According to the research conducted by the VA program's Substance Abuse Team, levels of the hormone cortisol substantially increase during the progression from chronic intoxication to withdrawal. This results in sleep disruption, cognitive deficits, diabetes, and mood disturbances.

"It has not been known whether the body adapts to the stress of drinking following daily heavy drinking in the non-laboratory setting, or whether cortisol levels continue to be elevated even after several weeks or months of drinking," said study author Bryon H. Adinoff, distinguished professor in the department of psychiatry at the University of Texas Southwestern Medical Center at Dallas and medical director of the Substance Abuse Team. "In this study, we show that even persons drinking for several months continue to show elevated levels of cortisol. In addition, levels of cortisol increase even further when the drinking stops. This increase occurs even before alcohol is gone from the body. The daily, heavy drinker may therefore have levels of cortisol two to three times the normal amount throughout the day and night."

Researchers studied two groups of males. One group was comprised of 73 alcohol-dependent patients seeking treatment in an intoxicated, withdrawal, or post-withdrawal situation, while the other group, comprised of 22 men, included alcohol-dependent patients who had enrolled in a residential treatment program and were abstaining from alcohol.

Researchers examined the cortisol levels of the participants through saliva tests and measured their breath-alcohol concentrations.

The findings showed that the cortisol concentrations in the alcohol-dependent participants increased during both intoxication and withdrawal.

"The confirmation that cortisol does, indeed, remain elevated throughout the drinking cycle suggests that it may be important to decrease cortisol levels during both chronic drinking and withdrawal," said Adinoff. "This suggestion is tentative, however, as it has not yet been shown that it is cortisol itself that is responsible for the medical and psychiatric problems associated with heavy drinking. Future studies should explore the relationship between elevated levels of cortisol during intoxication and withdrawal and the medical and psychiatric consequences of drinking, which may include sleep disruption, cognitive deficits, diabetes, and mood disturbances."

The study is published in the September 2003 issue of the journal Alcoholism: Clinical & Experimental Research.

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