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Looking Back, Looking Forward: Current Medications and Innovative Potential Medications to Treat Alcohol Use Disorder

Introduction

According to national surveys, more than 85% of U.S. adults have consumed alcohol at some point in their lifetime, and about 70% did so in the last year.1 Most individuals drink responsibly and without adverse effects. However, a substantial proportion of people misuse alcohol.1,2 Drinking patterns associated with alcohol misuse include binge drinking, heavy drinking, and high...

Impact of Continuing Care on Recovery From Substance Use Disorder

Continuing care is widely believed to be an important component of effective treatment for substance use disorder, particularly for those individuals with greater problem severity. The purpose of this review was to examine the research literature on continuing care for alcohol and drug use disorders, including studies that addressed efficacy, moderators, mechanisms of action, and economic impact...

Computerized Cognitive–Behavioral Therapy

With an estimated 90 percent or more of alcohol use disorders going untreated (Substance Abuse and Mental Health Services Administration 2012), the search for interventions that easily, effectively, and economically reach more people has become a priority. The landmark 1990 report, Broadening the Base of Treatment for Alcohol Problems (Institute of Medicine 1990), refocused alcohol treatment...

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...

Alcohol’s Negative Emotional Side: The Role of Stress Neurobiology in Alcohol Use Disorder

Introduction

The word “alcohol” often conjures up positive feelings and associations with fun, socializing, relaxing, and partying. Yet there is another side to drinking alcohol, especially with risky, hazardous levels of consumption. This side is associated with distress and may include anxiety, loneliness, pain, and depressive symptoms.1 This has been labeled the “dark side,” or “negative...

Pharmacotherapy for Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder: Targeting the Opioidergic, Noradrenergic, Serotonergic, and GABAergic/Glutamatergic Systems

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...

Recent Developments in Alcohol Services Research on Access to Care

Of the more than 18 million Americans who need treatment for alcohol use disorder (AUD), less than 10 percent actually receive care (Substance Abuse and Mental Health Services Administration [SAMHSA] 2013). This problem, often referred to as the substance abuse treatment gap, is a longstanding concern for alcohol services research. Studies suggest that many factors contribute to the treatment gap...

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Introduction

Prenatal alcohol exposure (PAE) is linked to miscarriage, stillbirth, preterm birth, sudden infant death syndrome, and fetal alcohol spectrum disorders (FASD).1 Although PAE is the sole necessary cause of FASD, the etiology of this leading preventable cause of disability is multifaceted and complex, including lifestyle, maternal, sociodemographic, social, gestational, and genetic...

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 AUD...

Recovery-Oriented Systems of Care: A Perspective on the Past, Present, and Future

Introduction

This perspective focuses on the relatively recent topic of recovery-oriented systems of care; although influential in practice, this concept has yet to be evaluated empirically and thus cannot yet be the object of a review. In lieu of such evidence, this article offers one perspective on the origins of this concept and its present status prior to considering possible directions in...