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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Related Experiment Video

Updated: Aug 16, 2025

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Hazardous drinking and alcohol use disorders.

James MacKillop1,2, Roberta Agabio3,4, Sarah W Feldstein Ewing5,6

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Alcohol use disorders (AUDs) are influenced by genetics, environment, and psychology. Evidence-based treatments exist but are underused, highlighting a need for better implementation in healthcare systems.

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Area of Science:

  • Addiction research
  • Neuroscience
  • Psychiatry

Background:

  • Alcohol is a widely consumed psychoactive drug globally.
  • Hazardous drinking and alcohol use disorders (AUDs) cause significant morbidity.
  • AUDs are complex conditions influenced by multiple factors.

Purpose of the Study:

  • To review contemporary etiological perspectives on AUDs.
  • To highlight the interplay of genetic, neurobiological, psychological, and social factors.
  • To discuss available and underused evidence-based interventions for alcohol-related harms.

Main Methods:

  • Biopsychosocial framework application.
  • Review of genetic and environmental influences.
  • Examination of neurobiological, psychological, and social determinants.

Main Results:

  • AUDs have a complex polygenic architecture and are influenced by environmental factors like adverse childhood experiences.
  • Neuroadaptive changes, brain differences, and motivational factors (impulsivity, alcohol overvaluation) are key determinants.
  • Social networks and sociocultural factors play a bidirectional role in AUDs.

Conclusions:

  • Effective screening, pharmacotherapies, psychological interventions, and policy strategies for reducing alcohol harms are available.
  • These evidence-based approaches are substantially underused.
  • Translating research into clinical practice and promoting widespread implementation are critical priorities.