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Alcohol use disorder

see ((Alcoholism))

Criteria used to diagnose alcohol use disorder (AUD) are based on neurobiological changes due to excessive alcohol use that contributes to predictable patterns of drinking and other behaviors.

Alcohol use contributes to injuries and many diseases, including malignancies of the oropharynx, esophagus, liver, colon, rectum,  and breast, and also liver disease such as hepatitis and cirrhosis.

People at risk of harm from alcohol use include: young people who are vulnerable to injuries and accidents, older people who are at increased risk of complications of the interaction of alcohol and medications, such as opioids, benzodiazepines, anti-depressants, and antihistamines and alcohol attributable falls.

Alcohol use in pregnancy creates a risk of fetal alcohol syndrome.

Alcohol, like other addictive drugs, stimulates regions of the brain associated with reward by releasing the neurotransmitter dopamine, which reinforces behavior and increases the likelihood that a behavior will be repeated.

In patients with AUD, dopamine increases in brain regions associated with reward in anticipation of alcohol use results in strong physiological cravings.

Such adaptations can lead to reduced enjoyment from every day experiences, resulting in low mood and the prioritization of alcohol use above other daily activities.

Chronic alcohol use increases reactivity to stress, further contributing to motivations to drink.

Excessive alcohol use affects the prefrontal brain areas associated with self regulation, decreasing one’s ability to resist cravings or impulses to use alcohol.

Alcohol use is associated with approximately 3 million deaths per year globally.

However, chronic heavy alcohol use results in reductions in dopamine release and decreased density of dopamine receptors, as well as physiological tolerance to alcohols effects.

US deaths attributed to alcohol exceed 140,000 annually and account for one and five deaths among US adults age 20 to 49.

 

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