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...
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Binge drinking thresholds have long been set at four or more drinks for women and five or more drinks for men over the course of a few hours. However, a significant number of people regularly consume much higher amounts of alcohol: double or even triple the standard binge drinking threshold. Researchers have begun to distinguish between typical binge drinking and this kind of “high-intensity...
“Maturing Out” of Binge and Problem Drinking
This article reviews literature aiming to explain the widespread reductions in binge and problem drinking that begin around the transition to young adulthood (i.e., “maturing out”). Whereas most existing literature on maturing out emphasizes contextual effects of transitions into adult roles and responsibilities, this article also reviews recent work demonstrating further effects of young adult...
Resilience to Meet the Challenge of Addiction: Psychobiology and Clinical Considerations
Evidence from different disciplines suggests that acute and chronic stress–related mechanisms play an important role in both the development and the chronic, relapsing nature of addiction (Baumeister 2003; Baumeister et al. 1994; Brady and Sinha 2005). Stress is defined as the physiological and psychological process resulting from a challenge to homeostasis by any real or perceived demand on the...
Drinking Across the Lifespan: Focus on Older Adults
In 2010, when the leading edge of the post–World War II “Baby Boom” reached age 65, the United States began a period of increased growth in its older adult population. By 2030, it is expected that there will be 72.1 million adults age 65 or older living in the United States, almost double the 2008 population. Those older adults will represent 19.3 percent of the U.S. population, compared with 12...
Among the many organ systems affected by harmful alcohol use, the lungs are particularly susceptible to infections and injury. The mechanisms responsible for rendering people with alcohol use disorder (AUD) vulnerable to lung damage include alterations in host defenses of the upper and lower airways, disruption of alveolar epithelial barrier integrity, and alveolar macrophage immune dysfunction...
Drinking Over the Lifespan: Focus on Early Adolescents and Youth
In describing patterns of alcohol use among early adolescents (ages 12–14) and youth (ages 15–20), there is both good news and bad news. The good news is that research findings with U.S. national epidemiology data from long-term annual surveys of high-school students, such as the Monitoring the Future surveys, have indicated historical shifts toward overall decreases in levels of alcohol use...
Binge Drinking’s Effects on the Developing Brain—Animal Models
Adolescence typically is a time of experimentation and emulation of adult behaviors, and many adolescents initiate alcohol and other drug (AOD) use during this developmental period. Brain development continues during adolescence, which could render the adolescent brain particularly vulnerable to alcohol’s effects. Consequently, adolescent alcohol exposure could result in long-lasting changes in...
The Role of Stress, Trauma, and Negative Affect in Alcohol Misuse and Alcohol Use Disorder in Women
There has been a global increase in alcohol misuse and rates of alcohol use disorder (AUD) over the last two decades. Recent substantial increases in the United States come from dramatic rises in the prevalence of alcohol misuse and AUD in women relative to men (women, 84% increase; men, 35% increase).
The prevalence of alcohol use and the contrast between the drinking patterns of men and women vary widely across the globe. For instance, rates of current drinking ranged from 3 percent and 37 percent for women and men, respectively, in the Indian state of Karnataka to 94 percent and 97 percent for women and men in Denmark (Wilsnack et al. 2009). Overall, however, men have higher rates of alcohol...