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A large proportion of the population consume alcoholic beverages at some time in their lives. For most people, alcohol consumption is low to moderate and is not associated with harmful physiological, psychological, or social outcomes. However, for a substantial number of individuals, alcohol consumption increases over time; leads to the development of tolerance and alcohol-related life...
The Convergent Neuroscience of Affective Pain and Substance Use Disorder
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...
Forebrain-Midbrain Circuits and Peptides Involved in Hyperalgesia After Chronic Alcohol Exposure
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...
Hepatic Cannabinoid Signaling in the Regulation of Alcohol-Associated Liver Disease
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...
Alcohol and Cannabis Use and the Developing Brain
Adolescence is marked by significant social, emotional, cognitive, and physical changes, as individuals transition from childhood to adulthood. Although the exact definition of adolescence tends to vary, recent findings regarding adolescent development and growth include individuals between the ages of 10 and 24.1 Consistent with this defined age range, the human brain continues to...
Recovery-Oriented Systems of Care: A Perspective on the Past, Present, and Future
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...
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 growing...
Alcohol Use Disorder: The Role of Medication in Recovery
It is estimated that nearly 14.6 million Americans currently meet the diagnostic criteria for alcohol use disorder (AUD)1 included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5),2 and approximately 88,000 die from alcohol-related causes in the United States each year.3 An older term, “alcohol dependence,” is equivalent to the DSM-5 criteria for AUD of...
The Role of the Family in Alcohol Use Disorder Recovery for Adults
It is almost axiomatic that alcohol use disorder (AUD) and the family are inextricably bound. AUD harms individual family members and the functioning of the family as a whole, and family members’ actions may exacerbate problematic drinking. Conversely, families play a key role in recovery from AUD, and recovery has a positive impact on family members and family functioning. Scientific...
Natural Recovery by the Liver and Other Organs After Chronic Alcohol Use
A vast body of evidence from human studies and animal research clearly indicates that chronic, heavy alcohol consumption causes structural damage and/or disrupts normal organ function in virtually every tissue of the body. In heavy consumers of alcohol, the liver is especially susceptible to alcohol-induced injury.1,2 Additionally, several other organs—including the gastrointestinal...
