Addiction Policy Forum Blog

7 min read

Alcohol use disorders are complex, but new research should improve practice

By Mark Gold, MD on November 14, 2019


Alcohol use disorders (AUDs) are one of the most common and least-treated health conditions in the world. Some AUDs decline in severity or even get better without treatment.1 AUDs often accompany depression, anxiety, fears and phobias, sleep disorders, liver problems, and other diseases. They may be caused by shared genes underlying other psychiatric conditions, especially depression.2 And while there’s a strong genetic component in many AUD cases, there are a host of contributing factors, from cultural and regulatory environments to psychological disposition to brain circuitry and anxiety, that can play important roles in the development of the condition—or, at least, that can play anything from a substantial role to a very limited one. It all depends. 

As any patient, involved health care practitioner, and/or expert would be quick to point out, AUD is a highly complicated condition, sometimes frustratingly so. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 6.2 percent of adults over 18 in the U.S. have an AUD, including over 9 million men and 5 million women.3 These numbers can be difficult to gauge in part because of the condition’s complexity—if we had a blood test that a physician could perform or a throat culture that could be sent to the lab, it would establish a diagnosis to everyone’s satisfaction. AUD is the most prevalent substance use disorder in the world, and from a public health perspective, it’s important not to let the complexity of AUD get in the way of sound policies and treatment practices. A comprehensive seminar recently published in The Lancet offered an updated discussion of the state of research on AUD, covering diagnosis, treatment, epidemiology, risk factors, environmental issues, and other considerations, as a guide to what we’ve learned about the condition.

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4 min read

Alcohol can increase your risk of developing cancer - even with moderate consumption

By Mark Gold, MD on August 15, 2019

Cancer is a serious public health risk, and approximately 7 million deaths per year around the world are attributed to smoking each year. In recent decades we have come to better understand the link between smoking and cancer; 22% of all cancers are linked to a person’s smoking and 70% of people globally now understand that link, up from just 40% in 1966. This relationship has often clouded a discussion of cancer risks. But as far as we have come in understanding how smoking, genetics, and even stress affect our chances of developing life-threatening cancers, we still understand very little about the relationship between alcohol and cancer. Only 13% of adults surveyed in the UK believe that cancer is a health risk of drinking alcohol, despite research linking it directly to multiple different forms of cancer that affect both men and women. Smoking and drinking both have second-hand effects to consider as well - 40,000 deaths each year attributed to non-smokers exposed to smoke. Alcohol and its effects on drivers is also significant, as auto and motorcycle traffic injuries are the ninth cause of death across all age groups, globally, and many are alcohol and/or drug-related. Despite a decrease in driving under the influence of alcohol prevalence over the past decades, DUIA prevalence still remains very high in the United States.1

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6 min read

The Science Behind A.A.

By Dr. Charlotte Wincott on August 6, 2019


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3 min read

What can rats tell us about making better medications for alcohol use disorder?

By Mark Gold, MD on July 25, 2019

Despite causing significant morbidity, mortality, and consequences relative to many other substance use disorders, alcoholism remains understudied in key respects. Some research has discovered certain brain pathways and structures linked to incentive cycles and reward-seeking behavior, but these findings have not necessarily been translated into treatment improvements. We still really do not understand why so many people have had a drink or drink regularly and do not have problems, or specifically addressed why 15% of people who consume alcohol struggle with loss of control-compulsive alcohol use in their behavior. To better understand what might cause people to move from controlled to uncontrolled alcohol use, researchers at Linköping University, the University of Gothenburg, and the University of Texas studied the rates at which rats seemed to prefer to self-administer alcohol or the sweetener saccharin.

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3 min read

Risks of Opioid & Alcohol Use for Women Increase with Age

By Mark Gold, MD on June 6, 2019

Alcohol use is very prevalent among Americans - more than half of U.S. adults drank last month - and alcohol is the third leading cause of preventable death after tobacco and poor diet/physical inactivity.1,2 When coupled with prescription opioid use, drinking becomes especially dangerous.3 Women are at high-risk of experiencing these adverse health effects, which worsen with age. A recent study illuminates the repercussions of concurrent alcohol and prescription opioid use in older women.

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3 min read

Ketamine and Naltrexone Combined Could Help Treat Depression and Addiction Simultaneously

By Mark Gold, MD on May 24, 2019

Ketamine was discovered by chemist Calvin Stevens in 1962 and its anesthetic effect was confirmed during testing with human prisoners in 1964. Ketamine was approved by the FDA in 1970 as Ketalar®, an injectable, rapid-acting general anesthetic. Because Ketamine does not cause respiratory depression or hypotension, it was released as a safer alternative to phencyclidine (PCP) that also provided excellent analgesia (pain relief).

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