The authors explore the possible role of basal ganglia/limbic striatal and thalamocortical circuits in craving and loss of control in alcohol abuse and dependence. Alcoholics may suffer from a defect in the neuronal systems within basal ganglia/limbic striatal and thalamocortical neuronal circuits, especially within the striatoaccumbal-ventral pallidal portion of this circuit or its dopaminergic nigrotegmental modulation. Alcoholic craving may result from a neurophysiologically driven obsession resulting from overactivity within the fronto-thalamic neuronal loop, and loss of control of alcohol consumption may be a neurophysiologically driven compulsion resulting from further impairment of the basal ganglia/limbic striatal portion of this circuit caused by the acute dopaminergic effects of intoxication.