Neurobiology of alcohol addiction

Abstract

Consumption of alcohol is the third leading cause of preventable deaths worldwide making it a major public health issue. After a brief account of the history and current situation of alcohol use and abuse, we describe the clinical pictures of the most severe neuropsychiatric consequences of pathological alcohol consumption, namely, alcohol addiction, Wernicke's encephalopathy, and fetal alcohol syndrome. We then explain the neurobiological and pharmacological mechanisms of alcohol's action in the brain that underlie its rewarding effects in humans and other animals. We point out how genetic factors in interaction with the environment influence the risk for heavy drinking, which ultimately may lead to alcohol addiction, a chronic relapsing disorder where relapse is characterized by compulsive alcohol seeking, and the loss of control in limiting alcohol intake. We account for some influential theories that try to explain the dysregulation in brain circuits along the development into an addicted state, and based on these concepts we point to pharmacological strategies that can reduce the risk for relapse and thus will be helpful in managing alcohol-addicted patients.