Substance Use Disorders A Biopsychosocial Perspective

In the United States, about 5 percent of the adult population (10 percent of current consumers of alcohol) suffers from an alcohol use disorder (AUD). Risk factors for AUD include genetic predisposition, difficult experiences in childhood, regular use of any addictive drug during early adolescence, and certain psychiatric syndromes. A severe, persistent type of AUD usually emerges before age 25, causing much dangerous intoxicated behavior. A less severe type has a later onset, fewer harmful consequences, and a more favorable prognosis. The course of alcohol AUD over decades is quite variable among those who continue to drink. Prolonged heavy use of alcohol damages the liver and many other organs and body systems, contributing to death in many with AUD. Women are more vulnerable to the toxic effects of chronic alcohol use. AUD typically emerges at a later age in women, but the problems escalate more rapidly. Most who drink alcohol do not become addicted, so use is generally accepted. Other, more addictive drugs (such as methamphetamine and opioids) appear to be more dangerous, but due to its widespread use, alcohol is a greater threat to public health.