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Neuroplasticity and Predictors of Alcohol Recovery

Recovery from alcoholism is a complex and long-term process with high relapse rates. Therefore, understanding why people relapse has been critically important to improving treatment outcomes. To that end, researchers are looking for clinical and biological markers that predict relapse after treatment and to use those risk factors to develop effective treatments to reduce relapse rates. One...

Neuroimmune Function and the Consequences of Alcohol Exposure

Induction of neuroimmune genes by binge drinking increases neuronal excitability and oxidative stress, contributing to the neurobiology of alcohol dependence and causing neurodegeneration. Ethanol exposure activates signaling pathways featuring high-mobility group box 1 and Toll-like receptor 4 (TLR4), resulting in induction of the transcription factor nuclear factor kappa-light-chain-enhancer of...

Alcohol’s Burden on Immunity Following Burn, Hemorrhagic Shock, or Traumatic Brain Injury

The incidence of traumatic injury in alcohol-intoxicated individuals continues to escalate. According to the Centers for Disease Control and Prevention (2012a), more than 38 million American alcohol users consume 5 or more drinks on the same occasion (i.e., binge drink) and do so about 4 times per month. This behavior is highly conducive to unintentional or accidental traumatic injury, which...

Stress and the HPA Axis: Role of Glucocorticoids in Alcohol Dependence

Stress, generally defined as any stimulus that disrupts the body’s internal balance (i.e., physiological homeostasis), has long been suggested to be an important correlate of uncontrolled alcohol consumption or relapse to drinking following a period of abstinence. Large epidemiological studies have reported that a variety of stressors are associated with increased alcohol consumption and binge...

Neural Pathways of Stress Integration: Relevance to Alcohol Abuse

Adaptation in the face of physical or psychological adversity is required for the survival, health, and well-being of all organisms. Adverse events, often denoted as “stressors,” initiate a diverse physiological response from multiple sources, including activation of the hypothalamic–pituitary–adrenal (HPA) axis.1 The HPA axis is responsible for the glucocorticoid component of the stress response...

Effects of Alcohol Dependence and Withdrawal on Stress Responsiveness and Alcohol Consumption

Although stress is known to be an important contributing factor to alcohol abuse and alcoholism, the interaction between stress and alcohol drinking behavior, as well as the mechanisms underlying this interaction in the context of dependence are complex and not well understood. On the one hand, alcohol is an effective anxiety-reducing agent (i.e., anxiolytic). Hence, motivation for drinking may be...

Genetic and Environmental Determinants of Stress Responding

The development of alcohol dependence is a complex process influenced by both genetic and environmental risk factors (Prescott and Kendler 1999). The relative contributions of genetic and environmental influences fluctuate across development. During adolescence the initiation of alcohol use is strongly influenced by environmental factors (Dick et al. 2007; Heath et al. 1997; Karvonen 1995...

Treatment of Alcohol Dependence With Drug Antagonists of the Stress Response

Although alcohol dependence affects 4 percent of the adult population and is the third leading cause of preventable death in the United States (Substance Abuse and Mental Health Services Administration 2009), fewer than 15 percent of people with alcoholism receive treatment (Hasin et al. 2007). The Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition Text Revision (DSM–IV–TR) ...

How Does Stress Lead to Risk of Alcohol Relapse?

It has long been known that stress increases the risk of alcohol relapse (Sinha 2001). Clinical observations, surveys, and epidemiological studies document an association between self-reports of stressors and subsequent return to drinking. Studies assessing alcohol relapse after treatment completion and discharge also indicate the contribution of highly stressful events independent of alcohol use...

Resilience to Meet the Challenge of Addiction: Psychobiology and Clinical Considerations

Evidence from different disciplines suggests that acute and chronic stress–related mechanisms play an important role in both the development and the chronic, relapsing nature of addiction (Baumeister 2003; Baumeister et al. 1994; Brady and Sinha 2005). Stress is defined as the physiological and psychological process resulting from a challenge to homeostasis by any real or perceived demand on the...