Although it is now more than two decades since it was first reported that the imidazobenzodiazepine Ro15-4513 reverses behavioral alcohol effects, the molecular target(s) of Ro15-4513 and the mechanism of alcohol antagonism remain elusive. Here, we show that Ro15-4513 blocks the alcohol enhancement on recombinant ''extrasynaptic'' ␣4͞63␦ GABAA receptors at doses that do not reduce the GABA-induced Cl ؊ current. At low ethanol concentrations (<30 mM), the Ro15-4513 antagonism is complete. However, at higher ethanol concentrations (>100 mM), there is a Ro15-4513-insensitive ethanol enhancement that is abolished in receptors containing a point mutation in the second transmembrane region of the 3 subunit (3N265M). Therefore, ␣4͞63␦ GABA receptors have two distinct alcohol modulation sites: (i) a low-dose ethanol site present in ␣4͞63␦ receptors that is antagonized by the behavioral alcohol antagonist Ro15-4513 and (ii) a site activated at high (anesthetic) alcohol doses, defined by mutations in membrane-spanning regions. Receptors composed of ␣43N265M␦ subunits that lack the high-dose alcohol site show a saturable ethanol dose-response curve with a half-maximal enhancement at 16 mM, close to the legal blood alcohol driving limit in most U.S. states (17.4 mM). Like in behavioral experiments, the alcohol antagonist effect of Ro15-4513 on recombinant ␣43␦ receptors is blocked by flumazenil and -carboline-ethyl ester (-CCE). Our findings suggest that ethanol͞Ro15-4513-sensitive GABA A receptors are important mediators of behavioral alcohol effects.alcohol intoxication ͉ alcohol receptor ͉ anesthetics A lthough alcohol is one of the most widely used and abused drugs, the molecular targets that mediate alcohol effects at concentrations relevant for mild social intoxication are only beginning to be revealed. Neurotransmitter receptors for GABA, NMDA and glycine, and G protein-gated K ϩ channels have been identified as potential alcohol targets that are sensitive to intoxicating alcohol concentrations (1-4). GABA A receptors (GABA A Rs) have long been suspected to be important mediators of alcohol effects (5, 6) because benzodiazepines (BZs) and barbiturates, classic GABA A R agonists, share common pharmacological properties with ethanol, such as sedativehypnotic, anti-anxiety, and motor in-coordinating and anticonvulsant effects and have additive, possibly even synergistic effects, when taken together with ethanol (7). In addition, BZs, barbiturates, and ethanol produce tolerance and cross-tolerance to each other (8), consistent with GABA A Rs as targets of action.We have recently identified subtypes of GABA A Rs, those containing the ␦ and the 3 subunit, that are uniquely sensitive to low alcohol concentrations (9). Consistent with the view that ␦ subunit-containing receptors are important mediators of alcohol actions is the finding that GABA A R ␦-subunit knockout mice show multiple defects in behavioral responses to ethanol (10). Receptors containing the ␦ subunit have an exclusively nonsynaptic distribution, ...