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Gut-Liver-Brain Axis and Alcohol Use Disorder: Treatment Potential of Fecal Microbiota Transplantation

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...

Electronic Feedback in College Student Drinking Prevention and Intervention

Alcohol consumption is prevalent among college students and can be associated with serious negative consequences. Several efficacious programs using one-on-one brief intervention techniques have been developed to target high-risk drinking by individual students, such as the Brief Alcohol Screening and Intervention for College Students (BASICS) (Dimeff et al. 1999). To reach a larger population (e...

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...

Neuroimmune Function and the Consequences of Alcohol Exposure

Induction of neuroimmune genes by binge drinking increases neuronal excitability and oxidative stress, contributing to the neurobiology of alcohol dependence and causing neurodegeneration. Ethanol exposure activates signaling pathways featuring high-mobility group box 1 and Toll-like receptor 4 (TLR4), resulting in induction of the transcription factor nuclear factor kappa-light-chain-enhancer of...

How Does Stress Lead to Risk of Alcohol Relapse?

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...

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...

Anxiety and Alcohol Use Disorders: Comorbidity and Treatment Considerations

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...

Brain Structure and Function in Recovery

Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently...

Racial/Ethnic Disparities in Mutual Help Group Participation for Substance Use Problems

Introduction

Racial/ethnic minority groups comprise a large proportion of the U.S. population and evidence a substantial need for treatment of substance use disorder (SUD). Analysis of the most recent, reliable data available—the 2018 National Survey on Drug Use and Health (NSDUH)1—found that the prevalence of past-year SUD among those age 12 and older was higher among some racial/ethnic minority...