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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...

A Look Back

NIAAA’s 50th anniversary is truly a highlight in the history of public health. More than 5 decades ago, a group of researchers, advocates, and elected officials made a farsighted decision when they pushed for the creation of a federal institution dedicated to research that improves the lives of millions of Americans and their families devastated by alcohol misuse. As a result, on...

Introduction

The word “alcohol” often conjures up positive feelings and associations with fun, socializing, relaxing, and partying. Yet there is another side to drinking alcohol, especially with risky, hazardous levels of consumption. This side is associated with distress and may include anxiety, loneliness, pain, and depressive symptoms.¹ This has been labeled the “dark side,” or “negative...

Introduction

According to national surveys, more than 85% of U.S. adults have consumed alcohol at some point in their lifetime, and about 70% did so in the last year.¹ Most individuals drink responsibly and without adverse effects. However, a substantial proportion of people misuse alcohol.^1,2 Drinking patterns associated with alcohol misuse include binge drinking, heavy drinking, and high...

Introduction

Endogenous cannabinoids, or endocannabinoids (eCBs), are bioactive lipid molecules that modulate signaling activity of several physiological processes involved in pain, appetite, energy balance, stress/anxiety, immune signaling, and learning and memory. Although understanding of the eCB system has grown in complexity since its discovery by Raphael Mechoulam, it is now widely known...

Introduction

For the past 25 years, a growing number of U.S. states have been progressively legalizing cannabis markets, first through the early adoption of medical cannabis laws, which enabled the purchase and possession of cannabis for specific medicinal purposes, and then more recently through laws regarding adult (i.e., “recreational”) use of cannabis. As of May 2021, more than 70% of U.S...

Introduction

Use of alcohol and related problems cause significant global and individual health-related harms, and alcohol use is currently the third-leading cause of preventable death in the United States.^1,2 Alcohol and cannabis are among the most commonly used psychoactive substances in the United States.³ Although concurrent use of alcohol and cannabis (i.e., co-use: defined as using both...

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...

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...

Introduction

Chronic pain increases the risk for development of alcohol use disorder (AUD). Given that acute alcohol consumption can reduce pain, humans sometimes drink alcohol for relief of pain. Chronic alcohol consumption, however, can increase pain sensitivity during withdrawal and facilitate pain sensitization related to comorbid pain conditions.¹ Ascending and descending nociceptive...