Table 1: The journey from responsible alcohol drinking to alcoholism - stahes and possible mechanisms [22,195,196].

Stages of alcohol addiction Possible mechanisms discussed in the review
1. Acute phase

Positive reinforcement

Negative reinforcement

Rising BAC, dopamine, opioid, GABA and serotonin receptors

Falling BAC, glutamate, NMDA and GABA receptors, and receptor/voltage gated Na+ channels.
2. Hangover/Tolerance craving Alcohol metabolism, acetaldehyde accumulation, excitatory
neurotransmitters, inflammatory signaling, serotonin receptors
3. Alcohol addiction Adenosine, dopamine, serotonin, GABA and glutamate receptors.
4. Withdrawal symptoms NMDA/Glutamate receptors, GABA, hyper-excitation, seizures.