicated in mediating some of the reinforcing effects of ethanol, however, the mechanism(s) of action remains to be elucidated; consideration as to ethanol's ability to interact with ligand-gated ion channels should be considered.
Accumulating evidence from electrophysiological, pharmacological and neurochemical studies suggest that ethanol may interact with the nicotinic acetylcholine receptor (nAChR). Thus, it has been shown that the ethanol-induced stimulation of the mesolimbic dopamine system and of locomotor activity as well as ethanol intake and preference in rodents may involve central nicotinic acetylcholine receptors.
Additionally, data has been presented that nAChRs located in the ventral tegmental area may be of particular importance for these effects of ethanol. Studies aimed at defining the nAChR subpopulation(s) involved in mediating ethanol-induced locomotor stimulation and accumbal dopamine overflow as well as ethanol-intake have revealed that alpha(3)beta(2) or alpha(6) (using alpha-Conotoxin MII) but not alpha(4)beta(2) (using dihydro-beta-erythroidine) or alpha(7) (using methyllycaconitine), could represent targets for developing new drugs in the treatment of alcoholism. These results do not allow any conclusion as to whether the involvement nAChRs in mediating the effects of ethanol is direct and/or indirect.
With regard to an indirect effect, evidence has accumulated indicating that the cholinergic excitatory input to the dopaminergic neurons in the ventral tegmental area may be an important part of the neuronal circuits mediating natural as well as drug-rewarded behavior. The possibility may thus be considered that ethanol activates the cholinergic afferents causing a release of acetylcholine in the ventral tegemental area leading to a stimulation of nAChRs and thereby excite the mesocorticolimbic dopamine system.
PMID: 15019421 [PubMed - indexed for MEDLINE]
Imagine being at or near the peak of physical withdrawal and nicotine detox, where your brain begins working fast and hard at restoring natural neurotransmitter sensitivities now that nicotine's arrival has ended. Imagine your conscious dreams and desires of freedom doing a wonderful job at calming, suppressing and overcoming subconscious fears, craves and anxieties associated with arresting your world of chemical dependency, a world of "nicotine normal."
Now imagine taking early recovery into a smoke and smoker filled environment and then commencing to drink large quantities of a mind altering and inhibition diminishing substance. What are the chances of your healing surviving?
It's what these threads are all about. Although Freedom teaches that we need not give up anything when quitting, that rule must be applied using a bit of common sense. We also teach baby steps and little bites and those principles work extremely well in helping each of us work-up to fully engaging all aspects of life. Alcohol may play a role in half of all fatal vehicle collisions here in the U.S. but it likely plays a much greater role in the death toll stemming from nicotine relapse.
Plan ahead! Break the event down into smaller doable bites. Have a coping plan ready. Have a back-up plan. Have an emergency plan. You have but one healling patient to protect and it is "you!" A host of expectations, emotions and new experiences to encounter but only one guiding principle determining whether the patient's healing lives or dies, no nicotine just one hour, challenge and day at a time, Never Take Another Puff, Dip or Chew! John (Gold x5)
Freedom teaches that we don't need to give up any part of our life when quitting except for our nicotine. The weekend has arrived again and with it the opportunity to have a few drinks and be with friends. How do you approach this most important encounter with alcohol, smokers and good times? What planning, if any, can you do? When is it safe to do so?The odds of a brand new quit surviving the pub or bar scene while consuming large quantities of alcohol are not promising! Walking into an environment loaded with ashtrays, lighters and packs everywhere in a smoke and smoker filled room, while consuming a mind and sense altering substance during a temporary period of time that you were giving it your all not to smoke nicotine can be a tragic mistake, even fatal. Although alcohol has been found to play a role in half of all fatal vehicle collisions, its death toll in relation to the destruction of quits is even greater.
Many of you have already successfully navigated this situation while others have not. If you have, please share the important lessons you learned. Your words of wisdom might save both a quit and a life.
My advice is simple! Think it though, plan ahead, keep your guard up, and always remember that you can walk away. An early encounter with alcohol can involve multiple triggers. Keep in mind that it's possible to address them one at a time. Alcohol itself could be a habit trigger, being around other smokers another, having a good or bad time while drinking a third or possibly even a fourth, and having too much to drink a possible fifth. Then again, your anxiety attack triggering cue could be something as simple as ice cubes hitting a glass in a dark smoke filled environment. We've each developed some pretty unique feeding habits.
You can drink at home first without the other stuff, or going out for a good time in a smoke and smoker filled location without drinking. The planning possibilities are numerous. It may be possible to handle it all at once and put it behind you but baby steps may be a better approach for you. You know you better than anyone else! Listen to yourself and above all keep in mind that loving "delay" - just three minutes - is one of your best friends right now. This too is doable!
Breathe deep, hug hard, live long! YQB John : )