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Alcohol Research & Health : the Journal... 2011Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and cost-effectiveness of treatment for alcohol use...
Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and cost-effectiveness of treatment for alcohol use disorders (AUDs). This overview article summarizes the approaches reviewed in this issue, including potential future developments for alcoholism treatment, such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with AUDs and co-occurring disorders, the role of 12-step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment. This research will not only reveal new medications and behavioral therapies but also will contribute to new ways of approaching current treatment problems.
Topics: Alcoholics Anonymous; Alcoholism; Animals; Behavior Therapy; Humans; Narcotic Antagonists; Substance Abuse Treatment Centers
PubMed: 23580014
DOI: No ID Found -
American Family Physician Apr 2003Ten percent of the population abuses drugs or alcohol, and 20 percent of patients seen by family physicians have substance-abuse problems, excluding tobacco use. These... (Review)
Review
Ten percent of the population abuses drugs or alcohol, and 20 percent of patients seen by family physicians have substance-abuse problems, excluding tobacco use. These patients can be identified by relying on regular screening or a high index of suspicion based on "red flags" that can be noted in various clinical situations. The modified CAGE questionnaire is an excellent screening instrument, but several alternatives are available. The best screening test is one that the physician will routinely use well. Laboratory indicators such as gamma-glutamyl transpeptidase, mean corpuscular volume, and carbohydrate-deficient transferrin are nonspecific but can add to the evidence of alcohol abuse. If problem alcohol use is diagnosed, even brief physician advice can be helpful. If the problem has progressed to addiction, referral to an addiction specialist or treatment center is recommended. Special issues arise in dealing with substance abuse in adolescents, elderly patients, and patients with mental illness, but the family physician can play an important role in recognizing this common problem.
Topics: Age Factors; Alcoholism; Humans; Mass Screening; Physician's Role; Sensitivity and Specificity; Substance Abuse Detection; Substance-Related Disorders; Surveys and Questionnaires; Transferrin; gamma-Glutamyltransferase
PubMed: 12722853
DOI: No ID Found -
American Family Physician Mar 2000Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later... (Review)
Review
Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later life, while the other two thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism. The common definitions of alcohol abuse and dependence may not apply as readily to older persons who have retired or have few social contacts. Screening instruments can be used by family physicians to identify older patients who have problems related to alcohol. The effects of alcohol may be increased in elderly patients because of pharmacologic changes associated with aging. Interactions between alcohol and drugs, prescription and over-the-counter, may also be more serious in elderly persons. Physiologic changes related to aging can alter the presentation of medical complications of alcoholism. Management of alcohol withdrawal in elderly persons should be closely supervised by a health care professional. Alcohol treatment programs with an elder-specific focus may improve outcomes in some patients.
Topics: Aged; Aging; Alcohol-Related Disorders; Alcoholism; Brain; Cognition; Diagnosis, Differential; Ethanol; Humans; Surveys and Questionnaires
PubMed: 10750878
DOI: No ID Found -
Pharmacology & Therapeutics May 2018Patients who suffer from alcohol use disorders (AUDs) usually go through various socio-behavioral and pathophysiological changes that take place in the brain and other... (Review)
Review
Patients who suffer from alcohol use disorders (AUDs) usually go through various socio-behavioral and pathophysiological changes that take place in the brain and other organs. Recently, consumption of unhealthy food and excess alcohol along with a sedentary lifestyle has become a norm in both developed and developing countries. Despite the beneficial effects of moderate alcohol consumption, chronic and/or excessive alcohol intake is reported to negatively affect the brain, liver and other organs, resulting in cell death, organ damage/failure and death. The most effective therapy for alcoholism and alcohol related comorbidities is alcohol abstinence, however, chronic alcoholic patients cannot stop drinking alcohol. Therefore, targeted therapies are urgently needed to treat such populations. Patients who suffer from alcoholism and/or alcohol abuse experience harmful effects and changes that occur in the brain and other organs. Upon stopping alcohol consumption, alcoholic patients experience acute withdrawal symptoms followed by a protracted abstinence syndrome resulting in the risk of relapse to heavy drinking. For the past few decades, several drugs have been available for the treatment of AUDs. These drugs include medications to reduce or stop severe alcohol withdrawal symptoms during alcohol detoxification as well as recovery medications to reduce alcohol craving and support abstinence. However, there is no drug that completely antagonizes the adverse effects of excessive amounts of alcohol. This review summarizes the drugs which are available and approved by the FDA and their mechanisms of action as well as the medications that are under various phases of preclinical and clinical trials. In addition, the repurposing of the FDA approved drugs, such as anticonvulsants, antipsychotics, antidepressants and other medications, to prevent alcoholism and treat AUDs and their potential target mechanisms are summarized.
Topics: Alcoholism; Animals; Drug Approval; Drug Repositioning; Humans; Signal Transduction; United States; United States Food and Drug Administration
PubMed: 29191394
DOI: 10.1016/j.pharmthera.2017.11.007 -
Public Health Reports (Washington, D.C.... 1988An empirical biobehavioral research approach to the conditions generally identified as alcohol abuse and alcoholism emphasizes the temporal ordering of participating... (Review)
Review
An empirical biobehavioral research approach to the conditions generally identified as alcohol abuse and alcoholism emphasizes the temporal ordering of participating biochemical, physiological, and behavioral events that provide an operational basis for characterizing the functional aspects of this complex disorder and identifying distinguishable features of the alcohol abuse and dependence process. The available evidence suggests that alcoholism is a condition determined by a host of continuous variables rather than an entity possessing static qualities that imply intractability. The challenge for biobehavioral research is to determine the details of how chronic and excessive alcohol drinking is generated as well as the conditions under which such overindulgence can be attenuated and prevented. Environmental context, for example, can dramatically alter the frequency and amount of alcohol intake. Such contextual malleability is suggested as an important key to at least some of the inconsistencies in the literature with regard to the conditions under which chronic and excessive alcohol intake occurs. Excessive and chronic alcohol ingestion would seem most parsimoniously viewed as a set of behaviors for which others might have been substituted, and intermittently do, rather than as a highly specific disorder or disease. Though current etiological, preventive, and therapeutic orientations emphasize the role of physical dependence and favor genetic influences as strong determinants of alcohol-related disorders, it is important to recognize that troubled drinking is malleable, waxing and then entering periods of remission, with alcohol drinking even in severely dependent individuals remaining susceptible to control by both antecedent and consequating environmental events.
Topics: Alcoholic Intoxication; Alcoholism; Animals; Behavior, Animal; Disease Models, Animal; Humans; Research Design
PubMed: 3141967
DOI: No ID Found -
Molecular Genetics and Genomics : MGG Jun 2014Alcohol abuse and alcoholism incur a heavy socioeconomic cost in many countries. Both genetic and environmental factors contribute to variation in the inebriating... (Review)
Review
Alcohol abuse and alcoholism incur a heavy socioeconomic cost in many countries. Both genetic and environmental factors contribute to variation in the inebriating effects of alcohol and alcohol addiction among individuals within and across populations. From a genetics perspective, alcohol sensitivity is a quantitative trait determined by the cumulative effects of multiple segregating genes and their interactions with the environment. This review summarizes insights from model organisms as well as human populations that represent our current understanding of the genetic and genomic underpinnings that govern alcohol metabolism and the sedative and addictive effects of alcohol on the nervous system.
Topics: Alcoholism; Animals; Epigenesis, Genetic; Ethanol; Gene Expression Regulation; Genetic Predisposition to Disease; Genomics; Humans; Phenotype
PubMed: 24395673
DOI: 10.1007/s00438-013-0808-y -
Alcohol Research : Current Reviews 2022This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as... (Review)
Review
This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world's largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, "Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research," devoted to key topics within the field of alcohol research. This article is based on Dr. Tapert's presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.
Topics: Adolescent; Alcohol Drinking; Alcohol-Related Disorders; Alcoholism; Brain; Humans; National Institute on Alcohol Abuse and Alcoholism (U.S.); United States
PubMed: 35465194
DOI: 10.35946/arcr.v42.1.07 -
Expert Review of Proteomics Aug 2012Alcohol abuse can lead to a number of health and social issues. Our current inability to accurately assess long-term drinking behaviors is an important obstacle to its... (Review)
Review
Alcohol abuse can lead to a number of health and social issues. Our current inability to accurately assess long-term drinking behaviors is an important obstacle to its diagnosis and treatment. Biomarkers for chronic alcohol consumption have made a number of important advances but have yet to become highly accurate and as accepted as objective tests for other diseases. Thus, there is a crucial need for the development of more sensitive and specific markers of alcohol abuse. Recent advancements in proteomic technologies have greatly increased the potential for alcohol abuse biomarker discovery. Here, the authors review established and novel protein biomarkers for long-term alcohol consumption and the proteomic technologies that have been used in their study.
Topics: Affinity Labels; Alcohol Drinking; Alcohol-Induced Disorders; Alcoholism; Biomarkers; Clusterin; Cytokines; Glycerophospholipids; Humans; Proteome; Proteomics; Sensitivity and Specificity; Time Factors; Transferrin
PubMed: 22967079
DOI: 10.1586/epr.12.38 -
Journal of Ethnicity in Substance Abuse 2019We used data from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions to examine racial-ethnic and nativity-based variations in...
We used data from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions to examine racial-ethnic and nativity-based variations in alcohol use/abuse and treatment seeking while accounting for acculturation, stress, and social integration factors. The dependent variables included alcohol use, risky drinking, DSM-IV alcohol use disorder, and treatment seeking in the past 12 months. Racial-ethnic categories included African, European, Asian/Pacific Islander, Mexican, Puerto Rican, and other Hispanic/Latino. Acculturation, social stress, and social integration were assessed with previously validated, detailed measures. Bivariate probit models with sample selection were estimated for women and men. Immigrant status and origin associations with alcohol use/abuse and treatment seeking were strong and largely unaffected by other social factors. Europeans and men of Mexican origin had the highest while women of African, Asian/Pacific Islander, and Puerto Rican origins had the lowest rates of alcohol use/abuse. Years in the United States was associated with a higher risk of alcohol use/abuse for all immigrant groups. Foreign-born individuals were no less likely than U.S. natives to seek treatment if they were abusing or were dependent on alcohol. Further modeling of these relationships among specific immigrant groups is warranted. These findings inform alcohol rehabilitation and mental health services for racial-ethnic minorities and immigrants.
Topics: Acculturation; Adolescent; Adult; Alcohol Drinking; Alcoholism; Emigrants and Immigrants; Female; Health Surveys; Humans; Male; Patient Acceptance of Health Care; Risk-Taking; United States; Young Adult
PubMed: 28678640
DOI: 10.1080/15332640.2017.1333476 -
Alcohol Health and Research World 1998Adolescents who abuse or are dependent on alcohol often have coexisting mental disorders. These disorders may both precipitate alcohol use disorders and result from... (Review)
Review
Adolescents who abuse or are dependent on alcohol often have coexisting mental disorders. These disorders may both precipitate alcohol use disorders and result from them. In addition, both types of disorders may arise independently in adolescents at high risk. Mental disorders that commonly co-occur with alcohol use disorders in adolescents include antisocial disorders, mood disorders, and anxiety disorders. Treatment programs for adolescents with alcohol use disorders should seek not only to eliminate alcohol and other drug use but also to improve the symptoms of other mental disorders.
Topics: Adolescent; Adolescent Behavior; Alcohol Drinking; Alcoholism; Humans
PubMed: 15706785
DOI: No ID Found