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 Longtime members of Alcoholics Anonymous (AA) often report little or no craving for alcohol, but why this happens remains poorly understood. Now, in what is believed to be the first study to explore brain physiology in AA members, researchers from NYU Langone Medical Center found that members who recited AA prayers after viewing drinking-related images reported less craving for alcohol after praying than after just reading a newspaper. The reduced cravings in those that prayed corresponded to increased activity in brain regions responsible for attention and emotion as measured by MRI, according to study results published recently in the American Journal of Drug and Alcohol Abuse. 
 
 “Our findings suggest that the experience of AA over the years had left these members with an innate ability to use the AA experience—prayer in this case―to minimize the effect of alcohol triggers in producing craving,” says senior author Marc Galanter, MD, professor of psychiatry and director of the Division of Alcoholism and Drug Abuse at NYU Langone. “Craving is diminished in long-term AA members compared to patients who have stopped drinking for some period of time but are more vulnerable to relapse.” 
 
 The study results revolve around craving, one of the criteria physicians use to diagnose addiction. Such strong desires can persist even in addicted people who no longer use alcohol or drugs, and AA members recite abstinence-promoting prayers to reduce cravings. 
 
 “We wanted to determine what is going on in the brain in response to alcohol-craving triggers, such as passing by a bar or experiencing something upsetting, when long-term AA members are exposed to them,” Dr. Galanter says. 
 
 To investigate, Dr. Galanter and his colleagues recruited 20 long-term AA members who reported no cravings for alcohol during the week preceding testing. The participants were placed in an MRI scanner and then shown either pictures of alcoholic drinks or people drinking to simulate drinking behavior in a laboratory setting. The pictures were presented twice: first after asking the participant to read neutral material from a newspaper, and again after the participant recited an AA prayer promoting abstinence from alcohol to represent the impact of AA. 
 
 According to the study authors, all research subjects reported some degree of craving for alcohol after viewing the images, and less craving after reciting an AA prayer. MRI data revealed that there were changes in parts of the prefrontal cortex, the region of the brain that controls attention, and in brain sites responsible for control of emotion and the semantic reappraisal of emotion, which represents the different ways a people understand situations based on their perspectives. 
 
 “This finding suggests that there appears to be an emotional response to alcohol triggers, but that it’s experienced and understood differently when someone has the protection of the AA experience,” Galanter says. 
 
 In Galanter’s decade-long research into the role of spirituality in long-term AA members, he and his colleagues have found that members undergo a transition from initially craving alcohol to a new status where they reported little or no craving. This reduction in craving, according to Dr. Galanter, is associated with the amount of time that passed following a “spiritual awakening” in AA, which marks a transition to a different attitude toward drinking. 
 
 Previous investigations by other researchers of the role of prayer on drinking behavior found that alcohol abusers who reported a spiritual awakening drank less after treatment for alcoholism. Research participants assigned to engage in prayer—unrelated to drinking—every day for four weeks drank about half as much as those who were not. 
 
 “Our current findings open up a new field of inquiry into physiologic changes that may accompany spiritual awakening and perspective changes in AA members and others,” says Galanter. He says the study results also support the validity of a long-term AA experience in terms of physiologic changes in the brain. 
 
 In early 2016, Oxford University Press published Dr. Galanter’s book, What Is Alcoholics Anonymous?, which provides context for his group’s studies of the psychological effects of AA. 
 
 Dr. Galanter’s co-authors were Zoran Josipovic, PhD, and Helen Dermatis, PhD, of NYU Langone, Jochen Weber of Columbia University, and Mary Alice Millard, formerly of NYU Langone. The research was supported by a grant from the John Templeton Foundation. 
 
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 Greg Williams 
 
 Phone: 212-404-3533 
 
 gregory.williams@nyumc.org ||||| The idea of a "sober January" has been around for as long as man has cursed his in-laws at Christmas. And while a month off the booze sounds like a seductive way to make up for all that hard-drinking festive excess, it’s actually a terrible idea, rooted in guilt rather than science. And for some people who actually have a real problem with alcohol, successfully completing a "sober January" can give the dangerous illusion that they don’t have a problem. 
 
 I should know. I was one of them. I speak not only as a veteran of many a sober January, but also as someone who was finally forced to admit that yes, they were an alcoholic, and had to stop drinking entirely. I have not had a drink for several years now. I don’t say this to boast, merely to put in context what follows. 
 
 I remember one hungover December morning telling a colleague at the magazine where I was working at the time that I was planning to stay off the drink for a month in the new year. 
 
 “Why on earth would you do that?” he replied. “A few drinks are the only thing that get you through January, it’s so bloody miserable.” 
 
 He wasn’t an addict, so he didn’t understand the allure of a sober January to someone who was – that the idea of getting obliterated over Christmas and New Year and then "white-knuckling" it for a month before picking up where you left off is deeply appealing to the classic all-or-nothing, getting-away-with-it mentality of the addict. 
 
 I managed several sober Januarys and they became an important weapon in my armoury of denial. Me, an alcoholic? Hardly! How could I manage to stay off drink for a month if I was? 
 
 I find it particularly depressing that this year, the idea of a dry January is being promoted by the UK’s biggest alcohol charity, the always well-intentioned Alcohol Concern. Although the charity is careful to state in small print at the bottom of its webpage that the challenge should "not be attempted by people with an alcohol dependency problem" unfortunately those are exactly the kind of people a promotion like this will attract. Year after year, the only mates that I could persuade to do a sober January with me were the ones who were as bad as or worse than me. The normals, like my co-worker, were never interested. Why would they be? 
 
 If you are worried about the amount you have been drinking, the answer is not to swear off drink for a month. The answer is to try and establish whether you do really have a problem. And the best way to do that, ironically enough, is to do some drinking. 
 
 This was the course of action recommended by Bill Wilson, the co-founder of the self-help movement Alcoholics Anonymous. Wilson believed that alcoholics suffer a kind of allergic reaction to alcohol, and that once they start drinking they develop an overwhelming craving for more. This craving, he thought, is only made worse by subsequent attempts to satisfy it with more drink, like an itch that gets worse the more you scratch it. 
 
 Wilson’s alcoholism test is remarkably simple, and does not involve any boxes to tick or medical examinations or liver function tests; it just requires a modicum of honesty. 
 
 “We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself,” he wrote. “Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try more than once. It will not take long for you to decide, if you are honest with yourself about it.” 
 
 So - unless your sole aim is to save cash - don't challenge yourself to a sober January. Anyone can do that. Try having a pint every night – but just one – if you really want to prove you don’t have a problem. 
 
 As my friend said all those years ago, January sucks - just look at the weather outside - and you normals should have all the help you can to get through it.
– Thinking of giving up booze for the month after a hedonistic holiday season? Well, you might be an alcoholic making a big mistake, writes Tom Sykes at the Telegraph. As a recovering alcoholic, Sykes should know. "I managed several sober Januaries, and they became an important weapon in my armory of denial," he writes. A real alcoholic, after all, couldn't make it, he reasoned. But the truth is the ritual appeals deeply "to the classic all-or-nothing, getting-away-with-it mentality of the addict," while "normals" have no use for it. He advises instead trying to have just one drink a night—if stopping after one is difficult, you'll know you have a problem. But if you actually are a "normal," it turns out there might be some merit in the month-long detox. The staff at the New Scientist ran a small-scale test on themselves, and got some pretty astonishing results. Ten staffers laid off booze for five weeks, and saw their liver fat, blood glucose, and blood cholesterol levels all fall significantly—reducing their risk for liver disease, diabetes, and heart disease—while four staffers who kept drinking saw no changes. But it was a fairly limited experiment, offering no clue how long those effects will last. Heather Timmons at Quartz argues that such "detoxes" are "useless" in the long-term, since the body regularly clears out toxins all on its own. So instead, she recommends taking two or three consecutive days off from drinking each week, since it takes the liver a full day to recover from heavy drinking—plus, over the course of a year, that ensures as many as 150 alcohol-free days.