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The Emergence, Role, and Impact of Recovery Support Services

Across the different developmental stages of the life course, alcohol and other drugs play an influential role in health, functioning, disease, disability, and premature mortality. A number of different approaches have emerged during the past 60 years to address areas impacted by alcohol and drug use, including formal professional treatment services, but also—in recognition of the need for ongoing...

Natural Recovery by the Liver and Other Organs After Chronic Alcohol Use

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...

The Convergent Neuroscience of Affective Pain and Substance Use Disorder

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...

Pharmacotherapy for Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder: Targeting the Opioidergic, Noradrenergic, Serotonergic, and GABAergic/Glutamatergic Systems

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...

Epigenetic Events in Liver Cancer Resulting From Alcoholic Liver Disease

The molecular pathogenesis of liver cancer (i.e., hepatocellular carcinoma [HCC]) is a multistep process that involves both genetic changes, such as chromosomal abnormalities and mutations of the DNA sequence (i.e., somatic mutations), and epigenetic mechanisms, such as chemical modifications of the DNA and the histone proteins around which the DNA is wrapped to form the chromosomes, microRNA...

Genetic and Environmental Determinants of Stress Responding

The development of alcohol dependence is a complex process influenced by both genetic and environmental risk factors (Prescott and Kendler 1999). The relative contributions of genetic and environmental influences fluctuate across development. During adolescence the initiation of alcohol use is strongly influenced by environmental factors (Dick et al. 2007; Heath et al. 1997; Karvonen 1995...

Alcohol and Skeletal Muscle in Health and Disease

Introduction

Alcohol misuse is the most common form of substance misuse and is associated with liver, cardiovascular, and metabolic diseases as well as with infections and cancers.1 Although an estimated 20% to 25% of people who drink heavily develop alcohol-related liver disease,2 40% to 60% of people with alcohol misuse have alcohol-related myopathy.3 Evidence that alcohol use leads to skeletal...

The Influence of Gender and Sexual Orientation on Alcohol Use and Alcohol-Related Problems: Toward a Global Perspective

The prevalence of alcohol use and the contrast between the drinking patterns of men and women vary widely across the globe. For instance, rates of current drinking ranged from 3 percent and 37 percent for women and men, respectively, in the Indian state of Karnataka to 94 percent and 97 percent for women and men in Denmark (Wilsnack et al. 2009). Overall, however, men have higher rates of alcohol...

Tracking the When, Where, and With Whom of Alcohol Use: Integrating Ecological Momentary Assessment and Geospatial Data to Examine Risk for Alcohol-Related Problems

Prevention researchers have found that drinking in different contexts is related to different alcohol problems. Where and with whom people drink affects the types of alcohol-related problems they experience. Consequently, identifying those contexts that result in the greatest number of problems provides a novel opportunity to target new prevention efforts aimed at those contexts. However...