CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Addiction and Craving

There is no one definition of addiction. There are many theories about the nature of addiction. One concept of addiction is presented by Stanton Peele from the Lindesmith Center. According to Peele, addiction exists within clear parameters and is:

1. Known through the drinker's behavior, as observed by others, or based on the subjective experience of the drinker;
2. Not all-or-nothing;
3. Possible with any experience, destructive or not; and
4. Beneficial to the user, such as providing a sense of power, control, or relief of anxiety.

One thing that all people with addictions have in common is their need for their drug of choice, including alcohol. This is called craving. Although many people who abuse alcohol experience craving, there is no standardized definition of this experience.¹⁰ There are, however, a number of models that attempt to explain craving.

• Neuroadaptive Model. When alcohol is in the system and in the brain for long periods of time, it induces changes in brain-cell functioning. When alcohol is no longer present, the changes cause an imbalance in brain activity that results in craving. The changes also generate memories of alcohol's pleasant effects that can be activated if a person returns to a setting previously associated with drinking.
• Classical Conditioning Model. If a person has responded to certain alcohol-related stimuli in the past by drinking, he or she will associate those cues with drinking in the future (e.g., the smell of beer or the sight of a bar).
• Psychiatric Model. Some psychiatric conditions affect the same brain regions, as do cravings. In essence, the person feels the psychological need to drink to compensate for other feelings or conditions. These conditions include depression and anxiety.

In general, craving tends to be situation-specific and readily triggered by stimuli or events previously associated with drinking or drug use. Craving can persist long after a person stops drinking.

A person who abuses alcohol creates a lifestyle concentrated on getting and consuming a drink. His or her friends share the desire to drink and be in places where alcohol is present.