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. Author manuscript; available in PMC: 2009 Feb 14.
Published in final edited form as: N Engl J Med. 2008 Aug 14;359(7):715–721. doi: 10.1056/NEJMct0801733

Figure 1. Neurochemical Circuits Involved in Alcohol Dependence and Craving.

Figure 1

When an alcohol-dependent person consumes alcohol, dopamine is elevated in the nucleus accumbens. One mechanism of this elevation is the release of β-endorphin, which stimulates dopamine release either directly (in the nucleus accumbens) or indirectly (in the ventral tegmental area) by inhibiting the activity of γ-aminobutyric acid (GABA) neurons, thereby alleviating the blockade on dopamine cells. Naltrexone reverses both of these actions.