Alcohol Use and Alcohol Use Disorders

Alcohol use disorders (AUDs), alcohol abuse and alcohol dependence, are among the most prevalent mental disorders in the United States and elsewhere. Controversy exists with respect to the optimal way of classifying these disorders and the boundaries between normal and abnormal drinking. Although AUDs can occur over much of the life span, from an epidemiological perspective it is largely a disorder of adolescence and young adulthood. Many who experience AUDs “mature out” of them as they age and acquire adult roles and, perhaps, as a function of normal personality. However, a significant minority of individuals fails to mature out, and some individuals develop AUDs later in adulthood. There are a number of etiological pathways associated with developing an AUD; foremost among them is a pathway shared with other externalizing disorders such as conduct disorder, adult antisociality, and other substance dependence. However, pathways associated with internalizing disorders and with individual differences in alcohol effects also exist. All of these pathways likely involve major genetic and environmental determinants. Given the etiological pathways that have been documented, it is not surprising that AUDs are often comorbid with other mental disorders. A number of approaches to the prevention and treatment of AUDs have been developed that are effective. Additionally, basic research is setting the stage for further advances in both behavior and drug treatments of AUDs.