Co-occurring post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are costly and consequential public health problems that negatively affect the health and well-being of U.S. military service members and veterans. The disproportionate burden of comorbid PTSD and AUD among U.S. military service members and veterans may be due to unique factors associated with military service, such...
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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...
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...
Alcohol Use Disorder and Antisocial and Borderline Personality Disorders
Introduction
The quest to understand the etiology, course, and treatment of alcohol use disorder (AUD) has given rise to an extensive body of work on identifying factors that contribute to these phenomena. Many of these factors, such as temperament and personality traits, are common to multiple psychiatric conditions, and some, such as variants of alcohol metabolizing genes, are specific to AUD...
Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder - Editor's Note
Alcohol use disorder (AUD) is a chronic, relapsing brain disease characterized by a reduced ability to stop or control alcohol use despite negative social, work, or health consequences. Often, it co-occurs and interacts with post-traumatic stress disorder (PTSD), which may develop after experiencing or witnessing a life-threatening event, such as combat, a natural disaster, a car accident, or...
Heavy drinking takes a high toll on society. Other articles in this issue summarize the disease burden and economic cost to society attributable to alcohol use, which provide a powerful incentive to develop and implement ways to reduce them. The focus of this article is on the role of selective (i.e., clinical) prevention and treatment approaches for heavy drinkers and people with alcohol use...
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...
Many service members and veterans seeking treatment for alcohol problems have experienced the life-threatening stress of combat, many have post-traumatic stress disorder (PTSD), and many service members and veterans seeking treatment for PTSD have alcohol or other substance problems. Sensitivity to these issues can influence how a therapist relates to the patient and also has possible...
Integrating Treatment for Co-Occurring Mental Health Conditions
Given the high co-occurrence between alcohol use disorder (AUD) and mental health conditions (MHCs), and the increased morbidity associated with the presence of co-occurring disorders, it is important that co-occurring disorders be identified and both disorders addressed in integrated treatment. Tremendous heterogeneity exists among individuals with co-occurring conditions, and factors related to...
Treatment of Alcohol Dependence With Drug Antagonists of the Stress Response
Although alcohol dependence affects 4 percent of the adult population and is the third leading cause of preventable death in the United States (Substance Abuse and Mental Health Services Administration 2009), fewer than 15 percent of people with alcoholism receive treatment (Hasin et al. 2007). The Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition Text Revision (DSM–IV–TR) ...