Sugar Cravings in Alcohol Use Disorders: The Science Behind

Understanding Sugar Cravings in Alcohol Addiction

In the realm of addiction and recovery, a peculiar question often arises: why do people with alcohol use disorders crave sugar? The answer, it seems, lies within the complex workings of the human brain and its response to addictive substances.

The Role of Alcohol on the Brain's Reward System

Alcohol impacts the brain's reward system, a group of neural structures responsible for incentive salience (i.e., "wanting" or desire), associative learning (primarily positive reinforcement), and positively-valenced emotions, particularly those involving pleasure as a core component. The reward system is primarily associated with the release of dopamine, a neurotransmitter that plays a pivotal role in the experience of pleasure and reward.

Specifically, alcohol stimulates the activity of dopamine-releasing neurons in the brain, particularly in a region known as the nucleus accumbens (NAc). This action contributes to the rewarding effects of alcohol and promotes continued alcohol consumption.

Influence of Dopamine Release on Cravings

Dopamine interacts with specific receptors on target cells, activating certain proteins known as G proteins. These proteins can affect the activity of ion channels in the cell membrane and regulate the production of small signaling molecules called second messengers within the cell [2].

Moreover, dopamine's phasic-synaptic actions modify the sensitivity of target neurons to other neurotransmitters, particularly glutamate. It enhances the excitatory effects of glutamate on the NMDA receptor and inhibits the effects induced by glutamate's binding to the AMPA receptor [2].

Dopamine's tonic-nonsynaptic actions modulate the release of other neurotransmitters (acetylcholine, glutamate, and gamma-aminobutyric acid) by dopaminergic and nondopaminergic neurons. Activation of extrasynaptic D1 receptors enhances neurotransmitter release, while activation of extrasynaptic D2 receptors reduces neurotransmitter release.

This interplay of dopamine, glutamate, and other neurotransmitters in the brain's reward pathway explains the heightened cravings for substances that stimulate this pathway, such as sugar, in individuals with alcohol use disorders. Thus, the sugar cravings experienced by many in recovery from alcohol addiction are not random, but rather a direct result of the complex neurochemical reactions triggered by alcohol consumption.

Link Between Sugar Cravings and Substance Use Disorders

Exploring the curious relationship between sugar cravings and substance use disorders is crucial for understanding why people with alcohol use disorders crave sugar. This exploration includes observing sugar cravings during addiction recovery and the impact of opioid and stimulant use on sugar intake.

Sugar Cravings in Addiction Recovery

People with substance use disorders often experience intense cravings for sugar during their recovery journey. According to APN, the preference for sweet foods can be linked to addictive behaviors. There seems to be an underlying connection between these addictive behaviors and sugar intake, which can be traced back to how sugar affects the brain.

Much like addictive drugs, sugar triggers the release of dopamine in the brain, making high-sugar foods more rewarding and pleasurable. This can be particularly tempting for people with a substance use disorder, especially since their dopamine reward networks have been compromised by addiction.

In addition to this, nutrient deficiencies and blood sugar issues resulting from severe alcohol use disorders can trigger cravings for high-sugar foods like chocolate, candy, or other sweet treats. Consequently, it's not uncommon for individuals in recovery to have a heightened craving for sugary foods.

Effects of Opioids and Stimulants on Sugar Intake

Substance use disorders are not limited to alcohol. People who misuse opioids and stimulants also show increased sugar consumption. For instance, opioid use is associated with significantly increased sugar consumption. Evidence suggests that people who misuse opioids consume 31% of their calories from sugar, more than double the national average.

On the other hand, stimulants like cocaine and amphetamines can also influence sugar consumption. Methamphetamine users, in particular, show higher sugar intake levels than the rest of the population. Methamphetamine use can reduce blood glucose levels, driving people toward sugary foods or drinks.

Figures courtesy APN

In conclusion, the link between sugar cravings and substance use disorders is complex and multifaceted. Understanding this connection can provide valuable insights into the recovery process and potentially offer new avenues for treatment and support.

Mechanisms of Sugar and Alcohol Cravings

Unraveling the reasons behind the cravings experienced by individuals with alcohol use disorders requires an understanding of the complex mechanisms at play. This section will explore the role of a neurotransmitter called dopamine in sugar and alcohol addiction and discuss the concept of 'sweet liking' in alcohol use disorder.

Dopamine's Role in Sugar and Alcohol Addiction

Dopamine, a chemical messenger in the brain, plays a crucial role in how we perceive pleasure. It is released in response to rewarding experiences, including the consumption of alcohol or sugar. Individuals with alcohol use disorders may experience increased dopamine release due to the effects of alcohol on the brain's reward system. This can lead to cravings for other substances that stimulate the reward pathway, such as sugar.

Dopamine interacts with specific receptors on target cells, activating proteins called G proteins. These proteins can affect the activity of ion channels in the cell membrane and regulate the production of small signaling molecules known as second messengers [2].

Furthermore, dopamine's actions can modify the sensitivity of target neurons to other neurotransmitters, particularly glutamate. It enhances the excitatory effects of glutamate on the NMDA receptor and inhibits the effects induced by glutamate's binding to the AMPA receptor [2].

In the context of sugar and addiction, sugar triggers dopamine release in a similar way to addictive drugs, making high-sugar foods more rewarding and pleasurable. This can be particularly tempting for people with a substance use disorder whose dopamine reward networks have been compromised by addiction.

Sweet Liking and Alcohol Use Disorder

The concept of 'sweet liking' refers to an individual's preference for sweet tastes, which can be heightened in alcohol use disorder. Increased dopamine release, triggered by the consumption of alcohol, can lead to an enhanced preference for sweet tastes. This, in turn, can result in an increased intake of sugary foods and beverages.

The link between alcohol use disorder and a preference for sweet tastes suggests that sweet liking may serve as a biological marker for alcohol use disorder, with those who have a heightened preference for sweets being more susceptible to developing an alcohol use disorder.

Understanding these mechanisms can provide valuable insights into the question of 'why do people with alcohol use disorders crave sugar?'. This knowledge can be instrumental in developing strategies for managing sugar cravings in individuals with alcohol use disorder.

Impact of Alcohol on Blood Sugar Levels

Alcohol consumption influences blood glucose levels and the body's ability to regulate them. This makes understanding the impact of alcohol on blood sugar levels crucial, especially for individuals dealing with alcohol use disorders, as it may provide insight into why they experience sugar cravings.

Alcohol's Effect on Glucose Regulation

Alcohol can interfere with blood sugar levels as well as the hormones needed to maintain them. People who frequently consume a lot of alcohol can deplete their energy storage within a few hours. Over time, excessive alcohol consumption can diminish the effectiveness of insulin, leading to high blood sugar levels. Many individuals with alcoholic liver disease also have glucose intolerance or diabetes [4].

Daily moderate alcohol consumption (up to one drink a day for women and up to two drinks a day for men) may improve blood glucose management and insulin sensitivity, potentially leading to lower A1C levels. However, excessive drinking (more than three drinks daily) can result in higher blood glucose and A1C levels [5].

Alcohol-Induced Hypoglycemia and Diabetes

Alcohol consumption can lead to dangerously low blood sugar levels because the liver prioritizes removing alcohol from the blood over managing blood sugar levels. This can result in alcohol-induced hypoglycemia, a condition where blood sugar levels drop beyond the normal range. Symptoms of hypoglycemia can overlap with being drunk, making it difficult to distinguish the two.

People with diabetes intending to drink alcohol should monitor their blood sugar levels before and up to 24 hours after drinking. They should also check these levels at bedtime to ensure stability before sleeping. Most people with diabetes can enjoy an occasional alcoholic drink, but the more alcohol a person consumes, the higher their risk of experiencing low blood sugar levels. Symptoms of low blood sugar can suddenly appear, so it is recommended to eat carbs before drinking alcohol to help maintain steady blood sugar levels. Patients can also carry glucose tabs in case of emergencies and should check their blood sugar levels regularly.

Alcohol, when combined with medications used to treat diabetes, especially insulin and sulfonylureas, can lead to hypoglycemia (low blood glucose). This is because the liver prioritizes metabolizing alcohol over maintaining blood glucose levels, potentially causing hypoglycemia. Drinking without eating food can exacerbate this effect.

Knowing the effects of alcohol on blood sugar levels and how it can lead to hypoglycemia, especially in people with diabetes, is crucial in managing alcohol and sugar cravings in individuals with alcohol use disorders. Understanding this link can lead to more comprehensive and effective treatment strategies.

Strategies for Managing Sugar Cravings

Managing sugar cravings is an important part of the recovery process for individuals with alcohol use disorders (AUD). This is because of the strong connection between the cravings for sweet foods and addictive behaviors. Understanding the relationship between alcohol and sugar cravings is crucial in developing effective strategies to manage these cravings.

Using Sweets in Alcohol Craving Management

Individuals in early recovery from AUD often experience intense cravings for sweets. Consuming sweets is often recommended as a strategy to manage alcohol cravings during this period.

However, the effectiveness of this approach in reducing alcohol cravings or relapse risk is still a topic of debate. Overconsumption of sweet foods can potentiate dopamine release in a manner similar to alcohol, contributing to cravings for both substances. Therefore, it's crucial to maintain a balanced diet and avoid excessive sugar intake during the recovery process.

Relationship Between Alcohol and Sugar Cravings

The relationship between alcohol and sugar cravings is complex. Both alcohol and sugar consumption stimulate the reward centers in the brain, leading to the release of dopamine, which is associated with feelings of pleasure and reward. This is why people with AUD often have a heightened preference for highly-sweet solutions, a phenomenon known as sweet liking [7].

Interestingly, it has been observed that consuming sweets earlier in the day can lead to higher alcohol cravings later in the day in individuals in early recovery from AUD [6].

Understanding these connections can inform strategies to manage sugar cravings in individuals with AUD. For instance, individuals in recovery might benefit from consuming balanced meals throughout the day to avoid spikes and crashes in blood sugar levels that could potentially trigger cravings. Furthermore, incorporating regular physical activity and cognitive-behavioral strategies can also help manage cravings and promote overall well-being.

In conclusion, managing sugar cravings is an important aspect of recovery from AUD. While sweets can temporarily alleviate alcohol cravings, it's crucial to approach this strategy with caution due to the complex relationship between alcohol and sugar cravings. With the right strategies and support, individuals in recovery can effectively manage these cravings and make significant strides towards recovery.

Genetic and Neurological Factors in Addiction

The question of why people with alcohol use disorders crave sugar is intrinsically linked to examining the genetic and neurological factors that contribute to addiction. There are several genes associated with alcohol dependence, and the function of the endorphin system in the brain is crucial to understanding addiction.

Genetic Influence on Alcohol Dependence

Alcoholism is a complex genetic disease influenced by variations in numerous genes. The genes ADH1B and ALDH2 have the strongest known effects on the risk of alcoholism. However, there are several other genes, such as GABRA2, CHRM2, KCNJ6, and AUTS2, that contribute to the likelihood of developing alcohol dependence.

While these genetic factors play a role, it's important to note that the development of alcohol use disorder (AUD) is a complex interplay of genetic, environmental, and behavioral factors. Understanding the genetic predispositions can help in tailoring interventions and treatments for AUD.

Endorphin System Dysfunction in Alcoholism

The endorphin system in the brain, which triggers feelings of happiness and reward, is significantly impacted by alcohol addiction. Studies show that individuals with alcohol addiction release fewer endorphins compared to a control group.

Addiction is sometimes described as a "reward deficient" state, where individuals cannot derive happiness or pleasure from normal activities and compensate with substance use. This indicates an imbalance in the brain's endorphin system [8].

In terms of treatment, despite various methods targeting the brain's reward system, three quarters of individuals with alcohol dependency are likely to relapse within the first year. This highlights the difficulty of effectively treating alcohol addiction [8].

A study involving PET scans revealed that alcohol-dependent individuals release significantly fewer endorphins than individuals without addiction problems, even after long periods of abstinence. This reduced endorphin release remains consistent despite abstaining from alcohol. This finding underscores the enduring nature of alcohol's impact on the brain and may explain the persistent craving for sugar, as sugar can also stimulate the brain's reward system.

In summary, genetic factors and the dysfunction of the endorphin system play significant roles in alcohol addiction. These factors contribute to the cravings for sugar observed in individuals with AUD, as the brain seeks alternative ways to stimulate its reward system. Understanding these mechanisms can help in developing more effective treatments for AUD.

References

[1]: https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html

‍[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826820/

‍[3]: https://apn.com/resources/why-are-sugar-cravings-common-in-addiction-recovery/

‍[4]: https://www.medicalnewstoday.com/articles/312918

‍[5]: https://diabetes.org/health-wellness/alcohol-and-diabetes

‍[6]: https://www.akronhouserecovery.com/blog-post/why-people-with-alcohol-use-disorders-crave-sugar/

‍[7]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462793/

‍[8]: https://www.imperial.ac.uk/news/187472/brains-sense-pleasure-reward-blunted-alcohol/