The Biology of Alcoholism

The previous volume, The Pathogenesis of Alcoholism: Psychosocial Factors, attempted to describe the interaction of biological, psychological, and social factors that lead to the initiation and perpetuation of alcoholism. The preface to that volume presented our particular view of the bio-. psycho-social interaction as a progressive process in which earlier developments produce new pathogenetic mechanisms, which in turn lead to still other cyclical feedback activities. Although influences from each of the three phenomenologic levels are at work during each stage of the clinical course, it would appear that social factors are most significant in the early phase, psychological factors at the intermediate level, and biological ones toward the end. These differences are only relative, however, for influences of all three types surely are operative during all stages of the syndrome. This appears to be particularly true for the biological parameters of activity. Don Goodwin (1976), who has supplied much of the data that support the role of hereditary factors in alcoholism, is wont to say that all living behavior is biological-by definition. The operational evidence for this is perhaps more evident in alcoholism than in other syndromes. For example, the general social indifference of many Asians to alcohol may reflect the presence of an atypical isoenzyme of alcohol dehydrogenase rather than some independently derived cultural norm.

of Volume 7.- 1 Genetic Factors in Alcohol Abuse: Animal Models.- Animal Models in Alcohol Research.- A Quantitative Genetic Model.- Genetically Defined Populations in Alcohol Research.- Selective Breeding.- Summary.- References.- 2 Genetic Factors in Alcoholism.- Common Methodological Problems in Research on Genetic.- References.- 3 Acute Pharmacological Actions of Ethanol on the Central Nervous System.- Membranes.- Effects of Ethanol on Brain Calcium.- Membrane-dependent Neurotransmitter Activity.- Summary.- References.- 4 Ethanol and Brain Mechanisms of Reward.- Substrates of Brain Stimulation Reward.- Substrates of Drug Reward.- Interactions of Drugs of Abuse with Brain-Stimulation Reward.- Speculations.- References.- 5 Ethanol as a Reinforcer: Comparison with Other Drugs.- Intravenous Drugs as Reinforcers.- Intragastric Drug Self-administration.- Ethanol and Other Drugs as Reinforcers by the Oral Route.- Summary and Conclusions.- References.- 6 A Behavioral Analysis of the Reinforcing Properties of Alcohol and Other Drugs in Man.- Behavioral Effects of Alcohol and Drugs.- Control of Behavior by Aversive Consequences.- Substance Abuse: Similarities and Differences.- Conclusions.- References.- 7 Neurochemical Aspects of Tolerance to and Physical Dependence on Alcohol.- Definitions of Functional Tolerance and Dependence.- Factors Modulating Ethanol Tolerance Development.- Effects of Ethanol Administration on Neurotransmitters.- Neurotransmitter Receptors.- Role of Neuronal Membranes in Development of Tolerance and Dependence.- Role of Condensation Products in Ethanol Tolerance and Dependence.- Conclusions.- References.- 8 Metabolic Mechanisms in Tolerance and Physical Dependence on Alcohol.- Metabolic Tolerance.- Metabolism Mechanisms in Physical Dependence.- References.- 9 Endocrine Mechanisms in Tolerance to and Dependence on Alcohol.- Alcohol-Endocrine Interactions.- Conclusions.- References.- 10 The Relationship of Tolerance and Physical Dependence to Alcohol Abuse and Alcohol Problems.- A Consideration of the Regulation of Alcohol Consumption.- Tolerance.- Physical Dependence.- Implications for Prevention and Treatment.- Conclusion.- References.- 11 Brain Dysfunction and Alcohol.- Structural Brain Damage.- Evoked Potentials.- Concluding Remarks.- References.- 12 Cognitive Deficits in Alcoholics.- Short-term Effects of Alcohol Ingestion.- Long-term Effects of Alcohol Ingestion.- Theoretical Considerations.- References.- 13 Prenatal Effects of Alcohol Abuse in Humans and Laboratory Animals.- Historical Introduction to Alcohol Abuse in Pregnancy.- Intrauterine Effects of Maternal Alcohol Abuse in Humans.- Animal Models of Maternal Alcohol Use and Abuse.- The Importance of Fetal Alcohol Syndrome to Problems of Female Alcohol Abuse.- Conclusions.- References.- 14 Amethystic Agents in the Treatment of Alcohol Intoxication.- Available Antagonists of Centrally Active Drugs.- Putative Alcohol Antagonists.- Conclusions and Recommendations for Future Study.- References.