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Putting the Screen in Screening: Technology-Based Alcohol Screening and Brief Interventions in Medical Settings

Alcohol is strongly linked to the leading causes of adolescent and adult mortality and health problems, making medical settings such as primary care and emergency departments important venues for addressing alcohol use. Extensive research evidence supports the effectiveness of alcohol screening and brief interventions (SBIs) in medical settings, but this valuable strategy remains underused, with...

Alcoholic Liver Disease: Pathogenesis and Current Management

Excessive alcohol consumption is a global healthcare problem. The liver sustains the greatest degree of tissue injury by heavy drinking because it is the primary site of ethanol metabolism. Chronic and excessive alcohol consumption produces a wide spectrum of hepatic lesions, the most characteristic of which are steatosis, hepatitis, and fibrosis/cirrhosis. Steatosis is the earliest response to...

The Promises and Pitfalls of Digital Technology in Its Application to Alcohol Treatment

Individuals seeking to change their alcohol use form a heterogeneous group with varied treatment goals—including moderation and abstinence—that therefore requires flexible treatment options. The availability of alcohol in the United States, and the pervasive social pressure to drink, warrant treatments that support individuals outside the treatment environment and that foster coping and self...

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...

Discovering Genes Involved in Alcohol Dependence and Other Alcohol Responses

A host of biological (i.e., genetic) and environmental factors interact throughout the addictive process to influence alcohol use and abuse. These processes are accompanied by a number of behavioral and neural events that include, but are not limited to, changes in the motivational effects of ethanol (both rewarding and aversive), tolerance to some effects of ethanol, and withdrawal when ethanol...

Early Life Stress as a Predictor of Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder

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...

The Role of the Family in Alcohol Use Disorder Recovery for Adults

Introduction

It is almost axiomatic that alcohol use disorder (AUD) and the family are inextricably bound. AUD harms individual family members and the functioning of the family as a whole, and family members’ actions may exacerbate problematic drinking. Conversely, families play a key role in recovery from AUD, and recovery has a positive impact on family members and family functioning...

In Utero Alcohol Exposure, Epigenetic Changes, and Their Consequences

Alcohol exposure of the developing embryo and fetus in utero can have a wide range of detrimental effects collectively referred to as fetal alcohol spectrum disorders (FASD). Researchers are intensively investigating the mechanisms that may contribute to alcohol’s effects on the developing organism and to the resulting consequences, particularly with respect to the cognitive and behavioral...

Sex and Gender Effects in Recovery from Alcohol Use Disorder

The current article provides a brief summary of biopsychosocial gender differences in alcohol use disorder (AUD), then reviews existing literature on gender differences in treatment access, retention, outcomes, and longer-term recovery. Among psychotherapies for AUD, there is support for the efficacy of providing female-specific treatment, and for female-only treatment settings but only when...

Alcohol and HIV Effects on the Immune System

Alcohol use disorder (AUD) and HIV infection both affect the immune system and frequently coexist in the same person, potentially multiplying the risk of infectious disease. Infectious disease, in turn, continues to be a major health concern and leading cause of morbidity and mortality worldwide, despite major advances in our understanding of the immune system, improvements in sanitation...