Alcohol use disorder (AUD) involves a progression from impulsive to compulsive drinking behavior resulting in long-term, relapsing alcohol use. As individuals transition across these drinking domains, a negative emotional state (i.e. the “dark side of addiction”) emerges upon withdrawal, resulting in preoccupation with obtaining alcohol (Koob and Le Moal, 2005). Alcohol dependence can be conceptualized as a three-stage cycle, binge/intoxication, withdrawal/negative affect, and preoccupation/craving—that progressively escalates over time due to compensatory allostatic changes in the brain’s stress and reward systems. These aberrant brain functions are likely a consequence of altered gene and protein expression that underlie persistent plasticity changes in the neural circuits responsible for different motivational systems.
