chapter  4
20 Pages

Drug Therapy for Alcohol Dependence

People who drink alcohol over long periods and excessively also have craving, defined as the conscious desire or urge to drink alcohol. Intense crav­ ing leads to a preoccupation with alcohol and increases the probability of drink­ ing (Anton, Moak, & Latham, 1995). Craving can occur in several circumstances: before alcohol ingestion, during alcohol ingestion, during acute withdrawal, and during exposure to the sight or smell of alcohol long after drinking has stopped. Craving has been linked to dopaminergic, serotonergic, and opioid systems that mediate positive reinforcement and to γ-aminobutyric acid, glutamatergic, and noradrenergic systems that mediate withdrawal (Littleton & Little, 1994). Reductions in craving are associated with longer abstinence (Anton, Moak, & Latham, 1996; Rohsenow et al., 1992).