Aberrant choice behavior in alcoholism

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Science  22 Jun 2018:
Vol. 360, Issue 6395, pp. 1298-1299
DOI: 10.1126/science.aau0668

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More than 2 billion people worldwide regularly drink alcohol. Alcohol is a component cause of more than 200 diseases and causes ∼3.3 million deaths per year globally (1). The major disease burden comes from harmful alcohol consumption and alcohol dependence. Not everyone who regularly consumes alcohol becomes dependent: ∼15% become engaged in harmful and compulsive alcohol drinking (2). Patients suffering from alcohol dependence no longer have the freedom to choose between alternative rewards because alcohol drinking dictates what should be done next, namely, shaping activities for the next drink. On page 1321 of this issue, Augier et al. (3) demonstrate that aberrant choice behavior—that is, choosing alcohol over an alternative reward—is a key driver for the transition from controlled to compulsive alcohol use. They also provide a mechanistic understanding of this aberrant choice behavior that could lead to new treatment opportunities.