Alcohol craving has been defined as a strong desire to consume alcohol and has been associated with loss of control over drinking, which is part of the alcohol dependence syndrome, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Although there has been some controversy over the definition and use of the term, the endophenotype of craving is a construct that is central to alcohol dependence and is often a target of intervention effort.60-63 Although there has been controversy over the measurement of subjective “craving” in humans, craving and loss of control drinking have been biologically linked to the actions of alcohol on the mesolimbic and mesocortical dopamine pathways in the brain (the neural substrates that putatively underlie the attribution of incentive salience to alcohol and other drugs of abuse), which is thought to be an important factor in the etiology of alcohol dependence. Individual differences in the development of loss of control drinking and the ability to stop drinking are likely to be related to genetic factors that influence the effects of alcohol on mesolimbic dopamine activation and craving.
