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Introduction

For the past 25 years, a growing number of U.S. states have been progressively legalizing cannabis markets, first through the early adoption of medical cannabis laws, which enabled the purchase and possession of cannabis for specific medicinal purposes, and then more recently through laws regarding adult (i.e., “recreational”) use of cannabis. As of May 2021, more than 70% of U.S...

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...

Introduction

Use of alcohol and related problems cause significant global and individual health-related harms, and alcohol use is currently the third-leading cause of preventable death in the United States.^1,2 Alcohol and cannabis are among the most commonly used psychoactive substances in the United States.³ Although concurrent use of alcohol and cannabis (i.e., co-use: defined as using both...

Introduction

Alcohol consumption, including any alcohol use; patterns of high-risk use, including binge drinking; and alcohol use disorder (AUD) incidence and prevalence, differs substantially over time and by life stage. Variation also occurs across demographic groups, and such differences themselves vary across time and place. In the first quarter of the 21st century, changes in incidence and...

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...

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...

Introduction

The prevalence of alcohol use disorder has been steadily rising around the world in recent years, and reducing the burden of alcohol-associated liver disease (ALD) caused by chronic alcohol consumption has become one of the most important global health issues.^1,2 Excessive alcohol drinking (more than 40 g of pure alcohol per day) is closely associated with increased risk of all-cause...

In recent decades, the term “recovery” as it pertains to alcohol use disorder (AUD) and drug use disorders has taken on increasing cultural and scientific significance in the United States and around the world. Its growing prominence as a culturally recognized and, importantly, positively valenced organizing concept has occurred in large part in direct response to help counter the pervasive and...

Introduction

This perspective focuses on the relatively recent topic of recovery-oriented systems of care; although influential in practice, this concept has yet to be evaluated empirically and thus cannot yet be the object of a review. In lieu of such evidence, this article offers one perspective on the origins of this concept and its present status prior to considering possible directions in...

Introduction

Pain is a complex, near-universal phenomenon, which can be conceptualized as a motivational state that engenders goal-directed action.¹ Motivational models of substance use highlight the role of expected effects and suggest that individuals become motivated to use substances when such use is perceived as holding greater value than other available objects or events.^2,3 A rapidly...