Alcohol and Cocaine Damage the Brain. Toronto Mayor At Risk
By Paddy Kamen, Publisher, BetterBrainBetterLife.com
The miracle that is Rob Ford’s brain has been fascinating to watch during the past year. Seldom do we witness such a public and ongoing array of rude and risky behavior from an elected official.
Why do I call Ford’s brain a miracle? Based on scientific research into the effects of alcohol and cocaine on the brain, it seems miraculous that Ford’s brain can function at all, for chronic misuse of alcohol and cocaine is proven to cause widespread brain damage. The frontal lobes (or prefrontal cortex), the cerebral cortex, and the amygdala are all impaired by over-consumption of alcohol.
Is Ford an addict? He declares not, and I’m in no position to know. He does admit to frequent drunken stupors and has been videotaped staggering around as if under the effects. But really, the proof of the pudding is in the tasting: while we can’t see the activity within Rob Ford’s brain, we can witness his behaviors and judge from them whether or not a problem might exist. I contend that voters should be concerned about Ford holding such a prominent position, for science shows us that higher-level thinking is seriously, and to some degree permanently, impaired by over-consumption of alcohol.
By Paddy Kamen, Publisher, BetterBrainBetterLife.com
The miracle that is Rob Ford’s brain has been fascinating to watch during the past year. Seldom do we witness such a public and ongoing array of rude and risky behavior from an elected official.
Why do I call Ford’s brain a miracle? Based on scientific research into the effects of alcohol and cocaine on the brain, it seems miraculous that Ford’s brain can function at all, for chronic misuse of alcohol and cocaine is proven to cause widespread brain damage. The frontal lobes (or prefrontal cortex), the cerebral cortex, and the amygdala are all impaired by over-consumption of alcohol.
Is Ford an addict? He declares not, and I’m in no position to know. He does admit to frequent drunken stupors and has been videotaped staggering around as if under the effects. But really, the proof of the pudding is in the tasting: while we can’t see the activity within Rob Ford’s brain, we can witness his behaviors and judge from them whether or not a problem might exist. I contend that voters should be concerned about Ford holding such a prominent position, for science shows us that higher-level thinking is seriously, and to some degree permanently, impaired by over-consumption of alcohol.
Brain scanning technologies and recent research support what seems to be the reality in Rob Ford’s case: he can think his way through some situations but not others. It’s one thing to know that it’s important to celebrate your football team’s success (as a volunteer coach), but another thing to evaluate whether tax dollars should be spent to do so. It’s one thing to ask staff to draft a memo on city business and another entirely to ask them to buy you personal items such as laundry soap and booze (allegations from former staff as reported by a police investigation).
It’s possible that the executive functions of Rob Ford’s brain have been affected by frequent binge drinking and at least occasional crack cocaine use. Researchers from the Federal University of Espirito Santo in Brazil and the Harvard Medical School found that while heavy drinkers may be able to do complex calculations or read a map, their ability to change their thinking in response to changing circumstances and to inhibit behaviors that harm others, is limited by damage to their frontal lobes and cerebral cortex. And so, in Rob Ford’s case, we see one level of thinking in denying an allegation of sexual impropriety from a former staff member and another, apparent lack of higher-level thinking when he brings his wife along to the news conference and humiliates her with crude remarks.
The study found that damage to the areas of the brain responsible for executive functions shows up on MRI scans even before inappropriate behaviors manifest, and is therefore predictive of lack of judgment. Such scans might eventually be used as screening tools, much like blood-screening for drugs is used for some jobs. Perhaps citizens could require individuals running for office to undergo such tests? Surely we deserve politicians capable of higher-level thinking?
Ester M. Nakamura-Palacios, an author of the study, says, “…an alcohol user may present executive dysfunctions even when clinical signs of alcohol dependence are absent or mild and their more global mental status is still preserved.” MRI scans may therefore provide an excellent diagnosis of addiction, opening the way to earlier remediation. Nakamura-Palacios posits that the brain reorganizes after a ‘toxic insult’ (i.e. alcohol abuse) and essentially sacrifices the higher functions in order to maintain those that use fewer resources. “It seems that the brain will sacrifice first the networks that cannot be sustained because of the high cost of their retention; this is true when metabolism is limited or persistent damage is on the rise.”
It’s possible that the executive functions of Rob Ford’s brain have been affected by frequent binge drinking and at least occasional crack cocaine use. Researchers from the Federal University of Espirito Santo in Brazil and the Harvard Medical School found that while heavy drinkers may be able to do complex calculations or read a map, their ability to change their thinking in response to changing circumstances and to inhibit behaviors that harm others, is limited by damage to their frontal lobes and cerebral cortex. And so, in Rob Ford’s case, we see one level of thinking in denying an allegation of sexual impropriety from a former staff member and another, apparent lack of higher-level thinking when he brings his wife along to the news conference and humiliates her with crude remarks.
The study found that damage to the areas of the brain responsible for executive functions shows up on MRI scans even before inappropriate behaviors manifest, and is therefore predictive of lack of judgment. Such scans might eventually be used as screening tools, much like blood-screening for drugs is used for some jobs. Perhaps citizens could require individuals running for office to undergo such tests? Surely we deserve politicians capable of higher-level thinking?
Ester M. Nakamura-Palacios, an author of the study, says, “…an alcohol user may present executive dysfunctions even when clinical signs of alcohol dependence are absent or mild and their more global mental status is still preserved.” MRI scans may therefore provide an excellent diagnosis of addiction, opening the way to earlier remediation. Nakamura-Palacios posits that the brain reorganizes after a ‘toxic insult’ (i.e. alcohol abuse) and essentially sacrifices the higher functions in order to maintain those that use fewer resources. “It seems that the brain will sacrifice first the networks that cannot be sustained because of the high cost of their retention; this is true when metabolism is limited or persistent damage is on the rise.”
The brain’s frontal lobes are also damaged by cocaine use, as was demonstrated in research from the University of Cambridge. Dr. Karen Ersche, of the Behavioural and Clinical Neuroscience Institute, discovered that cocaine users had almost twice the brain volume loss, particularly in the prefrontal cortex, as did healthy subjects. Ersche’s research was couched in the context of brain aging. She notes: “As we age, we all lose grey matter. However, what we have seen is that chronic cocaine users lose grey matter at a significantly faster rate, which could be a sign of premature ageing. Our findings therefore provide new insight into why the cognitive deficits typically seen in old age have frequently been observed in middle-aged chronic users of cocaine.” She reminds us that poor decision-making and ability to pay attention (or focus), combined with a lack of self-regulation, are hallmarks of people with this sort of brain damage.
Higher-level thinking is also difficult or impossible in people with reduced volume in the brain’s cerebral cortex, a thin layer of gray matter covering the surface of each cerebral hemisphere. Catherine Brawn Fortier, a neuropsychologist and researcher at the VA Boston Healthcare System and Harvard Medical School, and her colleagues compared high-resolution structural magnetic resonance scans from 65 participants in two demographic groups: 31 abstinent alcoholic participants (20 men, 11 women) and 34 non-alcoholic control participants (20 men, 14 women). They discovered that the outer layer of the cortex across the entire brain was reduced in those who had been heavy drinkers and that the degree of shrinkage was directly related to the amount of alcohol consumed. Says Fortier: “Pathology is often thought of as occurring as an all-or-none phenomenon—you either have brain damage or you don’t. This study shows that the damage occurs in gradations, and the more you drink, the greater the damage.”
How does this damage manifest? Fortier explains: “Severe reductions in frontal brain regions can result in a dramatic change to personality and behavior, taking the form of impulsivity, difficulty with self-monitoring, planning, reasoning, poor attention span, inability to alter behavior, a lack of awareness of inappropriate behavior, mood changes, even aggression.” Does this sound like anyone we know?
Fortier points out one of the tragedies of substance abuse: “…the very brain structures that are the most impacted are the ones that you need to change problematic behavior.” The same appears to be true of cocaine use; the Ersche study leads researchers to believe that reduction in brain volume is directly associated with an increased impulse to use cocaine.
It can, therefore, be extremely difficult, if not impossible for the brain damaged by drugs and alcohol to change, and we should not be surprised if the blustering, inappropriate, rude and crude personality that is Rob Ford continues to find it impossible to work effectively with other elected representatives (not to mention treating them with respect), or even show up for executive meetings of city council when the high school football team he coaches is on the field. How can he sort out his priorities if he is not capable of higher-level thinking?
Higher-level thinking is also difficult or impossible in people with reduced volume in the brain’s cerebral cortex, a thin layer of gray matter covering the surface of each cerebral hemisphere. Catherine Brawn Fortier, a neuropsychologist and researcher at the VA Boston Healthcare System and Harvard Medical School, and her colleagues compared high-resolution structural magnetic resonance scans from 65 participants in two demographic groups: 31 abstinent alcoholic participants (20 men, 11 women) and 34 non-alcoholic control participants (20 men, 14 women). They discovered that the outer layer of the cortex across the entire brain was reduced in those who had been heavy drinkers and that the degree of shrinkage was directly related to the amount of alcohol consumed. Says Fortier: “Pathology is often thought of as occurring as an all-or-none phenomenon—you either have brain damage or you don’t. This study shows that the damage occurs in gradations, and the more you drink, the greater the damage.”
How does this damage manifest? Fortier explains: “Severe reductions in frontal brain regions can result in a dramatic change to personality and behavior, taking the form of impulsivity, difficulty with self-monitoring, planning, reasoning, poor attention span, inability to alter behavior, a lack of awareness of inappropriate behavior, mood changes, even aggression.” Does this sound like anyone we know?
Fortier points out one of the tragedies of substance abuse: “…the very brain structures that are the most impacted are the ones that you need to change problematic behavior.” The same appears to be true of cocaine use; the Ersche study leads researchers to believe that reduction in brain volume is directly associated with an increased impulse to use cocaine.
It can, therefore, be extremely difficult, if not impossible for the brain damaged by drugs and alcohol to change, and we should not be surprised if the blustering, inappropriate, rude and crude personality that is Rob Ford continues to find it impossible to work effectively with other elected representatives (not to mention treating them with respect), or even show up for executive meetings of city council when the high school football team he coaches is on the field. How can he sort out his priorities if he is not capable of higher-level thinking?
Here is a list of some of the challenges for the brain damaged by alcohol and crack cocaine, with a few examples of behaviors we have seen from Rob Ford that appear consistent with such damage:
1. Poor impulse control (drinking to excess in public places, rude remarks made to the media, pushing over a colleague in the city hall council chamber).
2. A seeming inability to alter behavior (how many ‘drunken stupors’ have their been?).
3. Lack of awareness of inappropriate behavior (reading while driving a car and crude remarks before the media).
4. Difficulty self-monitoring (apparent association with known criminals).
5. Aggressive mood changes (video clips of Mr. Ford in a rage threatening to kill others).
6. Inflexible thinking (while we can’t know what Ford is thinking, defending reading while driving a car because he is a ‘busy man’ might signal inflexible cognitive abilities).
7. Poor assessment of social cues (reportedly having to be asked to leave several events due to behavior problems).
8. A tendency to blame others when he becomes uncomfortable (referring to other councilors as ‘corrupt’, calling journalists ‘pathological liars’, journalists being told they ‘didn’t ask the right question’).
9. Poor risk assessment (all of the above).
I, personally, have empathy for anyone suffering from behavioral challenges caused by substance abuse. I have lived through substance abuse issues with people I love dearly. At the same time, I wouldn’t want to put a person who lacked higher-level thinking ability in charge of a city, town, hamlet or even a football team.
I imagine that introspection might be in order when one becomes the subject of derisive commentaries and conversations around the world. But then, introspection is higher-level thinking, and the science research cited above shows that some people are no longer capable of this. I wonder what Rob Ford’s brain is capable of learning? Humility? Sensitivity? Responsibility? Perspective?
I’ve always believed that anyone can change, but it seems that the brain can only take so much abuse. Do I believe in miracles? Do you? Do the voters of Toronto?
1. Poor impulse control (drinking to excess in public places, rude remarks made to the media, pushing over a colleague in the city hall council chamber).
2. A seeming inability to alter behavior (how many ‘drunken stupors’ have their been?).
3. Lack of awareness of inappropriate behavior (reading while driving a car and crude remarks before the media).
4. Difficulty self-monitoring (apparent association with known criminals).
5. Aggressive mood changes (video clips of Mr. Ford in a rage threatening to kill others).
6. Inflexible thinking (while we can’t know what Ford is thinking, defending reading while driving a car because he is a ‘busy man’ might signal inflexible cognitive abilities).
7. Poor assessment of social cues (reportedly having to be asked to leave several events due to behavior problems).
8. A tendency to blame others when he becomes uncomfortable (referring to other councilors as ‘corrupt’, calling journalists ‘pathological liars’, journalists being told they ‘didn’t ask the right question’).
9. Poor risk assessment (all of the above).
I, personally, have empathy for anyone suffering from behavioral challenges caused by substance abuse. I have lived through substance abuse issues with people I love dearly. At the same time, I wouldn’t want to put a person who lacked higher-level thinking ability in charge of a city, town, hamlet or even a football team.
I imagine that introspection might be in order when one becomes the subject of derisive commentaries and conversations around the world. But then, introspection is higher-level thinking, and the science research cited above shows that some people are no longer capable of this. I wonder what Rob Ford’s brain is capable of learning? Humility? Sensitivity? Responsibility? Perspective?
I’ve always believed that anyone can change, but it seems that the brain can only take so much abuse. Do I believe in miracles? Do you? Do the voters of Toronto?