NDLI: Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Breese, George R. Sinha, Rajita Heilig, Markus
Description	Country affiliation: United States Author Affiliation: Breese GR ( Bowles Center for Alcohol Research and the UNC Neuroscience Center, UNC School Of Medicine, Chapel Hill, NC 27599, USA. george_breese@med.unc.edu)
Abstract	Alcoholism is a chronic relapsing disorder. Major characteristics observed in alcoholics during an initial period of alcohol abstinence are altered physiological functions and a negative emotional state. Evidence suggests that a persistent, cumulative adaptation involving a kindling/allostasis-like process occurs during the course of repeated chronic alcohol exposures that is critical for the negative symptoms observed during alcohol withdrawal. Basic studies have provided evidence for specific neurotransmitters within identified brain sites being responsible for the negative emotion induced by the persistent cumulative adaptation following intermittent-alcohol exposures. After an extended period of abstinence, the cumulative alcohol adaptation increases susceptibility to stress- and alcohol cue-induced negative symptoms and alcohol seeking, both of which can facilitate excessive ingestion of alcohol. In the alcoholic, stressful imagery and alcohol cues alter physiological responses, enhance negative emotion, and induce craving. Brain fMRI imaging following stress and alcohol cues has documented neural changes in specific brain regions of alcoholics not observed in social drinkers. Such altered activity in brain of abstinent alcoholics to stress and alcohol cues is consistent with a continuing ethanol adaptation being responsible. Therapies in alcoholics found to block responses to stress and alcohol cues would presumably be potential treatments by which susceptibility for continued alcohol abuse can be reduced. By continuing to define the neurobiological basis of the sustained alcohol adaptation critical for the increased susceptibility of alcoholics to stress and alcohol cues that facilitate craving, a new era is expected to evolve in which the high rate of relapse in alcoholism is minimized.
File Format	HTM / HTML
ISSN	01637258
e-ISSN	1879016X
DOI	10.1016/j.pharmthera.2010.09.007
Journal	Pharmacology & Therapeutics
Issue Number	2
Volume Number	129
Language	English
Publisher	Elsevier
Publisher Date	2011-02-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Therapeutics Discipline Pharmacology Alcoholism Physiopathology Psychology Allostasis Behavior, Addictive Kindling, Neurologic Stress, Psychological Alcohol Drinking Genetics Therapy Animals Cues Recurrence Substance Withdrawal Syndrome Metabolism Temperance Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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