Addiction Policy Forum Blog

6 min read

Punishment, the brain, and compulsive drinking

By Mark Gold, MD on January 28, 2020

Experts, analysts, and officials sometimes find certain mysteries of alcohol use disorder (AUD) frustrating. Wouldn’t it be so much easier if we could find a single, or even primary, cause of the condition? Or if we could know with certainty which interventions would work best for patients and under which conditions? We know that the share of all individuals who have used alcohol heavily is relatively high, but a much smaller share of that population develops AUD. Heavy drinking and binge drinking on their own, while still risky, are not the only problem. In a study published in Science, researchers took up this question: what leads only some individuals who drink heavily to drink compulsively? They tracked neuron activity in mice to gauge how experiences of punishment in the brain might affect compulsive drinking patterns.

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5 min read

One Woman’s Mission to Change Our Country’s Relationship with Alcohol

By Casey Elliott on January 23, 2020

Annie Grace is the author of This Naked Mind: Control Alcohol, Find Freedom, Discover Happiness And Change Your Life and The Alcohol Experiment. Alcohol misuse is related to more deaths in the United States than drug overdose, and deaths related to alcohol use have increased drastically since 1999. In 2017, 2.6 percent “of roughly 2.8 million deaths in the United States involved alcohol. Nearly half of alcohol‐related deaths resulted from liver disease (30.7%; 22,245) or overdoses on alcohol alone or with other drugs (17.9%; 12,954),” according to a recent study in Alcoholism.

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7 min read

The role of alcohol, drugs, and despair in falling U.S. life expectancy

By Mark Gold, MD on January 16, 2020

After 2014, U.S. life expectancy fell for 3 straight years. This striking trend is not associated with other wealthy countries in the world and has given rise to a cottage industry of speculation on causes, with varied social, cultural, and political actors making use of the findings for preferred narratives. Some of this speculation arose after Princeton economists Anne Case and Angus Deaton coined the term “deaths of despair,” an easily misunderstood phrase. Case and Deaton used the term to refer to fatal drug overdoses, alcohol-related diseases, and suicides. “We think of all these deaths as suicides, by a very broad definition,” these economists have written,“and we attribute them to a broad deterioration in the lives of Americans without a college degree who entered adulthood after 1970.”

In late 2019, a National Institute on Aging-supported review offered a comprehensive examination of falling U.S. life expectancy. This study used data from the CDC, National Center for Health Statistics, and U.S. Mortality Database to trace life expectancy trends over a longer time frame and analyze mortality rates for particular age cohorts. It paints a complicated picture of poor U.S. mortality trends, which are not driven just by our polysubstance epidemics, and a decidedly unhappy one. The authors write, “According to one estimate, if the slow rate of increase in US life expectancy persists, it will take the United States more than a century to reach the average life expectancy that other high-income countries had achieved by 2016.”

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