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The Effects of Binge-Drinking on Memory
Background on Alcohol:
Most simply stated, alcohol is a colorless, flammable form of the compound ethanol. Considered one of the world’s oldest drugs, alcohol is made from fermented grain, fruit juice, and honey. Because alcohol is a depressant, it works on the neurotransmitter systems of the nervous system to increase norepinephrine and dopamine release, decrease transmission of acetylcholine systems, increase transmission of GABA systems, and increase production of beta-endorphins in the hypothalamus. These chemical changes lower inhibition, slow reflexes, and produce a relaxing effect when alcohol is taken in moderation. However, when alcohol is abused, it can induce vomiting, speech problems, breathing difficulties, and ultimately, coma or death.
What path does alcohol take in the body?
Alcohol enters the body through the mouth and travels to the stomach and small intestine. Because alcohol molecules are soluble in lipid and water solutions, they can enter the bloodstream through the walls of the small intestine and use the heart as their engine to be pumped throughout the body. Alcohol is eventually converted to water, carbon dioxide, and energy by the liver. However, before this happen, alcohol reaches the brain via the bloodstream and can cause the effects mentioned above. Alcohol’s properties allow it to cross the blood-brain barrier, a wall of blood vessels and membranes that line the brain. (http://faculty.washington.edu/chudler/alco.html)
What is considered binge drinking?
A binge is described as an extended period of time (at least 2 days) during which a person becomes intoxicated and is willing to give up usual activities and obligations to stay intoxicated (http://www2.potsdam.edu/alcohol-info/BingeDrinking.html). Although this forms the core of the clinical definition of a binge, most online sources cite binge drinking as the consumption of five or more alcoholic drinks in a row for men and four or more for women. For most people, drinking 4-5 alcoholic beverages in a small time-frame will produce a blood alcohol level (BAC) of at least .08, which is the drunken driving limit in most states. This level of intoxication is tied to significant impairment in coordination and judgment (http://www.habitsmart.com/bal.html). What constitutes a “drink” depends on the kind of alcohol you are drinking. For example, each of the following are considered a drink and have similar effects on ones BAC:
· A 12-ounce beer or wine cooler
· A 5-ounce glass of wine
· A 2.5-ounce glass of fortified wine such as sherry
· A 1.5-ounce glass of 80-proof distilled spirits such as vodka
· About 4 ounces of liqueur (http://www.intelihealth.com)
How common is binge drinking?
About 20% of Americans age 12 and older are binge drinkers. What is especially scary is that many adolescents are able to obtain alcohol and partake in the dangerous practice of binging before they are old enough to legally buy a drink. Specifically, a 2001 survey reported that about 30% of high school seniors binged in the past two weeks (http://intelihealth.com).
It is a common perception that the college atmosphere breeds heavy partying and alcohol abuse. Not surprisingly, the highest rate of binge drinking occurs among 21-year-olds (48.2 percent) and full-time college students (43 percent). Being a member of a Greek organization further perpetuates this trend; fraternity and sorority members drink more and drink more frequently than their peers. One study cited that more college undergraduates will ultimately die from an alcohol-related cause than will go on to achieve an advanced degree (http://www.ncadd.org/facts/fyibinge.html).
Binge Drinking and Memory:
What is memory?
In psychological terms, memory can be defined as the storing of learned information and the ability to recall what has been stored (http://education.yahoo.com/reference/encyclopedia/entry?id=30969). Memory can be divided into sensory memory, short-term memory, and long-term memory. Sensory memory is a buffer for information coming into the body from any given channel (i.e. visual stimuli, auditory stimuli, etc…). Attention passes stimuli from the sensory to the short-term memory, where information can be processed and temporarily recalled. Long-term memory is intended for the lasting storage of a perception. Procedural long-term memory refers to the recollection of learned skills; declarative long-term memory, on the other hand, has to do with the remembering of a specific stimuli or occurrence (http://www.cc.gatech.edu/classes/cs6751_97_winter/Topics/human-cap/memory.html). The process by which a stimulus is processed though the memory systems is detailed below:
How does binge drinking effect memory?
While there is no consensus on how binge drinking influences one’s memory, most of the information on the web points to the hippocampus as a target of alcohol’s negative effects (http://www.personalmd.com/news/a1996123106.shtml). The hippocampus is an area in the brain thought to be responsible for learning and memory. Moderate to high doses of alcohol, the amount consumed during an average binge, suppress activity in the hippocampus, resulting in a decreased ability to retain new information. If new information cannot be retained in short-term memory, it has no chance of being consolidated in long-term storage. Based on information from rat studies, this deficit is thought to last into adulthood (http://www.health24.com/news/Addiction). Furthermore, those who start drinking during adolescence may be especially vulnerable to brain damage; the group in a certain rat study that made the most memory errors had been exposed to binge effects as adolescents.
An alternative theory suggests that memory is a problem of brain shrinkage. According to this source, the use of moderate to heavy amounts of alcohol leads to shrinkage that mirrors the effects of aging on the human brain. In fact, the rate of shrinkage in the frontal cortex is directly associated with the amount of alcohol consumed. Damage to this area results in problems with abstract reasoning and information storage (memory). The theory of brain shrinkage is optimistic in that it believes people under the age of forty can regain substantial brain function if they stop drinking. However, this may be less true of women, who are supposedly more susceptible than men to alcohol related brain shrinkage (http://www.agingincanada.ca/Seniors%20Alcohol/1e10.htm).
Among the clinically defined conditions that result from binge drinking is Korsakoff’s amnesic syndrome. This degenerative brain disorder is caused by a lack of thiamine (vitamin B1) in the body and produces symptoms of amnesia, attention deficit, and disorientation. Persons suffering from Korsakoff’s amnesia have trouble both in acquiring new memories and recalling previous ones. Even if symptoms are detected early, complete restoration of memory function is rare; moreover, left untreated, Korsakoff’s amnesia can be life-threatening (http://www.ninds.nih.gov/health_and_medical/disorders/wernicke-korsakoff.htm).
Scientific Literature Regarding Binge Drinking and Memory:
Binge drinking and memory acquisition:
Research on memory and alcohol use has provided support for the popular claim that binge drinking disrupts the brain’s ability to form new memories. Browning, Hoffer, and Dunwiddie (1992) reviewed over 20 studies that looked at the structures of memory, memory formation, and the effects of alcohol. The existing literature overwhelmingly reflected the notion that the hippocampus is a major player in the acquisition of memory. Studies of people who had damage to their hippocampus reveal that these people have intact retrieval systems (i.e. people could recall places and events from decades before) but lacked the ability to acquire and store new memories. Acute alcohol use such as a night of binge drinking yields similar deficits. The review included a study by Birnbaum et al. (1997), which asked intoxicated participants to recall a list of words they had learned prior to intoxication. Participants had no retrieval problems; however, when the list was presented to people who were already intoxicated, their ability to recall the words was significantly impaired. The similarity between the effects of alcohol abuse and hippocampal damage makes this brain structure a potential target for alcohol’s action (http://infotrac.galegroup.com/itw/infomark).
Obernier, White, Swatzwelder, and Crews (2001) used rats as their subjects to try to reproduce and extend the connection between binge drinking and acquisition deficits. Previous research has indicated that extrahippocampal regions are involved in specific memory functions, namely, spatial working memory and reversal learning. This particular study looked at whether exposing rats to amounts of alcohol sufficient to simulate binge drinking would lead to problems in acquiring spatial memory for a specific maze task and acquiring reversal memory (the spatial-opposite) for that task. Sixteen rats formed the participant group for this experiment; on the first day, all rats were anesthetized and implanted with stomach catheters. At 4-7 days post surgery, the eight rats in the alcohol group were given initial doses of 5 g/kg ethanol in a solution of Vanilla Ensure. Ethanol was administered every 8 hours for 4 consecutive days, all the while monitoring the rats’ blood ethanol levels. After 4 days of being withdrawn from any ethanol, the 8 rats in the alcohol group and the 8 rats in the control group (no ethanol) were trained on the Morris Water maze. The maze consisted of a pool of water that was 144 cm in diameter; submerged 2cm under the water in the pool was a white platform that was 10.25 cm in diameter and placed in the north-east quadrant. One rat at a time was placed in the pool and trained to find and stand on the platform; if the animal failed to reach the platform within a certain amount of time, it was guided by the experimenter. After 7 days of training, both groups were submitted to a reversal learning task and a spatial working memory task. In the reversal task, the platform was placed in the opposite quadrant of the pool (in comparison to the learning reference) and animals were given 4, 90-second trials to find the platform. In the spatial working memory task, the platform was randomly placed in a quadrant for each of the 4 trials. Results showed that the rats who had been exposed to ethanol took significantly more trials to learn the reversal task. Puzzling, however, is that the two groups did not differ significantly in their ability to learn the original reference memory task or the spatial working memory task. Thus, this study showed mixed support for the theory that excessive alcohol use leads to acquisition deficits (www.elsevier.com/locate/pharmbiochembeh)
Binge drinking and memory retrieval:
Following the mixed results of Obernier et al. (2001), there has been literature published to support the idea that alcohol actually leads to problems of retrieval and not acquisition. A 2002 study by Verster, van Duin, Volkersts, Schreuder, and Verbaten looked at whether a night of binge drinking affected memory functioning. Forty-eight moderate drinkers (consuming between 10 and 35 alcoholic beverages per week) made up the participants of this study; participants were randomly assigned to the alcohol or placebo group. Starting at 11pm, subjects in the alcohol group were given pure ethanol (1.4 g/kg body weight) mixed with orange juice (total volume of 500ml) every half hour until the equivalent of 8-9 standard, alcoholic beverages was reached. The placebo group was given 500ml of orange juice. Beverages in both groups were flavored and participants used nose-plugs in order to blind treatment. After getting a normal night’s sleep, participants were brought into the lab for BAC measurements. As soon as a participant’s BAC was zero, he/she was administered the Word Learning Test. This test consists of 12 parallel lists of 15 monosyllabic meaningful nouns. Fifteen words were presented 5 times on a computer screen, and after each presentation, subjects had to write down as many words as they could remember. Delayed recall was recorded after a 60 minute interval had passed. Results show that at baseline, the two groups did not differ on any aspect of memory. In the morning tests, however, the alcohol group scored significantly lower in delayed recall, indicating that retrieval (the ability to recall information stored) is affected by binge drinking. The fact that there were no impairments in immediate recall seems to indicate that encoding (bringing in new memories) stayed intact. (http://www.nature.com/cgi-taf/DynaPage.taf?file=/npp/journal/v28/n4/full/1300090a.html).
A comparison of binge drinkers and chronic alcohol misusers:
Although there is mixed evidence as to how binge drinking influences the memory systems of the brain, the consensus seems to be that there is a negative effect. The questions that remains, however, is whether or not alcohol affects the brain differently when it is consumed acutely as opposed to chronically abused. Kokavec and Crowe confronted this issue in their 1999 study regarding cognitive performance and alcohol. The study aimed to investigate whether cognitive performance in individuals who binge drank differed from those who drank more regularly. Based on self-reported information, subjects were divided into two groups of 50; those in the binge drinking (BD) group reported drinking 10 or more alcoholic beverages on no more than 2 days/week. Conversely, the non-binge drinking (NBD) group consisted of those who drank 10 or more standard drinks daily (i.e. chronic alcohol misusers). Participants were not given additional alcohol as part of the experiment. Several cognitive domains, such as IQ, learning, and memory, were assessed with standardized questionnaires. Results revealed that BD and NBD groups did not differ in memory acquisition or retrieval, showing that it is the alcohol, independent of pattern of use, that dictates the learning of new memories and the remembering of old ones. Moreover, the two groups scored similarly on visuo-motor speed, visuo-spatial organization, learning, and retrieval efficiency. The only domains that the two groups differed significantly on were verbal and visual memory; BD subjects generally performed better on these tasks than did NBD subjects. This finding suggests that although binge drinking is obviously unhealthy, its effects are less severe than those suffered by chronic drinkers (http://alcalc.oupjournals.org.proxy.library.vanderbilt.edu/cgi/content/abstract/34/4/601).
The science behind alcohol and the brain:
To add further support to their claim that the hippocampus is the site of memory production, Browning, Hoffer, and Dunwiddie (1992) discuss the mechanisms by which alcohol targets this structure. According to their review, there are certain neural circuits that act according to the “long-term potentiation” (LTP) effect. This effect is basically explained by the idea that the more we experience the connection between certain stimuli, such as the visual stimulus of a face and the person’s name, the stronger the connection our brain makes between the two stimuli. Neural circuits with these properties have been found in the hippocampus; in experiments, circuits in the hippocampus became stronger after being exposed to a high-frequency stimulus. Thus, LTP is a major contender as a model for how memories form. It is thought that neuronal circuits have to go through LTP in order to successfully acquire a memory. Accordingly, Sinclair and Lo 1986, Mulkeen et al. 1987, and Blitzer et al. 1990 have all done studies with rats and found that binge drinking blocks LTP from occurring at neuronal circuits in the hippocampus. It is currently thought that alcohol interferes with the strengthening of circuits in 3 ways: by inhibiting the release of neurotransmitter, by blocking neurotransmitter receptor, and by strengthening the receptor for GABA, an inhibitory neurotransmitter. Although the idea of LTP and memory is fairly recent and has yet to be widely tested, it gives us insight as to how alcohol produces its documented deficits on memory. (http://infotrac.galegroup.com/itw/infomark).
Summing up the Effects of Binge Drinking on Memory
In all, there is strong and varied evidence to support the fact that binge drinking has a negative effect on memory functioning. Results are mixed as to whether binge drinking evokes deficits in memory acquisition, retrieval, or both. Part of this uncertainty is based on the fact that studies that use rats as participants may have trouble generalizing their results to the human population. However, there are no studies to support the brain-shrinkage theory documented on the web. It seems that the acute aspect of binge drinking does not alone account for memory problems; long-term alcohol abuse may actually be more damaging than infrequent, heavy drinking. To my knowledge, no studies have looked at longitudinal data concerning binge drinking to see if memory deficits were permanent; furthermore, research on the brain, specifically the hippocampus, needs to be expanded to gain additional insight as to how alcohol is causing these functional memory problems. Still, recommendations based on this information are obvious. Alcohol, whether consumed in binges or chronically, is a potential threat to one’s ability to think and remember clearly. Therefore, the smart thing to do is to think before drinking and limit alcohol intake to a safe and reasonable amount. Below are some further recommendations on how to avoid binge drinking; these are especially applicable in the college environment.
How can you avoid binge drinking?
InteliHealth gives the following advice for avoiding excessive consumption and the resulting effects of alcohol abuse:
Alcohol. Retrieved September 16, 2004, from http://faculty.washington.edu.html.
Alcohol Affects Memory-portion of Brain. (1996). Retrieved September 16, 2004, fro http://www.personalmd.com/news/a1996123106.shtml.
Alcohol and Seniors. (2004, May 1). Retrieved September 16, 2004, from http://www.agingincanada.ca/Seniors%20Alcohol/1e10.htm
Binge Drinking and Memory Loss. (2003, October 20). Retrieved September 16, 2004, from http://www.health24.com/news/Addiction_Substance_abuse/11- 887,25094.asp.
Blood Alcohol Level (BAC) Monitoring. Retrieved September 16, 2004, from http://www.habitsmart.com/bal.html.
Browning, M.D., Hoffer, B.J., & Dunwiddie, T.V. (1992). Alcohol, memory, and molecules. Alcohol Health and Research World, 16(4), 280-294.
Ellis, L. (2003, March 10). Binge Drinking. Retrieved September 16, 2004, from http://www.intelihealth.com.
FYI: Binge Drinking. (1998, December). Retrieved September 16, 2004, from http://www.ncadd.org/facts/fyibinge.html
Hanson, D.J. (2004). Binge Drinking. Retrieved September 16, 2004, from http://www2.potsdam.edu/alcohol-info/BingeDrinking.html.
Human Memory. Retrieved September, 19, 2004, from http://www.cc.gatech.edu/classes/cs6751_97_winter/Topics/human- cap/memory.html
Kokavec, A., & Crowe, S.F. (1999). A comparison of cognitive performance in binge versus regular chronic alcohol misusers. Alcohol and Alcoholism, 34(4), 601-608.
Memory in Psychology. (2003). Retrieved September 19, 2004, from http://education.yahoo.com/reference/encyclopedia/entry?id=30969
NINDS Wernicke-Korsakoff Syndrome Information Page. (2003). Retrieved September 19, 2004, from http://www.ninds.nih.gov/health_and_medical/disorders/wernicke- korsakoff.htm
Obernier, J.A., White, A.M., Swatzwelder, H.S., & Crews, F.T. (2002). Cognitive deficits and CNS damage after a 4-day binge ethanol exposure in rats. Pharmacology, Biochemistry, and Behavior, 72, 521-532.
Verster, J.C., van Duin, D., Volkerts, E.R., Schreuder, A.H., & Verbaten, M.N (2003). Alcohol hangover effects on memory functioning and vigilance performance after an evening of binge drinking. Neuropsychopharmacology, 28, 740-746.
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