Michael Thank you for the welcome. The DSM has not used the words, alcoholic or alcoholism since the 1970's. What is used in diagnosis, is, "use, abuse, or dependence." There are many causative factor's that increase the possibility of substance abuse and to name a few, PTSD, childhood trauma, ADD, and depression. As to the biological component there are three drugs I know of which are being used to help with cravings, or re-setting the brain chemistry, as one MD I know states, those being Campral, Topomax and Naltrexone. Naltrexone is more frequently prescribed with good results. And there are those who need physical detox in a rehab setting, due to the body having reached a point it can no longer function without the drug/alcohol. It's been a few years since I've read any studies on dopamine, but do remember reading the use of drugs/alcohol might well have been the brain's attempt to normalize dopamine in the brain. I too am an advocate of finding the best approach to fit the individual. My experiences with LifeRing, Women for Sobriety, SOS for Women, Harm Reduction and Moderation Management have all been good. As for the disease model, sigh, this was created to sell rehabs, who are a 14B per year industry. They are a powerful group of lobbyists in DC. When I stopped smoking I used simple positive reinforcement. I gave myself the gift of scuba diving, and with alcohol I simply stopped. However, I did find I needed therapy for understanding, processing, and behavioral change, (what was driving me at the feeling level). Any new threads on the topic will peak my interest AnnaLisa