Alcoholism

Abstract

Alcohol has been consumed by humans for thousands of years, but its biological effects are complex and poorly understood. Similarly, alcoholism is a common and extremely debilitating condition for which there are no truly effective treatments, in part due to our incomplete understanding of the underlying biology of the condition. This chapter describes current understanding of the biology of alcohol intoxication and alcoholism, with a focus on the neurological and molecular bases for these phenomena. We explain what is known about how alcohol produces intoxication, tolerance and physical dependence, and how these relate to alcoholism. We describe risk factors for the development of alcoholism and how these relate to the acute and chronic effects of alcohol. We also outline the current treatments for alcoholism and some common co‚Äźmorbid disorders.

Key Concepts:

  • Alcoholism, like all addictions, is a disease.

  • Alcoholism is defined by repeated alcohol consumption despite known adverse consequences. The urge to drink is uncontrollable.

  • Alcoholism is distinct from the related phenomena of tolerance to alcohol and withdrawal from chronic alcohol exposure.

  • Alcohol is a weak and nonspecific drug, which acts through multiple molecular mechanisms.

  • There are few treatment options for alcoholism and those available have only limited success.

Keywords: ethanol; alcohol; alcoholism; craving; relapse; tolerance; withdrawal; naltrexone; acamprosate; disulfiram

Figure 1.

Sagittal section of the human brain illustrating the major mesocorticolimbic pathways involved in drug reward and reinforcement. Red lines represent dopaminergic projections from the VTA to the amygdala, NAc and medial frontal cortex. Green lines represent afferent fibres from the NAc that project back to the VTA.

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Further Reading

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National Institutes of Alcoholism and Alcohol Abuse (NIAAA) Frequently asked questions for the general public. Great resource for basic introduction to basic concepts in alcoholism. http://www.niaaa.nih.gov/alcohol‐health/overview‐alcohol‐consumption/alcohol‐use‐disorders

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Wallace, Melisa J, and Newton, Philip M(Aug 2012) Alcoholism. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0002010.pub3]