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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...

Religious Affiliation and Spiritual Practices: An Examination of the Role of Spirituality in Alcohol Use and Alcohol Use Disorder

Background for Real-Time Monitoring and Intervention Related to Alcohol Use

Real-time assessment, known as ecological momentary assessment (EMA), and real-time intervention (ecological momentary intervention [EMI]) can significantly extend the reach and impact of interventions to help individuals reduce their drinking behavior. For EMA, the user provides information on the variable of interest (e.g., drinking or craving) via a mobile device. This data reporting can occur...

Alcohol Use Disorder and Antisocial and Borderline Personality Disorders

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...

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Introduction

Prenatal alcohol exposure (PAE) is linked to miscarriage, stillbirth, preterm birth, sudden infant death syndrome, and fetal alcohol spectrum disorders (FASD).1 Although PAE is the sole necessary cause of FASD, the etiology of this leading preventable cause of disability is multifaceted and complex, including lifestyle, maternal, sociodemographic, social, gestational, and genetic...

The Burden of Alcohol Use: Focus on Children and Preadolescents

The burden of alcohol use usually is expressed as a function of the contribution of alcohol use in a population to morbidity and mortality in that population (Rehm et al. 2010). It is difficult to calculate the burden of alcohol use for middle-school and high-school adolescents (see Patrick and Schulembery, p. 193 in this issue) and nearly impossible to do so for children and preadolescents. There...

Stress and Alcohol: Epidimiologic Evidence

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...

Fetal Alcohol Spectrum Disorders: Awareness to Insight in Just 50 Years

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...

The Impact of Gene–Environment Interaction on Alcohol Use Disorders

This article explores interactions between genetic and environmental effects on alcohol use disorders (AUDs). Two contrasting ideas define what it means to have genes and environment interact. The first approach—the one that this article will focus on—is a statistical perspective. This approach is based on statistical models in which genetic and environmental factors are sometimes measured...

Maternal Substance Use: Consequences, Identification, and Interventions

Alcohol, tobacco, and cannabis are the substances most frequently used during pregnancy, and opioid-exposed pregnancies have increased fourfold. The purpose of this review is to describe the prevalence and consequences of prenatal exposure to alcohol, tobacco, cannabis, and opioids. Currently available screening questionnaires for prenatal substance use are summarized and contrasted with the...