Stress associated with chronic alcohol exposure and withdrawal results in a dysregulated HPA axis. Resultant elevated glucocorticoids dampen HPA activity through negative feedback, but there is evidence that glucocorticoids induce CRF activity in extra-hypothalamic sites such as the amygdala (Sawchenko, 1987). Thus, chronic alcohol exposure may ultimately dampen HPA axis while accentuating extra-hypothalamic CRF activity. This, in turn, may contribute to chronic alcohol-induced negative affect and increased motivation to drink (Koob, 2013; Lu and Richardson, 2014).
