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Area-Level Social Determinants of Alcohol-Related Mortality: Knowledge Gaps and Implications for Community Health

Key Takeaways

  • The literature on social determinants of alcohol-related mortality includes many studies focused on area-level determinants of alcohol-involved motor vehicle crashes and cirrhosis or liver disease mortality.
  • Extant research highlights the benefits of stronger alcohol policies and the importance of socioeconomic conditions as determinants of alcohol-related mortality.
  • Substantial gaps in...

Gut-Liver-Brain Axis and Alcohol Use Disorder: Treatment Potential of Fecal Microbiota Transplantation

Introduction

Alcohol-associated liver disease (ALD) is a leading cause of morbidity and mortality in people with alcohol use disorder (AUD).1 Alcohol exerts its effect on the liver through both direct and indirect pathways and can eventually lead to steatosis, steatohepatitis, fibrosis, hepatocellular carcinoma, and cirrhosis.2 However, only approximately 10% to 20% of patients with ALD develop...

NIAAA 50th Anniversary Festschrift: From the Editor

A Look Back

NIAAA’s 50th anniversary is truly a highlight in the history of public health. More than 5 decades ago, a group of researchers, advocates, and elected officials made a farsighted decision when they pushed for the creation of a federal institution dedicated to research that improves the lives of millions of Americans and their families devastated by alcohol misuse. As a result, on...

Alcohol Use Disorder and Alcohol-Associated Liver Disease

Introduction

Alcohol use disorder (AUD) is prevalent worldwide, and the burden of heavy alcohol consumption has been increasing over time. An important complication of prolonged, heavy alcohol use is alcohol-associated liver disease (ALD), which can progress from liver steatosis to fibrosis and cirrhosis and frequently involves alcohol-associated hepatitis. In particular, cirrhosis—the most severe...

Looking Back, Looking Forward: Current Medications and Innovative Potential Medications to Treat Alcohol Use Disorder

Introduction

According to national surveys, more than 85% of U.S. adults have consumed alcohol at some point in their lifetime, and about 70% did so in the last year.1 Most individuals drink responsibly and without adverse effects. However, a substantial proportion of people misuse alcohol.1,2 Drinking patterns associated with alcohol misuse include binge drinking, heavy drinking, and high...

Fetal Alcohol Spectrum Disorders: Awareness to Insight in Just 50 Years

Introduction

The establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1971 was bracketed by three seminal papers that laid the groundwork for the field of fetal alcohol spectrum disorders (FASD) research. In 1968, Lemoine et al.1 described children with birth defects and neurodevelopmental disorders associated with prenatal alcohol exposure (PAE). This French-language...

The Synaptic Interactions of Alcohol and the Endogenous Cannabinoid System

Introduction

Alcohol use disorder (AUD) is a chronic, relapsing brain disorder, characterized by a compromised ability to control alcohol use despite adverse occupational, social, or health consequences. Results from a 2019 National Survey on Drug Use and Health found that 5% of individuals over age 12 had AUD, affecting 14.5 million people in the United States. Alcohol and cannabis products are a...

The Convergent Neuroscience of Affective Pain and Substance Use Disorder

Introduction

A central feature of substance use disorder (SUD) is the emergence of negative affective or emotional states that influence the motivational properties of misused substances.1 Individual propensity to experience pain-related negative affect, for example, is hypothesized to be associated with the maintenance of both opioid use disorder (OUD) and alcohol use disorder (AUD). Chronic pain...

Alcohol, Opioids, and Pain - From the Editors

Opioids and alcohol are both effective analgesics under certain pain conditions. However, although the analgesic or pain-relieving properties of opioids are well known, information about the use of alcohol and its potential for misuse in the context of pain management has begun to emerge more recently. Alcohol doses required to alleviate pain are commensurate with binge drinking,1 defined as...

Forebrain-Midbrain Circuits and Peptides Involved in Hyperalgesia After Chronic Alcohol Exposure

Introduction

Chronic pain increases the risk for development of alcohol use disorder (AUD). Given that acute alcohol consumption can reduce pain, humans sometimes drink alcohol for relief of pain. Chronic alcohol consumption, however, can increase pain sensitivity during withdrawal and facilitate pain sensitization related to comorbid pain conditions.1 Ascending and descending nociceptive circuitry...