What makes alcohol addictive?

Several theories exist about why alcohol is addictive. These can be divided into three broad categories: biological, psychological, and social. The biological category consists of both proximate and ultimate causes. Proximate cause refers to the immediate physiological processes involved in how particular substances are more addictive than others. Less proximate causes include the genetic susceptibility toward being more prone to developing addiction. The ultimate cause refers to evolutionary explanations as to why humans developed an attraction to alcohol and why addiction became part of our genetic makeup. The evolutionary explanation on why humans drink alcohol was addressed in Question 4, which entailed the drunken monkey hypothesis. The proximate cause of alcohol's affect on the brain regarding the various neurotransmitter systems that alcohol impacts was addressed in Question 6. The various neurotransmitter systems seem to converge on dopamine. Like the expression "there are many roads to Rome," there are many neurotransmitter pathways to dopamine. Dopamine is the neurotransmitter in the brain that is most associated with reward. Alcohol increases dopamine both indirectly through other neurotransmitters as well as directly on dopamine itself. Research has demonstrated that dopamine is the neurotransmitter system affected by all drugs of abuse and probably influences all addictive behaviors. One of the most successful medications prescribed for smoking cessation is bupropion, known as Zyban, which increases dopamine in the brain. The genetics of alcohol addiction are covered in Question 21.

Learning Theory

Psychological and social theories also explain how alcohol is addictive. These theories can be thought of together under one broad category known as psychosocial theory. The most well-known and prominent theory is learning theory. Learning theory includes classical conditioning, operant conditioning, and modeling.

Classical Conditioning

Classical conditioning is a form of learning that occurs when a stimulus is paired in time with a reward that causes an automatic response. Pavlov, a Russian physiologist, used dogs as his subjects to demonstrate this basic phenomenon. In Pavlovs now classic experiment, a bell (stimulus) was paired with food (reward), causing a dog to salivate. After repeated pairings, the food could be removed, and the bell alone would cause a dog to salivate. This automatic response required no conscious learning on the dog's part.

Bupropion generic for Wellbutrin, marketed as an antidepressant, and Zyban, marketed as a smoking cessation medication.

Zyban see bupropion.

Psychosocial theory a theory developed in the early 1900s that the cause of mental illness pertains to environmental circumstances.

Learning theories pertain to the acquisition of knowledge and skills and modi fying behavior to learn new behaviors through behavior modification interventions (positive and negative reinforcement, extinction) and cognitive behavior interventions.

Classical conditioning a type of learning that results when a conditioned and unconditioned stimulus are paired together, resulting in a similar response to both stimuli.

Operant conditioning a type of learning that is concerned with the relationship between voluntary behavior and the environment.

Modeling learning through pervasive imitation.

Intermittent reinforcement the reinforcement of a behavior (the reward) that occurs some of the time as opposed to continuous reinforcement that occurs every time after the behavior occurs.

Extinction elimination of a classically conditioned response by the repeated presentation of the conditioned stimulus without the unconditioned stimulus.

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