We now report on a more comprehensive and extended 10-year follow-up and re-examination of acute responses to alcohol in the CSDP. We shift the analytical focus to examine differences in the acute responses to alcohol, based on who, among the entire sample, did or did not manifest AUD after a decade of natural drinking. The approach comprises a three-phase assessment, i.e., initial, 5- and 10-yr examinations of alcohol responses in young adulthood through middle age. We evaluated the existence of adaptive changes in subjective responses to alcohol consumption in the development and progression of addiction. Our goal was to determine whether AUD is marked by increases, decreases, or no change in the sensitivity to alcohol’s stimulating, motivating, rewarding, or sedating effects.