Alcohol use disorder (AUD) is a significant contributor to morbidity and mortality in the United States. It contributes to over 140,000 annual deaths, to over 200 related diseases and health conditions globally, and accounts for 5.1% of the global disease burden. Despite its substantial impact, AUD remains undertreated, marked by a scarcity of approved medications. This paper explores the current treatment landscape and novel strategies for both alcohol withdrawal syndrome and AUD. Promising results, including the use of psychedelics alongside psychotherapy, noninvasive neural-circuit-based interventions, phosphodiesterase-4 inhibitors, and GLP-1 receptor agonists, have emerged from recent studies. While these advancements show potential, further research is crucial for a comprehensive understanding of their effectiveness. The clear shortage of approved medications and other treatment modalities underscores the pressing need for ongoing research.

This systematic review investigates the bidirectional relationship between alcohol consumption and disrupted circadian rhythms. The goal of this study was to identify (i) the types of circadian rhythm disruptors (i.e. social jet lag, extreme chronotypes, and night shift work) associated with altered alcohol use and (ii) whether sex differences in the consequences of circadian disruption exist. We conducted a search of PubMed, Embase, and PsycINFO exclusively on human research. We identified 177 articles that met the inclusion criteria. Our analyses revealed that social jet lag and the extreme chronotype referred to as eveningness were consistently associated with increased alcohol consumption. Relationships between night shift work and alcohol consumption were variable; half of articles reported no effect of night shift work on alcohol consumption. Both sexes were included as participants in the majority of the chronotype and social jet lag papers, with no sex difference apparent in alcohol consumption. The night shift research, however, contained fewer studies that included both sexes. Not all forms of circadian disruption are associated with comparable patterns of alcohol use. The most at-risk individuals for increased alcohol consumption are those with social jet lag or those of an eveningness chronotype. Direct testing of the associations in this review should be conducted to evaluate the relationships among circadian disruption, alcohol intake, and sex differences to provide insight into temporal risk factors associated with development of alcohol use disorder.

This systematic review (PROSPERO CRD42021234598) fills a gap in the literature by assessing the efficacy of psychosocial interventions in patients with alcohol use disorder and alcohol-related liver disease (ARLD), focusing on drinking reduction and abstinence as intervention goals. A systematic search for randomized controlled trials (RCTs) was conducted across various databases. Study screening and data extraction were conducted independently by two reviewers. The data were presented through narrative synthesis. Primary outcomes were alcohol reduction and abstinence at the longest follow-up. Ten RCTs were included, evaluating interventions such as cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), motivational interviewing, or peer support. The total population included 1519 participants. Four studies included a combination of more than one intervention, and two trialed an integrated approach, including medical and psychosocial management. A significant reduction was observed with MET, while abstinence was observed with peer support, MET, and CBT/MET within integrated treatment. The overall certainty of the evidence was moderate. Six studies presented a low risk of bias, one had some concerns, and three were high risk. The findings highlight the potential of psychosocial interventions, with MET being repeatedly associated with improved outcomes. Integrated treatment also demonstrated a promising role in ARLD. Future research should head toward improving the robustness and quality of the evidence. It should also aim to further tailor and trial new psychosocial interventions on this specific clinical population. This will enhance the translation of the evidence into real-world settings.

Auto-brewery syndrome (ABS) occurs when the gastrointestinal tract produces excessive endogenous ethanol. This article examines various aspects of ABS such as its epidemiology, underlying etiology, diagnostic difficulties, management strategies, and social implications. By synthesizing the existing medical literature, we hope to identify understanding gaps, pave the way for further research, and ultimately improve detection, treatment, and awareness. The databases we used are PubMed, PubMed Central, and Google Scholar. We carefully screened all published articles from inception till date and narrowed down 24 relevant articles. We at Richmond University Medical Center and Mount Sinai are one of the leading medical centers for diagnosing and treating this rare condition in the United States.

Globally, an estimated 107 million people have an alcohol use disorder (AUD) leading to 2.8 million premature deaths each year. Tuberculosis (TB) is one of the leading causes of death globally and over 8% of global TB cases are estimated to be attributable to AUD. Social determinants of health such as poverty and undernutrition are often shared among those with AUD and TB and could explain the epidemiologic association between them. However, recent studies suggest that these shared risk factors do not fully account for the increased risk of TB in people with AUD. In fact, AUD has been shown to be an independent risk factor for TB, with a linear increase in the risk for TB with increasing alcohol consumption. While few studies have focused on potential biological mechanisms underlying the link between AUD and TB, substantial overlap exists between the effects of alcohol on lung immunity and the mechanisms exploited by Mycobacterium tuberculosis (Mtb) to establish infection. Alcohol misuse impairs the immune functions of the alveolar macrophage, the resident innate immune effector in the lung and the first line of defense against Mtb in the lower respiratory tract. Chronic alcohol ingestion also increases oxidative stress in the alveolar space, which could in turn facilitate Mtb growth. In this manuscript, we review the epidemiologic data that links AUD to TB. We discuss the existing literature on the potential mechanisms by which alcohol increases the risk of TB and review the known effects of alcohol ingestion on lung immunity to elucidate other mechanisms that Mtb may exploit. A more in-depth understanding of the link between AUD and TB will facilitate the development of dual-disease interventions and host-directed therapies to improve lung health and long-term outcomes of TB.

Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic and mystical-type experiences that result. After a substantial period of restrictions limiting investigations into the therapeutic potential of psychedelics, a relatively recent recommencement of interest has sparked the burgeoning possibility for these drugs to play a part in the treatment of a wide array of psychopathologies. One of the most promising is in the study of addiction. Evidence has emerged that psychedelic agents may provide a novel avenue for the clinical treatment of patients dealing with substance use disorders (SUD). These serotonergic hallucinogens have displayed remarkable and enduring positive outcomes in this area, even when administered as one or two doses. The neural targets for these psychedelics are varied and underlie a complex mechanism of action-modulating multiple neural networks. It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation.

Alcohol Use Disorder (AUD) has a disconcertingly high relapse rate (70-80% within a year following withdrawal). Preventing relapse or minimizing its extent is hence a challenging goal for long-term successful management of AUD. New perspectives that rely on diverse neuromodulation tools have been developed in this regard as care supports. This paper focuses on electroencephalogram-neurofeedback (EEG-NF), which is a tool that has experienced renewed interest in both clinical and research areas. We review the literature on EEG-based neurofeedback studies investigating the efficacy in AUD and including at least 10 neurofeedback training sessions. As neurofeedback is a form of biofeedback in which a measure of brain activity is provided as feedback in real-time to a subject, the high degree of temporal resolution of the EEG interface supports optimal learning. By offering a wide range of brain oscillation targets (alpha, beta, theta, delta, gamma, and SMR) the EEG-NF procedure increases the scope of possible investigations through a multitude of experimental protocols that can be considered to reinforce or inhibit specific forms of EEG activity associated with AUD-related cognitive impairments. The present review provides an overview of the EEG-NF protocols that have been used in AUD and it highlights the current paucity of robust evidence. Within this framework, this review presents the arguments in favor of the application of EEG-NF as an add-on tool in the management of alcohol disorders to enhance the cognitive abilities required to maintain abstinence more specifically, with a focus on inhibition and attentional skills.

UNASSIGNED: There have been increasing reports of increased risk of alcohol use disorder (AUD) in the post bariatric surgery patient. The aim of this systematic review and meta-analysis is to observe the rate of AUD in the postoperative period following bariatric surgery for weight management.
UNASSIGNED: Electronic searches were performed using six databases from their dates of inception to January 2017. Studies observing the trend in AUD post bariatric surgery were identified. Data for relevant endpoint was extracted and analysed.
UNASSIGNED: Ten studies were identified for inclusion of analyses. One year post operatively pooled odds were 1.004 [95% confidence interval (CI), 0.921-1.094; P=0.935], with no significant difference found in the proportion of patients with AUD at 1 year vs. pre-surgery. Two years post operatively pooled odds were 0.981 (95% CI, 0.843-1.142; P=0.806), with no significant difference found in the proportion of patients with AUD at 2 years vs. pre-surgery. Three years post operatively pooled odds were 1.825 (95% CI, 1.53-2.178; P<0.001) with a significant increase in AUD particularly with gastric bypass surgery.
UNASSIGNED: In conclusion, prevalence of AUD increases in patients undergoing gastric bypass surgery but not gastric banding. The risk of AUD was found to not be significantly increased in the first 2 years postoperatively but increasing after this period.