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Measuring the Burden—Current and Future Research Trends: Results From the NIAAA Expert Panel on Alcohol and Chronic Disease Epidemiology

Research is continuing to investigate how alcohol impacts chronic disease. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) hosted a 2-day Expert Panel on Alcohol and Chronic Disease Epidemiology in August 2011 to review the state of the field on alcohol and chronic disease. The panel was chaired by Kenneth J. Mukamal, M.D., and Rosalind A. Breslow, Ph.D., M.P.H., R.D., and was...

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...

Brain Structure and Function in Recovery

Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently...

Early Life Stress as a Predictor of Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder

During the critical developmental periods of childhood when neural plasticity is high, exposure to early life stress (ELS) or trauma may lead to enduring changes in physiological stress systems and enhanced vulnerability for psychopathological conditions such as post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) in adulthood. Clinical and preclinical studies have sought to...

Advances in Medications and Tailoring Treatment for Alcohol Use Disorder

Despite decades of research on various methods for treating alcohol use disorder (AUD), AUD remains prevalent throughout the world, making it critical to develop a more comprehensive approach to address the issue. Heavy drinking is the third largest risk factor for global disease burden, leading to enormous social and economic decline (World Health Organization 2014). Each year, alcohol misuse is...

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-Endocannabinoid Interactions: Implications for Addiction-Related Behavioral Processes

Introduction

Endogenous cannabinoids, or endocannabinoids (eCBs), are bioactive lipid molecules that modulate signaling activity of several physiological processes involved in pain, appetite, energy balance, stress/anxiety, immune signaling, and learning and memory. Although understanding of the eCB system has grown in complexity since its discovery by Raphael Mechoulam, it is now widely known...

Sleep-Related Predictors of Risk for Alcohol Use and Related Problems in Adolescents and Young Adults

Introduction

Abundant cross-sectional data indicate that alcohol use and related problems are accompanied by disruptions to sleep and circadian rhythms.1 Alcohol's negative impacts on sleep are well established, especially in adults, and a smaller body of literature also reports alcohol's disruption of circadian rhythms.2-4 Growing evidence supports sleep and circadian factors as influencing...

Neuroplasticity in Human Alcoholism: Studies of Extended Abstinence with Potential Treatment Implications

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...