Nicotine: Alcohol Reward Interactions

Abstract

It is well established that the continued intake of drugs of abuse is reinforcing-that is repeated consumption increases preference. This has been shown in some studies to extend to other drugs of abuse; use of one increases preference for another. In particular, the present review deals with the interaction of nicotine and alcohol as it has been shown that smoking is a risk factor for alcoholism and alcohol use is a risk factor to become a smoker. The review discusses changes in the brain caused by chronic nicotine and chronic alcohol intake to approach the possible mechanisms by which one drug increases the preference for another. Chronic nicotine administration was shown to affect nicotine receptors in the brain, affecting not only receptor levels and distribution, but also receptor subunit composition, thus affecting affinity to nicotine. Other receptor systems are also affected among others catecholamine, glutamate, GABA levels and opiate and cannabinoid receptors. In addition to receptor systems and transmitters, there are endocrine, metabolic and neuropeptide changes as well induced by nicotine. Similarly chronic alcohol intake results in changes in the brain, in multiple receptors, transmitters and peptides as discussed in this overview and also illustrated in the tables. The changes are sex and age-dependent-some changes in males are different from those in females and in general adolescents are more sensitive to drug effects than adults. Although nicotine and alcohol interact-not all the changes induced by the combined intake of both are additive-some are opposing. These opposing effects include those on locomotion, acetylcholine metabolism, nicotine binding, opiate peptides, glutamate transporters and endocannabinoid content among others. The two compounds lower the negative withdrawal symptoms of each other which may contribute to the increase in preference, but the mechanism by which preference increases-most likely consists of multiple components that are not clear at the present time. As the details of induced changes of nicotine and alcohol differ, it is likely that the mechanisms of increasing nicotine preference may not be identical to that of increasing alcohol preference. Stimulation of preference of yet other drugs may again be different -representing one aspect of drug specificity of reward mechanisms.

Novel Therapy for Nicotine Addiction in Alcohol Dependent Rats

“…Humans that co-abuse alcohol and nicotine have a worse clinical outcome than individuals who use either substance [35]. Although nicotine and alcohol interact in their rewarding effects [36], few clinical studies have addressed the possibility of a co-treatment, and the data have produced mixed results for treating nicotine-dependence in alcoholdependent subjects [37][38][39].…”

A clinical and psychological study of tobacco dependence in patients with alcoholism

“…Анализируя сведения о табакокурении и ТЗ, неко-торые авторы, однако, не приводят точные показа-тели распространенности никотиновой зависимо-сти с учетом пола и возраста, хотя и говорят о более частых случаях ТЗ и АЗ у мужчин и курильщиков с длительностью табакокурения 25 лет и более [7]. В некоторых работах [2,7,[15][16][17] констатируется б`льшая распространенность табакокурения и ТЗ среди больных АЗ, которая может превышать пока-затели в общей популяции в 2-10 раз. Только в од-ной работе из Японии ТЗ среди больных алкоголиз-мом оказалась ниже (22%), чем среди здоровых (54,4%) [10].…”

“…В зарубежных публикациях описываются рас-пространенность ТЗ у больных с АЗ, их этиология, клиника, нейробиологические, нейрокогнитивные и генетические аспекты, синдром отмены, влечения в процессе лечения и реабилитации, подходы к ле-чению ТЗ [4][5][6][7][8][9][10][11][12][15][16][17][18]. Установлено, что хрони-ческая никотиновая интоксикация действует не только на никотиновые рецепторы в мозге, но также и на структуры, которые вызывают аффинитет к ни-котину.…”

“…Задействованными оказываются катехол-аминовые, глутаматные, опиатные и каннабиноид-ные рецепторы и такой нейромедиатор ЦНС, как ГАМК. В дополнение к рецепторной и нейротранс-миттерной системам никотин индуцирует эндо-кринные, метаболические и нейропептидные изме-нения [17]. Сходные повреждения вызывает и алко-голь [16].…”

Expression of Symptoms of the Most Common Comorbid Mental Disorders in Slovenian Alcohol Addicted Patients

“…Zasvojene osebe si z uporabo alkohola in nikotina nižajo negativne odtegnitvene simptome od obeh zasvojenosti, ampak mehanizem, prek katerega alkohol in nikotin pri zasvojenem uporabniku medsebojno zvišujeta uporabo, je sestavljen iz več komponent in še ni popolnoma raziskan (30,31).…”