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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

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 quest to understand the etiology, course, and treatment of alcohol use disorder (AUD) has given rise to an extensive body of work on identifying factors that contribute to these phenomena. Many of these factors, such as temperament and personality traits, are common to multiple psychiatric conditions, and some, such as variants of alcohol metabolizing genes, are specific to AUD...

Introduction

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...

Alcohol use disorder (AUD) and depressive disorders are among the most prevalent psychiatric disorders and co-occur more often than expected by chance. The aim of this review is to characterize the prevalence, course, and treatment of co-occurring AUD and depressive disorders. Studies have indicated that the co-occurrence of AUD and depressive disorders is associated with greater severity and...

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...

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...

Introduction

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...

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...

“Those who cannot remember the past are condemned to repeat it.”

—George Santayana

Few observations in psychiatry have been documented as long and as consistently as the association between anxiety (and general negative affect) and the chronic misuse of alcohol. Research has shown that up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one...