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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) ...

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...

Translating Alcohol Research: Opportunities and Challenges

More than 20 years ago, Daniel Koshland compared basic with applied research, stating: “Basic research is the type that is not always practical but often leads to great discoveries. Applied research refines these discoveries into useful products” (Koshland 1993). This statement implies that basic science does not have a direct impact on human health and disease or patient outcome but offers the...

Alcohol Use Disorder and Alcohol-Associated Liver Disease

Introduction

Alcohol use disorder (AUD) is prevalent worldwide, and the burden of heavy alcohol consumption has been increasing over time. An important complication of prolonged, heavy alcohol use is alcohol-associated liver disease (ALD), which can progress from liver steatosis to fibrosis and cirrhosis and frequently involves alcohol-associated hepatitis. In particular, cirrhosis—the most...

Cognitive-Affective Transdiagnostic Factors Associated With Vulnerability to Alcohol and Prescription Opioid Use in the Context of Pain

Introduction

Pain is a complex, near-universal phenomenon, which can be conceptualized as a motivational state that engenders goal-directed action.1 Motivational models of substance use highlight the role of expected effects and suggest that individuals become motivated to use substances when such use is perceived as holding greater value than other available objects or events.2,3 A rapidly...

Alcohol Dependence and Genes Encoding α2 and γ1 GABAA Receptor Subunits

Even though the consequences of alcohol dependence (AD) clearly are devastating and obvious to observers, the molecular mechanisms involved in the development of the disease are far from clear and understood. The search for these mechanisms is made even more difficult by the vast number of genes, proteins, and pathways in the human body that potentially could be involved, and by the obvious...

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...

Patterns of Cannabis and Alcohol Co-Use: Substitution Versus Complementary Effects

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...

The Endocrine System and Alcohol Drinking in Females

Sexually dimorphic effects of alcohol exposure throughout life have been documented in clinical and preclinical studies. In the past, rates of alcohol use disorder (AUD) were higher in men than in women, but over the past 10 years, the difference between sexes in prevalence of AUD and binge drinking has narrowed. Recent evidence adds to historical data regarding the influence of sex steroids on...