Recent advances in neuroscience have made it possible to investigate t
he pathophysiology of alcoholism at a cellular and molecular level. Ev
idence indicates that ethanol affects hormone- and neurotransmitter-ac
tivated signal transduction, leading to short-term changes in regulati
on of cellular functions and long-term changes in gene expression. Suc
h changes in the brain probably underlie many of the acute and chronic
neurological events in alcoholism. In addition, genetic vulnerability
also plays a role in alcoholism and, perhaps, in alcoholic medical di
sorders.