Behavioral Neurobiology of Alcohol Addiction: A Decade of Great Challenges, New Hopes, and Hypes.

Over a decade after the first edition of "Behavioral Neurobiology of Alcohol Addiction," the field faces persistent challenges and emerging opportunities in developing treatments for alcohol use disorder (AUD). The translational gap between preclinical findings and new treatments remains, exacerbated by a replicability crisis in animal research, publication biases, and limited predictive validity of existing models. Advances offering renewed hope include molecular and circuit-level technologies, AI-driven data analysis, real-world assessments, and new pharmacological candidates such as GLP-1 agonists and psychedelics. Recognition of inflammation, pain, and neuroimmune factors as integral to AUD is increasing. The authors caution against exaggerated claims and oversimplified models, and argue that neurobiological progress must be complemented by public health strategies to reduce stigma and improve access to care.

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Abstract

Over a decade after the first edition of "Behavioral Neurobiology of Alcohol Addiction," this chapter revisits the field at a critical juncture, marked by both persistent challenges and emerging opportunities. We reflect on the translational gap that has stalled the development of new treatments for alcohol use disorder (AUD), despite decades of promising preclinical findings. Particular attention is given to the replicability crisis in animal research, publication biases, and the limited predictive validity of existing models. At the same time, we highlight advances that offer renewed hope, including molecular and circuit-level technologies, AI-driven data analysis, real-world assessments, and new pharmacological candidates, such as GLP-1 agonists and psychedelics. These breakthroughs are considered alongside the increasing recognition of inflammation, pain, and neuroimmune factors as integral to AUD. However, we caution against exaggerated claims and urge the field to avoid oversimplified models, especially those that conflate habits and compulsions. Finally, we argue that neurobiological progress must be complemented by public health strategies aimed at reducing stigma and improving access to care. By fostering empirical rigor, embracing complexity, and maintaining critical self-reflection, addiction science can better align its innovations with real-world clinical and societal needs.