Many service members and veterans seeking treatment for alcohol problems have experienced the life-threatening stress of combat, many have post-traumatic stress disorder (PTSD), and many service members and veterans seeking treatment for PTSD have alcohol or other substance problems. Sensitivity to these issues can influence how a therapist relates to the patient and also has possible...
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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...
Recovery-Oriented Systems of Care: A Perspective on the Past, Present, and Future
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...
Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision...
Alcohol’s Negative Emotional Side: The Role of Stress Neurobiology in Alcohol Use Disorder
Introduction
The word “alcohol” often conjures up positive feelings and associations with fun, socializing, relaxing, and partying. Yet there is another side to drinking alcohol, especially with risky, hazardous levels of consumption. This side is associated with distress and may include anxiety, loneliness, pain, and depressive symptoms.1 This has been labeled the “dark side,” or “negative...
Computerized Cognitive–Behavioral Therapy
With an estimated 90 percent or more of alcohol use disorders going untreated (Substance Abuse and Mental Health Services Administration 2012), the search for interventions that easily, effectively, and economically reach more people has become a priority. The landmark 1990 report, Broadening the Base of Treatment for Alcohol Problems (Institute of Medicine 1990), refocused alcohol treatment...
Alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) are highly comorbid, and treatment outcomes are worse in individuals with both disorders. Several neurobiological systems have been implicated in the development and maintenance of AUD and PTSD, and pharmacologic interventions targeting these systems for singular diagnoses of AUD or PTSD have proven effective. However, there are...
Impact of Continuing Care on Recovery From Substance Use Disorder
Continuing care is widely believed to be an important component of effective treatment for substance use disorder, particularly for those individuals with greater problem severity. The purpose of this review was to examine the research literature on continuing care for alcohol and drug use disorders, including studies that addressed efficacy, moderators, mechanisms of action, and economic impact...
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...
Alcohol Use Disorder: The Role of Medication in Recovery
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...