Abstinence does not work because the alcohol-dependent brain will not rest until it has a drink. This is the reason members of AA have to go to meetings the rest of their lives. Even though they haven’t had a drink in ten years, the brain that became addicted to alcohol remains addicted to alcohol.
This is why AA is correct when they state that even if you haven’t had a drink for 20 years, if you slip, you begin drinking right where you left off. It reveals to us that abstinence does not change the fundamental neurobiology of addiction, no matter how long you’ve gone without a drink.
Alcohol Deprivation Effect
At some point, most alcohol-dependent drinkers are unable to fend off the urge to drink, no matter what they try. When people do drink after sustained abstinence, it is more often than not a self-destructive binge characterized by larger quantities of use than before they stopped. This is also a part of the Alcohol Deprivation Effect.
The basic reason that this occurs is that the neurological disorder (i.e. addiction) that develops after repeated drinking is primarily about the association your brain has created between alcohol and pleasure. This is called Operant Conditioning, which is a type of learning. When you drink, the pleasure you get is from the release of endorphins.
This un-learning or pharmacological extinction occurs every time you drink with naltrexone, because your brain gradually no longer associates alcohol with pleasure. Eventually, your brain will lose interest in alcohol, and you will find that you can take it or leave it.
Abstinence does not teach your brain this lesson, because as far as your brain is concerned, the last time you drank alcohol, it received its fix of endorphins. This is true even if you haven’t had a drink in over a decade.