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According to the World Health Organization (http://www.who.int/substance_abuse/facts/alcohol/en/index.html), each year alcohol causes 2.5 million (3.8 percent of total) deaths and 69.4 million (4.5 percent of total) disability-adjusted life-years (DALYs) lost to disease worldwide. Alcohol dependence (alcoholism) also is a major health problem in the United States, affecting 4 to 5 percent of the...

Adrenocorticotropic hormone (ACTH): Also known as corticotropin, is a hormone produced and secreted by the anterior pituitary gland. It is an important component of the hypothalamic–pituitary–adrenal (HPA) axis and often is produced in response to biological stress (along with corticotropin-releasing factor from the hypothalamus). Its principal effects are increased production and release of...

Findings from epidemiologic studies and research with experimental animal models provide insights into alcohol-related disease pathogeneses. Epidemiologic data indicate that heavy drinking and smoking are associated with high rates of pancreatic disease. Less clear is the association between lower levels of drinking and pancreatitis. Intriguingly, a very low percentage of drinkers develop clinical...

Excessive alcohol consumption is a global healthcare problem. The liver sustains the greatest degree of tissue injury by heavy drinking because it is the primary site of ethanol metabolism. Chronic and excessive alcohol consumption produces a wide spectrum of hepatic lesions, the most characteristic of which are steatosis, hepatitis, and fibrosis/cirrhosis. Steatosis is the earliest response to...

Stress, generally defined as any stimulus that disrupts the body’s internal balance (i.e., physiological homeostasis), has long been suggested to be an important correlate of uncontrolled alcohol consumption or relapse to drinking following a period of abstinence. Large epidemiological studies have reported that a variety of stressors are associated with increased alcohol consumption and binge...

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...

Special emphasis populations in the current context can be defined as groups experiencing health disparities resulting in elevated risk to health, safety, and well-being from drinking alcohol. Individuals from marginalized minority populations often encounter barriers to accessing and receiving effective alcohol treatment due to social inequities and disadvantaged life contexts, which also may...

Introduction

Although the awareness of the negative impact of prenatal alcohol exposure (PAE) was already alluded to in ancient writings¹ and the impact of ethanol embryopathy in animal models was studied as early as 1910,² the conceptualization of a syndrome associated with PAE was not recognized within modern medicine until the mid-20th century.^3,4 The syndrome or disorder was not uniformly...

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...

Introduction

The establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1971 was bracketed by three seminal papers that laid the groundwork for the field of fetal alcohol spectrum disorders (FASD) research. In 1968, Lemoine et al.¹ described children with birth defects and neurodevelopmental disorders associated with prenatal alcohol exposure (PAE). This French...