Recent advancements in understanding brain alcohol metabolism opens new avenues for understanding individual differences in alcohol’s subjective effects and behavioral consequences. The discovery of regional and cell-specific distributions of alcohol-metabolizing enzymes —and the impact of their manipulation on motor and cognitive functions— presents groundbreaking opportunities for novel therapeutic targets. Further research could determine the behavioral impact of alcohol metabolism in other brain-specific regions, the effect of different patterns of alcohol intake on this local metabolism, and the timing of developmental alcohol exposure, such as drinking in youth or in utero exposure. Mechanistic studies in humans are challenging, but neuroimaging studies and in vitro human-banked tissue studies of specific brain regions could be instrumental in demonstrating translational value. In addition, ethanol alters the pharmacokinetics and pharmacodynamics of numerous medications, raising concerns about increased toxicity and impaired efficacy. Could some of the pharmacodynamic interactions between alcohol and other drugs be mediated by common pharmacokinetic processes at the central level?
