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...
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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...
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) ...
Alcohol consumption during pregnancy can interfere with both embryonic and fetal development, producing a wide range of outcomes that fall under the rubric of fetal alcohol spectrum disorders (FASD). FASD is the nondiagnostic umbrella term used to refer to the full range of effects that can occur following prenatal alcohol exposure. Such exposure can produce a variety of effects, including...
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...
Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women
1Health Behavior Research and Training Institute, University of Texas at Austin, Austin, Texas
Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused...
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...
Introduction
Alcohol-associated liver disease (ALD) is a leading cause of morbidity and mortality in people with alcohol use disorder (AUD).1 Alcohol exerts its effect on the liver through both direct and indirect pathways and can eventually lead to steatosis, steatohepatitis, fibrosis, hepatocellular carcinoma, and cirrhosis.2 However, only approximately 10% to 20% of patients with ALD develop...
Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision...