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The association between alcohol misuse and organ damage, specifically liver disease, has been recognized for more than 200 years (Maher 1997). Yet it was not until the early 1970s that researchers demonstrated a direct causal relationship between drinking and this serious—and sometimes fatal—condition.

“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...

During the critical developmental periods of childhood when neural plasticity is high, exposure to early life stress (ELS) or trauma may lead to enduring changes in physiological stress systems and enhanced vulnerability for psychopathological conditions such as post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) in adulthood. Clinical and preclinical studies have sought to...

Introduction

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...

According to the World Health Organization (http://www.who.int/substance_abuse/facts/alcohol/en/index.html), each year alcohol causes 2.5 million (3.8 percent of total) deaths and 69.4 million (4.5 percent of total) disability-adjusted life-years (DALYs) lost to disease worldwide. Alcohol dependence (alcoholism) also is a major health problem in the United States, affecting 4 to 5 percent of the...

Adolescence represents a vulnerable period for developing youth. Alcohol use and misuse are especially problematic behaviors during this time. Adolescents are more sensitive to alcohol and less tolerant of its detrimental effects than are adults. Research in humans and animals has revealed that early alcohol consumption can result in delayed pubertal development. Animal studies have shown that...

In large amounts, alcohol and its metabolites can overwhelm the gastrointestinal tract (GI) and liver and lead to damage both within the GI and in other organs. Specifically, alcohol and its metabolites promote intestinal inflammation through multiple pathways. That inflammatory response, in turn, exacerbates alcohol-induced organ damage, creating a vicious cycle and leading to additional...

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...

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...

Exposure of the developing embryo and fetus to alcohol can have profound adverse effects on physical, behavioral, and cognitive development. The resulting deficits collectively have been termed fetal alcohol spectrum disorders (FASD). They range in severity from mild cognitive deficits to a well-defined syndrome (i.e., fetal alcohol syndrome [FAS]), which is broadly characterized by low birth...