Evidence shows that heavy alcohol use modifies the structure and physiology of the brain, although the extent of recovery after years of abstinence is unclear.

Recent neuroimaging studies have revealed that chronic alcoholism can damage the cerebellum, which plays an important role in regulating motor control, attention and language. It can also cause the prefrontal cortex to shrink and degrade, potentially impairing decision-making skills and social behavior. Studies have also found damage in the white matter of the brain, which connects these regions.

The question remains, however, whether such extensive damage can be reversed after abstaining from alcohol. Researchers have studied the effects of abstinence on the brains of alcohol-dependent individuals by comparing subjects recovering from years of alcohol abuse with those who do not drink or drink minimally. Scientists have also investigated changes in brain volume in initial versus sustained abstinence in one set of subjects.

Several of these studies have shown that years of abstaining from booze can allow brain regions to return to their original volume and can repair neural connections across different regions. Much of this restoration occurs in the system most adversely affected by chronic alcoholism—the frontocerebellar circuitry, which regulates decision making, reasoning and problem solving.

Other reports, however, have found sustained injury in certain areas. Some former alcohol abusers show permanent damage to the hippocampus, a brain region that regulates long-term memory and spatial navigation, and only partial resolution of lesions on the white matter.

Although the effects of abstinence on the alcohol-abused brain vary, it appears that we display at least some ability to recover from the effects of excessive drinking. Future neuroimaging studies should clarify the full extent and potential for recuperation.