Alcohol’s Negative Emotional Side: The Role of Stress Neurobiology in Alcohol Use Disorder
The word “alcohol” often conjures up positive feelings and associations with fun, socializing, relaxing, and partying. Yet there is another side to drinking alcohol, especially with risky, hazardous levels of consumption. This side is associated with distress and may include anxiety, loneliness, pain, and depressive symptoms.1 This has been labeled the “dark side,” or “negative emotional, stress side,” of alcohol intake.2 These two paradoxical, dialectically opposing alcohol experiences map onto the biphasic drug effects of alcohol, with alcohol being both a stimulant and a depressant drug. They also represent a shift from positive to negative situations that may drive alcohol intake, especially as alcohol intake increases from low or moderate “social” levels of drinking to binge, heavy, and chronic consumption. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines drinking in moderation as an intake of two drinks or less per day for men and one drink or less per day for women. Binge drinking is generally defined as five or more drinks per occasion for men and four or more drinks per occasion for women. Heavy drinking is generally defined as more than four drinks per day or more than 14 drinks per week for men and as more than three drinks per day or more than seven drinks per week for women.3