Quitting alcohol may seem like a straightforward decision, but a new study has revealed a surprising twist: for some people, abstaining from alcohol can actually increase their risk of relapse. Researchers have discovered that the brain’s response to abstinence can be a major factor in this phenomenon, and they’re working to develop new screening tools to identify those at risk.

The study, led by Dr. Danny G. Winder and Dr. Marie A. Doyle, involved giving mice long-term access to alcohol followed by a period of forced abstinence. The results showed that a subset of the mice developed a strong aversion to bitter-tasting alcohol, but despite this, they continued to drink in large quantities. This was associated with increased activity in a specific region of the brain called the bed nucleus of the stria terminalis (BNST).

The researchers found that when the abstinent mice were given access to the bitter-tasting alcohol, they would attempt to drink it even though it was no longer available. This behavior was linked to increased activity in the BNST, and the team observed that the mice with the highest activity levels in this brain region were also those that had developed the strongest aversion to the bitter-tasting alcohol.

Interestingly, the researchers saw activity in the BNST even before the mice were given access to the bitter-tasting alcohol. This suggests that it may be possible to identify people who are at risk of relapsing by screening for BNST activity when someone is given access to alcohol.

Alcohol misuse is a significant public health challenge in the United States, with deaths associated with alcohol use in 2024 being 4.5 times higher than those attributed to opioids. While harm reduction strategies are being explored for opioid use disorder, abstinence remains a mainstay of most approaches to alcohol use disorder. However, clinicians are often ill-equipped to predict who will need help, and the number of people diagnosed with this condition has effectively doubled since 1999.

The researchers hope that their findings will contribute to the development of better strategies for identifying those at risk of developing alcohol use disorder and helping them navigate treatment. They are also working to understand the role of the BNST in behavior related to alcohol use disorder and to develop new treatments that target this brain region.