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Heavy drinking takes a high toll on society. Other articles in this issue summarize the disease burden and economic cost to society attributable to alcohol use, which provide a powerful incentive to develop and implement ways to reduce them. The focus of this article is on the role of selective (i.e., clinical) prevention and treatment approaches for heavy drinkers and people with alcohol use...

Even though the prevalence of alcohol use in the United States generally is lower among women compared with men (Substance Abuse and Mental Health Services Administration [SAMHSA] 2011), this gap has narrowed (Grucza et al. 2008). Furthermore, although women consume alcohol at lower levels than men, their body composition puts them at higher risk than men of developing some alcohol-related...

The development of alcohol dependence is a complex process influenced by both genetic and environmental risk factors (Prescott and Kendler 1999). The relative contributions of genetic and environmental influences fluctuate across development. During adolescence the initiation of alcohol use is strongly influenced by environmental factors (Dick et al. 2007; Heath et al. 1997; Karvonen 1995...

Exposure to varying forms of stress is an integral life experience that can provoke a variety of reactions. In research on alcohol, drug, and psychiatric disorders, the term “stress” often is understood to indicate any experience denoting adversity (Dohrenwend 2000). Stress exposures consist of external stimuli that are threatening or harmful; elicit fear, anxiety, anger, excitement, and/or...

It has long been known that stress increases the risk of alcohol relapse (Sinha 2001). Clinical observations, surveys, and epidemiological studies document an association between self-reports of stressors and subsequent return to drinking. Studies assessing alcohol relapse after treatment completion and discharge also indicate the contribution of highly stressful events independent of alcohol use...

Stress, generally defined as any stimulus that disrupts the body’s internal balance (i.e., physiological homeostasis), has long been suggested to be an important correlate of uncontrolled alcohol consumption or relapse to drinking following a period of abstinence. Large epidemiological studies have reported that a variety of stressors are associated with increased alcohol consumption and binge...

In the 13 years since Alcohol Research & Health (now titled Alcohol Research: Current Reviews) first visited the topic of “Alcohol and Stress” (see Vol. 23, No. 4, 1999), there has been a sustained flow of new information in the field prompting us to publish this updated edition. Indeed, one could argue that this second look at the topic is long overdue. An entirely new lexicon of terms¹ has been...

Co-occurring anxiety disorders and alcohol use disorders (AUDs) are of great interest to researchers and clinicians. Cumulative evidence from epidemiological and clinical studies over the past few decades has highlighted both the frequency and clinical impact of this comorbidity. Investigations into the unique connections between specific anxiety disorders and AUDs have shown that this association...

Evidence from different disciplines suggests that acute and chronic stress–related mechanisms play an important role in both the development and the chronic, relapsing nature of addiction (Baumeister 2003; Baumeister et al. 1994; Brady and Sinha 2005). Stress is defined as the physiological and psychological process resulting from a challenge to homeostasis by any real or perceived demand on the...

Problematic alcohol use within the United States military has been linked to substantial financial and productivity losses. Data from 2006 revealed that excessive alcohol consumption cost the U.S. military $1.12 billion per year (Harwood et al. 2009). Regarding medical expenditures, studies have found that excessive alcohol use by military members results in an annual cost of $425 million...