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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...

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...

Circadian Genes, the Stress Axis, and Alcoholism

Alcohol abuse and dependence are estimated to affect 1 in 8 adults in the United States and several hundred million people worldwide (Grant et al. 2004). To define at-risk populations and develop better treatments, it is important to further identify the genetic and environmental factors that contribute to alcohol addiction. Recent evidence suggests that the body’s internal system that helps...

Fetal Alcohol Spectrum Disorders: Awareness to Insight in Just 50 Years

Introduction

The establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1971 was bracketed by three seminal papers that laid the groundwork for the field of fetal alcohol spectrum disorders (FASD) research. In 1968, Lemoine et al.1 described children with birth defects and neurodevelopmental disorders associated with prenatal alcohol exposure (PAE). This French...

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...

Stress and the HPA Axis: Role of Glucocorticoids in Alcohol Dependence

Stress, generally defined as any stimulus that disrupts the body’s internal balance (i.e., physiological homeostasis), has long been suggested to be an important correlate of uncontrolled alcohol consumption or relapse to drinking following a period of abstinence. Large epidemiological studies have reported that a variety of stressors are associated with increased alcohol consumption and binge...

Alcohol's Effect on Host Defense

Alcohol has been the most common substance of use and abuse in human history. Moderate amounts of alcohol are enjoyed for its anxiolytic effects; however, its addictive properties can lead to chronic, excessive alcohol use and alcohol use disorder. In addition to its commonly recognized behavioral effects, alcohol affects many organs, including the immune system that controls the body’s defense...

Neuroplasticity in Human Alcoholism: Studies of Extended Abstinence with Potential Treatment Implications

A person with alcoholism engages in risky or dangerous drinking despite experiencing serious negative physical and social consequences. Such persistence in pursuing damaging behaviors suggests that the short-term “appetitive” results of drinking (such as intoxication and losing one’s inhibitions) have greater control over the alcoholic’s behavior than do the negative consequences. From a...

Effects of Alcohol Dependence and Withdrawal on Stress Responsiveness and Alcohol Consumption

Although stress is known to be an important contributing factor to alcohol abuse and alcoholism, the interaction between stress and alcohol drinking behavior, as well as the mechanisms underlying this interaction in the context of dependence are complex and not well understood. On the one hand, alcohol is an effective anxiety-reducing agent (i.e., anxiolytic). Hence, motivation for drinking may be...

AUD Risk, Diagnoses, and Course in a Prospective Study Across Two Generations: Implications for Prevention

Introduction

A large proportion of the population consume alcoholic beverages at some time in their lives. For most people, alcohol consumption is low to moderate and is not associated with harmful physiological, psychological, or social outcomes. However, for a substantial number of individuals, alcohol consumption increases over time; leads to the development of tolerance and alcohol-related...