Learning Mechanisms in Alcohol Use Disorders.

Pavlovian and operant learning mechanisms promote and maintain alcohol intake despite aversive consequences. Here, we review the evidence for drug-associated modifications of basic learning mechanisms during the initiation and maintenance of alcohol use disorders in humans. We discuss how neuroadaptive effects elicited by chronic alcohol intake in the so-called brain reward system can bias learning and decision making towards drug consumption and contribute to the relapse risk after detoxification. Robustness of results and limitations of the respective neurobiological or imaging techniques are addressed. We opine that studying the effects of alcohol intake on Pavlovian and reinforcement learning can inform psychotherapeutic interventions and help to better understand some new neurobiological interventions. We argue that a focus on drug effects biassing basic learning mechanisms can help to reduce the stigma associated with drug consumption and emphasize behavioural and neurobiological interventions that take individual learning mechanisms into account when promoting alternative coping strategies.