Disturbances of the stress response - The role of the HPA axis during alcohol withdrawal and abstinence

Interactions among the brain, the pituitary gland, and the adrenal glands ( i.e., the hypothalamic-pituitary-adrenal [HPA] axis) help regulate the body 's response to stress. The adrenal hormone cortisol plays a key role in str ess reduction through its effects on multiple body systems. Excessive corti sol activity during both chronic alcohol administration and withdrawal may underlie some of the clinical complications of alcoholism, including increa sed risk of infectious diseases; bone, muscle, and reproductive system chan ges; altered energy metabolism; and disorders of mood and intellect. Despit e excessive cortisol levels during intoxication and withdrawal, however, th e HPA axis becomes less responsive to stress during abstinence, potentially resulting in an impaired capacity to cope with relapse-inducing stressors.