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Name: Alexey Boris Kampov-Polevoy Birth: December 23, 1950; Moscow, USSR Education: MD in Internal Medicine, 1st Moscow Medical School, USSR, 1974; PhD in Pharmacology, Institute of Pharmacology USSR Academy of Medical Sciences, 1979. Experience: Fellow, UNC-Bowles Center for Alcohol Studies, Department of Psychiatry, University of North Carolina at Chapel Hill, 1994-present; Research Scholar, Department of Psychiatry, Chemical Dependency Treatment Program, University of Minnesota, Minneapolis, MN, 1991-1993; Professional-in-Residence, Betty Ford Chemical Dependency Treatment Center, Palm Beach, CA, 1990; Resident, Hazelden Foundation (for chemical dependency treatment), Center City, MN, 1990; Visiting scientist, Biomedical Research Center of Alko Ltd., Helsinki, Finland, 1989; Senior Researcher, Institute of Pharmacology, USSR Academy of Medical Sciences, 1979-1992; Instructor, Department of Pharmacology, 1st Moscow Medical School, 1977-1978. Family: Married to Julia D. Khanova with 2 children, Anastasia and Alexander.

If Alexey Kampov-Polevoy, UNC-Bowles Center for Alcohol Studies researcher, is correct, the legendary jazz saxophonist John Coltrane's twin addictions to sweets and alcohol may prove to be more than a coincidence. Kampov-Polevoy has discovered that preference for sweets is systematically linked to craving for alcohol among both laboratory rats and human alcoholics. Kampov-Polevoy hopes to use this data to explore diagnostic tools and treatment options for alcoholism.

In a series of experiments on several strains of rats genetically predisposed through selective breeding to drink alcohol, Kampov-Polevoy found that the rats consume more of a sugar solution and prefer more concentrated sweet solutions than do normal rats. In fact, animals bred to prefer alcohol may ingest double or triple the amount of a sweet solution compared to rats without such a genetic predisposition.

"Loss of control over sweets predicts a loss of control over alcohol."

The finding that alcohol-preferring rats prefer more concentrated sweet solutions than normal rats has been replicated with human alcoholics. In an experiment published in the February 1997 issue of The American Journal of Psychiatry, Kampov-Polevoy asked 20 alcoholic men who had been detoxified from alcohol for at least 28 days and 37 men who had never been diagnosed as alcoholics to rate the sweetness of and their preference for each of five sugar solutions varying in sweetness. Study participants, who were not told which of the solutions they were sampling, tasted the solutions in random order. Sweetness of each solution was rated on a scale ranging from "not sweet at all" to "extremely sweet," while preference for each solution was rated on a scale ranging from "disliked very much" to "liked very much."

The results were striking. Sixty-five percent of the detoxified alcoholics preferred the most concentrated sugar solution, which had more than twice the sweetness of a cola. In contrast, a scant 16% of nonalcoholic subjects preferred the most concentrated sugar solution (see below). The solution most frequently preferred by the nonalcoholic subjects was only half as sweet as the solution preferred by the alcoholics. Detoxified alcoholics were much more likely than nonalcoholic subjects to have a strong sweet preference.

Distribution of subjects preferring different sucrose concentrations in the nonalcoholic control group (N=37), and alcoholics from North Carolina (N=20) and Indiana (N=19) samples.
Nonalcoholic subjects * Preferred sucrose concentration (M)	Nonhospitalized alcoholics ** IN Sample Preferred sucrose concentration (M)	Detoxified alcoholics* NC Sample Preferred sucrose concentration (M)
Most nonalcoholics preferred solutions half as sweet as those preferred by alcoholics. 65% of detoxified alcoholics, compared with 16% of nonalcoholic subjects, preferred the most concentrated sugar solution (0.83M) in the Carolina Sweet Test.
*AB Kampov-Polevoy, JC Garbutt, D Janowsky. Preference for high concentration of sucrose solution in alcoholics. American Journal of Psychiatry. 154: 269-270; 1997. **AB Kampov-Polevoy, JI Nurnberger, JC Garbutt, D Janowsky. Sweet liking and high novelty seeking in different samples of alcoholics: Replication. Alcoholism Clinical and Experimental Research, 21(3) p. 30A; 1997.

The characteristic that distinguishes both alcohol-preferring rats and alcoholic humans is not that they drink alcohol and that they eat sweets—since nonalcoholic animals and humans consume alcohol and sweets—but that they appear to be unable to check their consumption of sweets and alcohol. "It is not alcohol drinking per se that reflects alcoholism," remarks Kampov-Polevoy, "it is loss of control over drinking. Loss of control over sweets predicts a loss of control over alcohol consumption."

The loss of control over sweet intake and alcohol consumption may be mediated by common neurochemical pathways in the brain that control perception of and responses to the rewarding aspects of environmental stimuli. Both alcohol consumption and consumption of sweets are known to affect the brain opioid system. It is possible that alterations in the functioning of systems such as the opioid system alter the rewarding properties of alcohol and sweets among alcoholics and contribute to a loss of control over their intake.

Kampov-Polevoy emphasizes that, although the sweet test was able to identify alcoholics in this study, the fact that 16% of the nonalcoholic subjects (like the majority of alcoholics) preferred the sweetest solution indicates that a strong liking for sweets alone is not enough to indicate the presence or likelihood of alcoholism. Kampov-Polevoy believes that craving for sweets combined with particular personality traits may identify a predisposition to alcoholism more definitively than the sweet test alone. Applying the standardized Tridimensional Personality Questionnaire, Kampov-Polevoy has learned that sweet-liking alcoholics score high on the personality traits of harm avoidance and novelty seeking, but sweet-likers who are not alcoholics tend to score low on both of these traits. Thus, a preference for sweets combined with the traits of high harm avoidance and high novelty seeking may prove to be more strongly predictive of a tendency to alcoholism than the preference for sweets alone. "The sweet-liking alcoholic," says Kampov-Polevoy, "is a person who might love to sky dive but is afraid to go to the airplane."

The Sweet Team: J.C. Garbutt, Alexei Kampov-Polevoy, Linda L. Powell, David Overstreet, David Janowsky, John I. Nurnberger, Jr. (not pictured).

Kampov-Polevoy first became interested in the association between alcoholism and intake of sweets in the late 1980s as a clinician in his native Russia, where he noted that recovering alcoholics have a particular affinity for candy and other sweets. Kampov-Polevoy observed that recovering alcoholics heaped teaspoon after teaspoon of sugar in their coffee and that they tended to consume large quantities of candy and cookies. The chocolate Hershey Kisses on Kampov-Polevoy's office desk disappeared so quickly during counseling sessions that he stopped filling the dish. When he asked his mentor and colleagues whether or not they had noticed a similar association between alcoholism and intake of sweets, they concurred with his observations. However, Kampov-Polevoy found very little on this topic in the scientific literature. Until Kampov-Polevoy began his systematic study and documentation of the association between craving for sweets and excessive alcohol drinking, the association existed largely as folklore.

To date, Kampov-Polevoy's studies in human patients have been conducted among alcoholics in recovery or among close relatives of alcoholics. Because preference for sweet solutions is tested after the alcoholism is established, the possibility cannot be ruled out that the alcoholism itself affected the preference for sweet solutions. In order to rule out this possibility, Kampov-Polevoy plans to administer the sweet test to schoolchildren and to quantify prospectively over the long term the subsequent incidence of alcohol-related problems among those exhibiting a sweet preference compared with those not exhibiting a sweet preference. Kampov-Polevoy expects to find that children with a preference for highly concentrated sweet solutions experience a higher subsequent incidence of alcohol-related problems than children not exhibiting a sweet preference.

Kampov-Polevoy hopes that his findings with the sweet test will pave the way for an easy-to-administer diagnostic test for risk of developing alcoholism. Kampov-Polevoy emphasizes the importance of proper education concerning the results of diagnostic tests. Says Kampov-Polevoy, "If in the future an individual is shown in a diagnostic sweet test to have a predisposition to alcoholism, this finding should not be viewed as a stigma, but as an opportunity. This finding will give the individual a chance of modifying behavior to correct a problem before it happens. Almost everything is more manageable when it is known in advance."

In addition to their use in diagnostic tests, sweets may one day be used in the treatment of alcoholism. Kampov-Polevoy cites the fact that many treatment counselors urge consumption of sweets as one method of alleviating the craving for alcohol. Consistent with this recommendation, Kampov-Polevoy's experiments have shown that alcohol-preferring rats consuming a saccharine solution (used to avoid the complication of calories from sugar) for approximately 4 days reduced their intake of alcohol compared with alcohol-preferring animals consuming water containing no saccharine. Interestingly, the reduction in alcohol intake among saccharine-treated rats persisted for 7 to 10 days after the saccharine was removed. These findings suggest the intriguing possibility that the increased sweet consumption among human alcoholics abstaining from alcohol may be a form of self-medication—a possibility objectified by John Coltrane, who conquered his addictions to alcohol and heroin but never could abstain from sweet potato pie.