Health Hacktivators With Dr Alka Patel – How Can I Alter My Addiction To Alcohol

You're listening to Health Hacktivators with me, Dr. Alka Patel, on the Woman's Radio Station. Before we get into today's conversation, please do support today's show sponsor, Youth and Earth. Youth and Earth have a range of products that I love to use myself to supercharge my metabolism, to support my health, and to slow down cellular aging. So just be sure you click the link in the show notes for exclusive offers which Youth and Earth are so generously giving only for for listeners of this show. Welcome to Health Hacktivators with lifestyle medicine doctor, GP, and longevity expert Dr. Alok Patel. This show will help you to discover a hidden health hacking code that unlocks your phenomenal potential for an outstanding healthspan, lifespan, and wealthspan. The show features candid conversations with celebrities, influencers, and industry icons, real-life stories, and cutting-edge health hacktivating advice that other doctors might not tell you. Discover why now is the time to join the strategic self-care revolution and experience the profound effects this will have on your personal and professional success. Now, here is your host, Dr. Alka Patel. Hi, hey, and hello, Health Activators. Are you ready to unlock your Health Activation Code in 3 steps using the power of data and devices to make decisions that will change your destiny? On today's show, I am asking one question, reviewing two references, and giving you three health hacks so that hacktivating your health is as easy as 1, 2, 3. Today's one question is, how can I alter my addiction to alcohol? Now, on last week's show, I was talking to Scott Mitchell. Scott, you'll know, is the husband of the late Dame Barbara Windsor, and he talked ever so openly and very, very refreshingly about his addiction to alcohol. So if you haven't already listened to this conversation, then please make sure that you do because it really is a wonderful conversation. And it's what has prompted me to shine the light on alcohol addiction this week. So in today's episode, what I'll be doing is starting by telling you about the different types of alcohol, how alcohol is metabolized, and how it affects you so that by the end of the show, you will know whether alcohol is safe or not, and at what level of consumption. And I will also be exploring addiction, what it is, why it occurs, what changes in your brain take place with addiction, so that then you can target this to reverse addiction with 3 key hacks that I'll be giving you using data and devices to support your decisions around alcohol. So before we get into addiction, let me talk about alcohol itself. Now, alcohol has been around for a long, long time, thousands and thousands of years, and it has been used for many, many purposes. And some of these purposes also include medicinal reasons as well, things like sterilization and cleaning and as reagents in labs as well. But its most common use, and I know everyone will be familiar with this, the most common use of alcohol is to alter the human state. Because here's a substance that can create such an elevated state of— how can I describe it— a state of laughter and lightness when you take it, that so many people just keep going back for more and more and more. And of course, who doesn't want laughter and lightness in their life? Who doesn't want even more laughter and lightness in their life? So what what is the fuss? What is the harm? Well, to answer this, let's get into the biochemistry of alcohol. So there's 3 main types of alcohol: isopropyl alcohol, methyl alcohol, and ethyl alcohol. And of all these 3, only ethyl alcohol, or ethanol as you may more familiarly know it, only ethanol is the form that we humans have decided to drink because it's less toxic than the others. And that is an important thing to know. Notice that I didn't say non-toxic, I said less toxic, because the form of alcohol that we drink, ethanol, it may be less toxic than the other forms of alcohol, but it's still toxic. It still shares those structures of its brother and sisters. It's from the same family, differs only by a couple of hydrogen atoms. So there is no denying it, no matter how much lightness and laughter alcohol gives you, it is a toxin. And you may be wondering, well, what is a toxin? So by definition, a toxin is a substance that causes harm. And I think understanding the properties of alcohol might help to explain why and how it causes harm. So let's talk about Metabolism next. So alcohol— and when I talk about alcohol now in the rest of the show, know that I'm referring to ethanol. Alcohol is so toxic that the body knows that it has to get rid of it very, very quickly. So to do that, it has created a detoxification pathway. So it's a two-step pathway, and in the first step, alcohol is very quickly converted to a molecule that's called acetaldehyde, and it does this through an enzyme called ADH, alcohol dehydrogenase. Now unfortunately, human design does have its imperfections because acetaldehyde, as it turns out, is even more toxic than alcohol, so you need to get rid of that as fast as possible as well, which is why there's a second step where the acetaldehyde is converted to acetate through the enzyme ALDH, aldehyde dehydrogenase. And acetate is non-toxic and it gets removed from the body as carbon dioxide and water. Now I did say it's an imperfect design, but maybe thinking about it, it's probably absolutely the perfect design to stop you consuming toxic products in the first place. If only we paid attention, hey? And the important thing to know here, is that you can only metabolize acetaldehyde at a certain rate every hour. And that is important to know. This is a rate-limiting step, which means that if you're building up acetaldehyde faster than you can clear it, then you're going to get even more toxic effects. Now, what research also shows is that different people carry different variations of the ADH and the ALDH enzymes that I've referred to, and this is all related to gene variants. So what this means is that some of these variants mean that enzymes are working more or less efficiently than others, which means that some people can break down alcohol to acetaldehyde or acetaldehyde to acetate more quickly than others. So a fast ADH enzyme or a slow ALDH enzyme is what then can cause toxic acetaldehyde to build up in the body, creating more dangerous and more unpleasant effects. And there's an interesting thing to know as well. Interestingly, the type of ADH and ALDH that an individual carries has also been shown to influence how much he or she drinks. So how does this work? Well, think of this: high levels of acetaldehyde, because it's toxic, it makes drinking very, very unpleasant. You can get facial flushing and nausea and a rapid heartbeat even when small amounts of alcohol are consumed by people who carry this gene variant for fast ADH or slow ALDH, because then there's a delay in the processing of acetaldehyde in the body. Which then causes it to then build up. And so people who have this gene variant may automatically tend to drink less, which sounds like good news because then they're somewhat protected from alcohol addiction. They just don't want to drink as much because its effects are so unpleasant. But— here's the but— whilst you may get a false sense of security from being protected from addiction because the flushing and the feeling of nausea stops you drinking so much, there there's still a health warning attached to alcohol for you. Because if I go back to the literature again, there's a team of researchers that were led by Helmut Seitz and his team who found that even though individuals whose gene variants mean that they're less likely to consume large amounts of alcohol, what happens is when they do drink, their risk for developing certain cancers is higher than drinkers who are exposed to less acetaldehyde during alcohol metabolism. And why is this? It's because alcohol and its metabolites are a carcinogen, which means they cause cancer. And as I said in my conversation with Scott Mitchell on last week's show, There is no safe level of alcohol consumption. I would love, love, love to be able to tell you that, hey, look, 1 or 2 glasses a night or a few more at the weekend, that's okay, it's safe. But I can't. And the reason I can't is because there's an effect on your brain at both macro and microstructural levels, even at what you might consider to be low levels of alcohol consumption. So there's a meta-analysis that was published in the journal Nature in 2022, and it looked at data from over 36,000 adults. And what it found was changes in brain volume and in the white and gray matter of the brain's microstructure, even at an average of 1 to 2 daily alcohol units. And this association, of course, became stronger as the alcohol intake increased. So what this means is, well, it doesn't mean that you have to be drinking 1 or 2 units every day. It's an average. So this applies to you if you're someone who has, say, a glass of wine every evening after the kids go to bed, or if you have 3 or 4 pints of beer on a Friday night, or 2 or 3 glasses of wine at the weekend, because this then averages out to 1 or 2 units a day. And the Chief Medical Officer may have deemed 14 units a week to be safe drinking levels, and so many people keep that at the forefront. 14 units, I'm okay till I get to 14 units. But less than that, it's not safe. It's just safer than drinking even more. And what the International Agency for Research on Cancer has also done is it's classified alcohol It's a Group 1 carcinogen, meaning it's classified as causing cancer in humans. And I do want to emphasize this, not with any scare tactics or any judgment attached to it, but simply so that you're in a position of knowing. And I get it, totally get it. Sometimes you'd rather not know what you know. Maybe you want the feeling of freedom and social ease at the party. Maybe you feel you deserve that glass of wine after a long day's work or after the children have gone to bed. Maybe you feel you should be able to let your hair down at the weekend and on holiday. I totally, totally understand that, but just know, and you know this, all decisions have consequences. And of course, you'll know there are some people who drink a lot of alcohol who don't develop cancer, and there are some who drink very little alcohol who do develop cancer. So whether it does or whether it doesn't, just know that it can. At any level of consumption, alcohol can cause cancer. So there's a few other effects of alcohol that are important as well. Let me now switch to talking about the solubility of alcohol. So alcohol is both water and fat soluble, and what this means is, well, it means two important things. Firstly, it means that it passes through your stomach lining into your bloodstream very, very quickly, sometimes within 5 minutes or so of drinking. And it then gets into your cells very, very quickly as well, because cells have a lipid lining, a fat lining. And because alcohol is fat soluble, it just passes straight through. Now there's many other molecules that in order to get into cells, they have to sit on cell receptors and they have to wait to be allowed in through a whole series of chemical processes. But not alcohol. Alcohol just slips on through. And the other place that alcohol just slips through is the blood-brain barrier. Now, your brain is protected by a selective barrier that generally only allows certain substances through, but alcohol, because of its solubility, again, it just gets through. There is no stalling, no questions asked. Alcohol just slips through. So then what happens? What happens when alcohol enters this neuron-rich environment of the brain? Well, it's pretty free then to go, to go anywhere in the brain. But one of the first places that it seems to be attracted to is the prefrontal cortex. And there's a few important things that go on in the prefrontal cortex, that front part of your brain. And one of these things is inhibition. So there are inhibitory circuits at play in your prefrontal cortex, and it's all mediated by a chemical called GABA—G-A-B-A—gamma-aminobutyric acid. And what happens is that with alcohol, these inhibitory circuits, they get lifted, which is why at parties and at bars you'll see lots of disinhibited behavior. So think about it. Have you, have you ever noticed how the volume of the conversations when you're in a bar just seems so high and voices seem to be getting louder and louder as the night goes on? Or have you noticed people gesticulating more, using their hands and their arms, moving around a lot more? That's all disinhibition. If you notice that, that's all down to the effect of GABA being lifted. And then the more you drink, what then happens is that the GABA effect on impulse suppression related to your thoughts is then also lifted, which means you do things without thinking them through. And then your memory circuits are also affected. Alcohol has a very strong effect on your neural networks that are involved in memory formation and in the storage of memory. And you might have experienced this or been out on a night with friends as well. Ever been out on a night of drinking and then forgotten parts of that night? Or maybe and forgotten all of it, or maybe you've been with friends who can't remember half the night and you're having to fill in the missing pieces. That's all the effects of alcohol and acetaldehyde affecting those neural circuits in your brain. Now you might be listening thinking, well, that's not me. I mean, I'm okay. I only drink every now and again. I only have the odd glass of wine in the evenings. I don't drink during the weekdays. I only drink at weekends. Maybe you're you're thinking, "None of this really applies to me." But the toxicity of alcohol on your neural circuits, it isn't just experienced by heavy consumption or by daily drinking or by binge drinking at weekends. It occurs with even that one drink. Because what we know is that these changes in your neural circuits, they also get reinforced every time you drink. And that's regardless of the level of consumption. And what's interesting as well is that you're not then only more impulsive whilst you're drinking, but over time you become more impulsive even when you're not drinking. So think about that. This is something really important to highlight. Lack of impulse control and judgment then percolates into your everyday life. Personality traits can seem to change. Have you maybe noticed that in yourself? Ever said, "Gosh, I never used to be like this," or have you noticed changes in perhaps your spouse or in friends who drink, thinking, "They never used to be like this," "He's really changed," "She's really different now"? That's the impact on your neuronal circuits, on your impulsivity continuing even when you're not drinking. So where does addiction fit into this? Well, we've talked about what makes alcohol toxic and how that feeling of being drunk is the direct toxic effect of alcohol. And we've talked about its metabolites and the effect that they have on the brain's neural circuits as well. We've talked about alcohol being carcinogenic. So what about addiction. How do you know if you have an addiction to alcohol? Well, if you remember in the last episode, I talked about the 4 C's: craving, compulsion, consequence, and control. So craving involves this desire to drink, and then it's followed by a compulsion, which is an urge that you just can't overcome. And then when you drink, you face the consequences, and these can be positive consequences positive consequences that satisfy that craving and also negative consequences like the impact on your health and relationships and finances. But here the negative consequences are just not strong enough to overturn that craving and then what follows is issues of control with loss of control as the spiral continues. So how do you know if this could be you? Or someone that you know or that you care about or are close to? Well, let's have a look at data. What data can you use to answer this? So there's a validated questionnaire which is called the AUDIT questionnaire, A-U-D-I-T, Alcohol Use Disorders Identification Test, AUDIT. So what I would suggest is using this as your primary starting point to identify possible Addiction. Now I'll put a link to the questionnaire and the scoring system in the show notes, but what I do want to do is go through the questions together now so that I can provide some information on the relevance of each question. So this isn't just about ticking a box on a questionnaire. Each question has got a much deeper relevance. So let's do this together now. If you want to grab a piece of paper, so if you haven't got one handy, just press pause. If you need to find a pen and paper, uh, go and do that and then come back. And what I'm going to do is give you a series of 10 questions that I want you to score yourself against. And this is how the scoring works. So just write this down. The scoring works in this way. If your answer to each question or a question is never, then score yourself 0. Less than monthly scores 1. Monthly scores 2, weekly scores 3, and then daily or almost daily scores 4. So have you got that? So never is 0, less than monthly is 1, monthly is 2, weekly is 3, and daily or almost daily is 4. So here's the questions. Here are the data questions. So give yourself a score for each question as I go through them. And then at the end, I'll give you a chance to add up all your scores to give yourself one final score. So question 1, it's how often do you have a drink containing alcohol? Never, less than monthly, monthly, weekly, daily? So that's an easy question to get started with. How often do you have a drink containing alcohol? Question 2: How many units of alcohol do you drink on a typical day when you are drinking? Now we haven't talked about units yet, so let me just clarify what is a unit of alcohol. So 1 unit is half a pint of beer or lager or cider. It's half a glass of wine, or it's one measure of a spirit. So to help with that a little bit and to put that into context, a pint of beer, a pint of lager or a pint of cider, that would be 2 units. And then a standard small glass of wine you're served in bars, it's usually 175ml, which is just over 2 units. And a large glass of wine, that's usually 250ml, that would be 3 units. And if you're at home or you're out and you've had a bottle of wine, that's typically 9 units. So This is a rough guide. So thinking about that, how many units of alcohol do you drink on a typical day when you are drinking? And I want you to be honest here, really, really honest, because most people underreport. Don't do that. Don't underreport. Be honest. Think about a day when you've been drinking. What's that like? Question 3. Question 3 is, how often have you had 6 or more units if you're female, or 8 or more units if you're male, on a single occasion in the last year? So think about the last year, one day, one night out, one evening. How often have you had 6 or more units if you're female, or 8 or more if you're male? Typical day, typical single night out, do you usually have more than 6 or 8 units? And how often do you do this? Never, less than monthly, monthly, weekly, or pretty much daily. Now, these first 3 questions that you've just answered, they're all part of a short form questionnaire, Audit C. And if you've already scored 5 or more, then it's even more important important for you to zone in and answer these next 7 questions. So we're on question 4 now. Question 4 is, how often during the last year have you found you are not able to stop drinking once you started? And this is important. Many addicts, they report a feeling of not having an off switch. They don't feel able to stop once they start. So So have you, for example, have you ever had a packet of sweets where you were just going to have the one and before you know it you've polished off the whole packet? Or you were just going to have that one biscuit and then you've devoured the whole pack? It's the same with alcohol. Do you ever think, I'll just have one or two drinks, then end up being the last person standing still to be drinking? Or perhaps you're not even standing at that point but still drinking. Or maybe you come home from a day of work, pour yourself just that one glass wine whilst you're cooking, and by the time you go to bed, the bottle is empty. So how often does that happen? Because this question about having a stop button, that relates to craving and compulsion. You remember those 4 C's? Craving and compulsion are the first 2. It's this sense that you, you just can't stop the urge, that desire to drink. It's just too strong. And the next 5 questions, they all relate to those second 2 C's, consequences and control. So question 5, how often during the last year have you failed to do what was normally expected from you because of your drinking? And so think about scenarios where this might be relevant. Have you ever not woken up in time to get to work on time or not been able to pick up your daughter from school? Maybe you've missed a meeting or not met your financial responsibilities. Have you ever done that? How often? Question 6: How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session? Now here I want to talk a little bit about hair of the dog. Many people talk about hair of the dog, don't they? Have you ever heard of that phrase? Well, It's a shortening of the phrase "the hair of the dog that bit you," and it comes from an old folk remedy for rabies where it was thought that if you place the hair from the dog that bit you into the wound, then you would heal. It's the principle of curing like with like. And then in around the 16th century, this metaphor started to be used as a way for dealing with a hangover. Like with like, using drink to deal with drink. The question is, does this work? Is there any scientific basis to this? Well, what the science does tell us is that alcohol causes vasodilatation. What does this mean? Well, vasodilatation is the relaxation of your blood vessels. So your blood vessels, they dilate and they open up. So if you think about a hangover, which is more correctly termed post-alcohol consumption malaise, then the typical feelings that you experience are a heavy head, a headache, stomach cramp, maybe fogginess, just this feeling of not feeling great. And that occurs for a number of reasons, and one of these is the dilatation and constriction of your blood vessels. So vasodilatation is associated with your parasympathetic nervous system, with calmness and relaxation, which is what alcohol gives you. But then there's the rebound. There's always the rebound. When the alcohol wears off, there's then vasoconstriction, narrowing of your blood vessels, which is why you get that sort of sharp, heavy head in the morning after the night before. And some people then think, hair of the dog, 'Have another drink, it will help me.' And it might while you're drinking because the alcohol then the next day can cause again some vasodilatation. So the headache then feels as though it's easing as the blood flow through the head starts to increase and improve. So your head feels less heavy and it feels less foggy. But what happens is that after that drink, after that hair of the dog drink, the rebound kicks in again with vasoconstriction and the headache and the heaviness continues, and it's even more prolonged than it would have been if you didn't have the hair of the dog the next day in the first place. So hair of the dog, bad idea, actually terrible idea. Don't do it. Don't ingest more alcohol simply to try and recover from a hangover because what it's doing is prolonging it. Okay. Question 7: How often during the last year have you had a feeling of guilt or remorse after drinking? Now guilt is a common feeling in addiction. You might feel guilty about things you've said or done whilst drinking, or you may feel guilty about the effect that you're having on loved ones, may be guilty about the damage to your health, and this guilt can then affect your mood, which results in feelings of stress or anxiety or depression. And if you drink, or if you're around others who drink, what you'll know is that there is a connection between alcohol and emotions. You, you feel it. And when it comes to addiction, this is even more relevant. So how does this work? How does this connection between alcohol and emotions work? Well, you've already heard me talk about how alcohol is converted to acetaldehyde, and then how alcohol and acetaldehyde directly pass into that rich neuronal circuitry of the brain. So what happens here is that alcohol then directly acts at the synapses. The synapses are the connections between your neurons, and it acts at the synapses between what we call your serotonergic neurons. And what is this? Well, serotonin is a chemical mediator that's involved in your feel-good feelings. And when you drink alcohol, you disrupt these mood circuits. So first few drinks, those serotonin circuits, they get supercharged. You feel great. Your mood elevates. Painful feelings, they're forgotten. Any shame or guilt that you feel, it's dissipated. And then as the alcohol wears off, your mood dips. And as the serotonin dips, what do you do? You get another drink to restore that mood uplift that you've been experiencing. But alcohol is also a depressant, so you reach this threshold which you can't continue to have that uplift. And also, as the acetaldehyde starts to build up, your cortex of course starts to then shut down. Your motor cortex shuts down, so your coordination gets affected. Your posture changes, it's much harder to hold yourself upright. Your speech areas change, so you start to slur, and your serotonergic synapses are downregulated so that your mood dips. And the next day, the shame and the guilt is there even more acutely. You feel worse than you did, and you start the cycle again to try and alleviate those painful feelings. And there is another important thing also that happens with alcohol in relation to mood. So alcohol also affects your HPA. So what's your HPA? It's your hypothalamic-pituitary-adrenal axis. So your hypothalamus, it's a small part of your brain that is the Well, it's the master controller of lots of core functions, and it sends signals— it sends signals to the pituitary gland to release hormones, and then some of these hormones talk to your adrenal glands, which sit above your kidneys, and the adrenal glands then release cortisol, which is your stress hormone. So with ongoing alcohol use, and whether that's one or two drinks a night or drinking only at weekends, ends, what happens is your HPA axis, your HPA changes so that you release more baseline cortisol even when you're not drinking. So what does this mean? Well, it means that you feel even more stressed, even more anxious, more guilt, more shame when you're not drinking. And then it's these changes in the neural circuitry that then cause people to want to drink even more just to get back to that baseline in terms of stress modulation and feelings and mood. So this question, Question 7, how often are you experiencing guilt and shame from drinking, is a very, very important pointer to the potential changes in your neural circuits related to your mood that you might be experiencing. Okay, Question 8, 8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? Blackouts. Blackouts are important to consider because they might point to you having a genetic variant that predisposes you to addiction. Now, when I say blackouts, well, blacking out doesn't mean passing out, it means means drinking and then not remembering events because your memory circuits in your hippocampus are totally shut down. And this is a pretty dangerous space to be in. The reason that it's potentially dangerous is because it's also been found that many people who have a tendency to blackout are also those that, well, instead of being sedated by ongoing alcohol consumption, what happens is that they remain highly energized by alcohol, which then results in much more risky behavior. Behaviours like drink driving or running into a road or running into the sea. And it's that high-energy effect of alcohol that makes addiction to it even more likely, and it makes the risks even higher too. So are you someone who blacks out? Are you someone where your friends have to fill in the missing pieces of the night for you? Question 9: Have you you or somebody else being injured as a result of your drinking. Injuries. Well, here's a statistic: 5.2 million people die, die worldwide each year due to alcohol-related injuries, and 3.2% of deaths are caused by alcohol directly. And it's not just fatal injuries that matter. Many, many non-fatal injuries directly related to alcohol as well. Falls, burns, workplace injuries, violence, driving accidents. So have you or somebody else been injured as a result of your drinking? And finally, question 10: Has a relative, a friend, a doctor, or a healthcare worker been concerned about your drinking or suggested that you cut down? Why is this question important? Well, because often others will see what you can't see, or perhaps see what you don't want to see. So that's all 10 questions. Now, if you add up all your scores from each question, that will give you an overall score, and this score is a vital piece of personal data for you. It just relates to you. Next question is, what do you do with this data? What you do is that you use it. You use it to make a decision. So look at that number, and if you've got a score above 20, that's a very strong indication of addiction. A score between 19 and 16 puts you at a very, very high risk of addiction and is score of between 15 and 8 is an increasing risk. Score of 7 to 0 may not indicate addiction, but it still points to harm because, as I've said throughout this episode, there is no safe level of consumption. And I don't say this because I want all my listeners to be teetotalers. It's not that at all. But what I do want is for you to be in a position of making an informed choice so that you can then make a conscious choice about what you drink, when you drink, drink and how often you drink. And what I do strongly, strongly urge you to do is that if there's anything in what you've heard today or in your score and your data that signals even possible addiction, then make a decision to change your destiny, because addiction can be overcome. We're going to take a short break now for some music, and we'll be back shortly with even more health hacktivations. I fell in love again. All things go, all things go. Drove to Chicago. All things know, all things know. We sold our clothes to the state. I don't mind, I don't mind. I made a lot of money. A lot of mistakes in my mind, in my mind. You came to take us. All things go, all things go to recreate us. All things grow, all things grow. We had our minds set. All things know, all things know. You had to quiet down. All things go, all things go. I drove to New York in a van with my friend. We slept in parking lots. I don't mind, I don't mind. I was in love with a place in my mind. In my mind, I made a lot of mistakes. In my mind, in my mind, you came to take us. All things grow, all things grow, to recreate us. All things grow, all things grow, we have our minds set. All things grow, all things grow, All things go, you have to find it. All things go, all things go. If I was crying in the van with my friend, it was for freedom. From myself and from the land. I made a lot of mistakes. I made a lot of mistakes. I made a lot of mistakes. I made a lot of mistakes. You came to take us. All things go. All things All things go to recreate us. All things grow, all things grow. We had a mindset. All things know, all things know. You had to find it. All things grow, all things grow. You came to take us. All things grow, all things grow. So how do you do this? Well, I want to take a look at some devices that might help you with this. Now monitoring your level of consumption is important. If you can monitor it, you can manage it. And one of the first questions on that audit score, you'll remember, was how many units of alcohol do you drink? And as I said earlier, most people underreport. Plus, exact units, they can be a bit tricky to quantify. Say if you're drinking a cocktail or you're pouring drinks, which are not exact measures, which is why there is a tech solution to this. There's a company called BACtrack, B-A-C-track, which is based in San Francisco, and they've created a device called SKYN, S-K-Y-N. N. Now this device, it looks like a wristband, like a Fitbit or a watch, but instead of measuring your speed or your heartbeat, what it's doing is measuring your body's alcohol content, BAC. And what you can then do is see your blood alcohol content on your wrist. So this device, it's in beta testing phase at the moment, at the time of this recording, and you can join as a beta tester by wearing a small, discreet wearable, and it will give you lifetime feedback on your blood alcohol levels. And this market for alcohol measuring apps and devices, well, it really is growing pretty fast. There's quite a few apps out there. There's an app as well called Less, which helps you track your intake, and by tracking, you're raising your self-awareness. There's another called Drink Less, and this is an app which has been created by a team of behavioral scientists at University College London. And in this app, you track and you set targets, and you also log your mood as well. So you remember there's a strong connection between mood and alcohol and addiction as well. So these are all very, very useful devices, and I know that it can sometimes feel pretty hard reaching out for help. And many, many of my clients tell me that drinking is just not something they want to talk to their doctor about, which is where these sorts of devices can help you to, to become more self-aware of your own drinking habits, to take responsibility, to take control. There isn't really a substitute for specific support. They're no substitute, but they are great tools for getting you to see your own patterns. And as I always say, numbers give you a nudge. Numbers are very, very powerful in getting you to change your actions, which is why tracking makes a difference, and which is why I would certainly advocate having a look at some of these devices that I've mentioned to So now you've got your data and you're using devices and you've made a decision that you're going to overcome your addiction to alcohol. What next? Well, remember those 4 C's: craving, compulsion, consequences, control. I want to focus on just that first C, craving. So now getting to the end of this episode and I want to leave you with a technique called craving surfing. Now before I get into the technique itself, let's just talk about dopamine, which is directly related to craving. So dopamine. Now the way that the brain signals pleasure is through the release of a neurotransmitter, a chemical messenger called dopamine, which it releases into a part of the brain called the nucleus accumbens. So think of this as your pleasure center. Now seeking out pleasure, it's a very, very powerful survival mechanism, and we all have a background level of dopamine which gently ebbs and flows around a tonic background level. So if you go back to the, to the physics that we learnt at school, to every reaction there's an equal and opposite reaction, remember that. What this means is that whenever you experience pleasure, your dopamine levels rise and then they drop. They drop below baseline and then they're pushed up again as you seek reward and pleasure to lift that dopamine level up again, and then you continue as that waxes and that wanes. Now, this pleasure, it comes from a vast range of daily sources. We are pleasure-seeking beings. But what happens with alcohol is two things. One is that that just thinking about alcohol causes a mini spike, which is a release of anticipatory dopamine. So dopamine is more of an anticipatory neurotransmitter than a pleasure neurotransmitter alone. It's a motivation molecule. So you have an anticipatory mini spike, and that's then followed by a mini deficit below your baseline, which then creates the craving. So what does this mean? It means that anticipation, sometimes triggered by just a thought, anticipation is then immediately followed by a wanting. And it is that dopamine deficit state that then drives you and motivates you to go out and seek and get the alcohol that you want. It's about pleasure, and it's also about motivation, and it's also about wanting. Wanting. And then the second thing that alcohol itself does is it causes a higher surge of release of dopamine from the nucleus accumbens, much higher than natural non-alcohol or non-drug rewards do, which then means that after that upward rise, that downward drift is also far greater. Remember, equal and opposite reactions. Which then means that you seek out even greater pleasure, and that's why even stronger craving kicks leading to compulsion. You experience a strong, strong urge to drink, and it's all driven by your survival need for dopamine. And here's something important: there's a difference between liking and wanting. So over time, the wanting increases even though the liking might decrease. You continue to crave alcohol, to seek it out, to want it, despite not liking the negative consequences and the problems it causes, simply because you're trying to get back to your tonic dopamine baseline. Well, there's good news. The good news is that this is all reversible. When you stop drinking, the dopamine transporter levels in your brain, they've been found to return back to baseline. So you get back to your much more gentle eb and flow. Now you might be wondering, well, how long does this all take? Well, in 30 days it is possible to reach a dopamine reset. Now this doesn't mean that everything related to addiction is overcome in 30 days, but it does mean that the neurotransmission effect of dopamine that plays this big part in craving, well, that can be reset. So on a more practical level, think of it in perhaps 10-day chunks. When you stop drinking, days 1 to 10, they will be hard, maybe even horrible. Cravings will be high. You might experience a host of physical and psychological effects— headaches and shaking, sweating, nausea, feeling anxious, restless, not sleeping. And this can all start within a few hours after you stop drinking. Often it peaks a day or two later and then generally improves over 5 to 10 days. Now, just to preface this by saying some withdrawal effects from alcohol can be much, much more serious, so you may need a medically supervised withdrawal and detoxification process and program, particularly if you are a long-term or heavy drinker. So please, please make sure you speak to your doctor. And of course, as always, you know that you can speak to me as well. You know how to reach me on email, lifestylefirst@dralcapatel.com, or through the social at Dr. Alka Patel UK. So days 1 to 10, cravings are high. Days 10 to 20, well, some days start to feel much easier. And days 20 to 30, the reset is kicking in and the cravings and the urges, they reduce. Now one key way to reach this dopamine reset and work through those cravings is through this technique that I mentioned, this hack called craving surfing. Suffering. So what this means is that when you're craving alcohol, instead of trying to fight it, you accept the craving and you ride it out. So think of it like this, think of it like riding the crest of a wave when you're surfing. The crest will soon break and it will dissipate, and it's the same with cravings. Cravings rarely last, in fact rarely last longer than 30 minutes or so if you don't continue to feed them. But most people do feed their cravings, and they do this perhaps without realizing it. You feed cravings simply by ruminating, overthinking them, giving them attention, continuing to think about them. And you also feed cravings by fighting them, by trying to distract yourself from them, trying to suppress thoughts or feelings, and what this does is it just makes the craving bigger. But if you ride out the craving without trying to battle it, without judging it or distracting from it, it will pass much, much more quickly than you think. So here's the 3 hacks for craving surfing. Firstly, assess how you're experiencing the craving. So sit somewhere as comfortably as you can, take if take a few deep breaths and focus your attention inward. Just allow your attention to wander through your body and notice that part of your body where you're experiencing the craving and what those sensations feel like. And tell yourself what it feels like. Start naming it. So you might say, for example, my craving is in my head, and it's in my chest, and it's in my stomach. Secondly, focus on one area to start with where you're experiencing the craving. Really zone in on this. How do those sensations in that one area feel? Maybe you're feeling hot or cold or tingly. Maybe your muscles are tense. And again, describe those changes and those sensations. My head feels like it's bursting. My chest feels so heavy. I'm just thinking about the taste of alcohol in my mouth. And then thirdly, do the same for each part of your body that's experiencing the craving. So what is this all about? Well, the purpose of craving surfing is not to make the cravings disappear, but it's to experience them in a new way. And as you carry on doing this, every time you feel a craving, you'll learn how to ride your cravings out. That's the neuroplasticity of your brain. You'll carve out new ways of experiencing your craving until they go away naturally. And what you will notice is that after just a short while, that craving will have gone. So keep practicing that. And remember, if the craving changes, then all those other C's that follow— compulsion, consequence and control, they'll also change too. Now I know that's a lot that we've covered in this episode. Alcohol and alcohol addiction, it really is a huge topic, and I know also that there's many, many areas that I haven't covered as well. So as this show continues, this will certainly be a topic that I'll be coming back to. But let me wrap up this episode. Let me recap on what we've looked at today. What we've looked at at our types of alcohol. We've looked at how it's metabolised, its toxicity, its carcinogenicity. We've considered what level of drinking is unsafe, and we've explored how alcohol affects the brain and how it exerts its addictive properties. We've then looked at data so that you can understand the effects of alcohol on you, and we've looked at some devices that can help you to measure and monitor your alcohol consumption or track and target your alcohol goals. And I've ended with 3 hacks to curb the craving. And through all of that, what we've done is we've answered that question, haven't we? How can I alter my addiction to alcohol? So I'll put references to some links in the show notes to 2 pieces of research that I've mentioned today as well, and I'll also include include a link to a blog that I've written to follow on from this show so that you can explore some of the areas in more detail. So please make sure that you do click on that link and take a read. And finally, what I want to end by saying is really what I said in last week's conversation with Scott. I said addiction is all about connection, and there's another hormone oxytocin, which is involved in human connection and in bonding, and it directly links with dopamine and the release of dopamine, which means that when you connect with other humans, you get a dopamine hit which replaces the dopamine you might be getting from alcohol. Why am I saying this? Well, the reason I'm saying this is because whether you choose to to alter your alcohol addiction by enrolling on a rehab program, getting therapy, or taking a self-directed approach, support is essential. So please don't try and do it all alone. Recovering from alcohol addiction is so much easier when you have people that you can lean on for encouragement or for comfort or for guidance. So lean, lean on close friends and family, your partner, your spouse. Create a social network, a sober social network. Join recovery support groups like the AA, Alcoholics Anonymous, and please, please do reach out to me if you want any additional support. You are not alone, and I wish you a health-activating day. Thank you for listening to Health Hacktivators. If you have enjoyed this episode, then please support the show by leaving us a 5-star review wherever you get your podcasts and by sharing this episode with a friend. Don't forget to click the link in the show notes right now to find out more details about what was covered in this episode and to connect with Dr. Alka Patel in order to take your strategic self-care to the next level. Please do support today's show partner, Youth and Earth. Youth and Earth have a range of products that I love to use myself to supercharge my metabolism, to support my health, and to slow down cellular aging. Just be sure you click the link in the show notes for exclusive offers which Youth and Earth are so generously giving for listeners of this show. Thank you for listening to Health Activators with me, Dr. Alka Patel, on the Woman's Radio Station. I'd love you to stay connected through the socials. You can find me at Dr. Alka Patel UK. And to learn more about the Women's Radio Station, do give them a follow too on their socials at Women's Radio STN.