What is the “kindling” effect in alcoholism?
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Alcohol (along with benzos (like xanax), z-drugs (like ambien) and barbituates (not really used in the US anymore)) all work on a chemical in the brain (also known as a “neurotransmitter”) called GABA. GABA is responsible for slowing down how quickly your brain cells talk to each other. These drugs bind to GABA receptors, making you more relaxed, less anxious, and fall asleep easier.
Unfortunately, GABA is a very finicky chemical. If a brain cell receives more GABA than it is used to, then it will get rid of receptors for GABA to try to balance it out. When the alcohol or other GABA drug is stopped, those receptors don’t come back right away. Now, until the receptors grow back, the GABA naturally in your brain can’t have as much of an effect. This is what the bad feeling of withdrawal is.
Kindling happens when you withdraw multiple times. Your brain remembers what alcohol is whenever you start using it again. It knows that it needs to get rid of receptors, so it does it a little faster and a larger amount because it expects you to be drinking for a long time, like you did last time. When you stop alcohol again, you have even less GABA and even less receptors than you did last time you quit, so the withdrawal is even worse. Your brain still remembers the next time, and the next time, and the next time, getting rid of GABA and receptors more effectively every time you start using again.
If you do this enough times, your brain just gives up trying to heal because it is always expecting the drug. Eventually when the drug is taken away, your brain cells just go “what’s the point of regrowing these receptors? He/she’s just going to give me alcohol soon anyway”.
And then you have almost no GABA or receptors in the brain, so you could have given yourself a wide variety of chronic – maybe permanent – symptoms associated with low GABA; severe anxiety, insomnia, tremors, muscle issues, cognitive issues, memory issues, and even epilepsy. The first time you quit it can take a few weeks to a few months to get your receptors back. By the umpteenth time, it can take years to heal, if you ever do. The only way to make you a functional human being is to introduce a new GABA drug to mimic the effects of the chemical. However, these drugs – you guessed it – lead to down regulating GABA over time, so you need to take more and more and more.
GABA is one of the most vital chemicals in your brain for you to live a comfortable and happy life, but it’s also one of the most finicky and can wreak absolute havoc on your life if it’s low. That’s why kindling is rare for most other drugs, but it’s nearly unavoidable specifically for GABA drugs should you withdraw multiple times.
Edit: Kindling, as I alluded to early on, can also happen easily with benzodiazepines (Ativan, Klonopin, Xanax, Valium, Rohypnol (illegal in the US – also known as a “roofie”) etc.), Z-Drugs (Ambien, Imovane, Lunesta, Sonata, etc.) and barbituates (usually only used for veterinary purposes nowadays – these are what put dogs down (and they could put you down too, which is probably why they’re not prescribed anymore)).
There are safer GABA drugs that work a little differently and in a different area of the brain. Anti-seizure drugs like gabapentin (neurontin) and similar don’t cause as much downregulation and are safer for long-term use.
TL:DR – Kindling is your brain remembering that you are replacing its natural chemical with another chemical, so it gets rid of its ability to use its natural chemical because it simply doesn’t need it anymore. Every time you re-expose the drug, your brain still remembers it and gets rid of its natural chemical more and more until it gets rid of so much that you either die, take years to heal, or live the rest of your life as an anxious, insomniac, and possibly epileptic wreck.
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