Pharmacotherapy for Alcohol Use Disorder

Swift, Robert M.; Aston, Elizabeth R.

doi:10.1097/hrp.0000000000000079

Cited by 78 publications

(55 citation statements)

References 144 publications

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“…The use of screening and brief intervention for hazardous alcohol use is endorsed by the NIAAA (2004/2005). Addiction treatment services should also adopt the use of evidence‐based relapse prevention medications that have demonstrated effectiveness in reducing problematic alcohol use but are currently underutilized (Swift and Aston, ).…”

Section: Discussionmentioning

confidence: 99%

Hazardous Alcohol Use Associated with Increased Sexual Risk Behaviors Among People Who Inject Drugs

Fairbairn

Hayashi

Milloy

et al. 2016

Alcoholism Clin & Exp Res

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Background Alcohol is associated with a multitude of severe health consequences. While risk behaviours related to illicit drug use are commonly studied among people who inject drugs (PWID), the role of alcohol use has received substantially less attention in this population. We explored whether drug and sexual risk behaviours as well as experiences of violence were associated with hazardous alcohol use in a cohort of PWID. Methods Analyses were conducted using observational data from a prospective cohort of community-recruited HIV-negative PWID in Vancouver, Canada. We used the US National Institute on Alcohol Abuse and Alcoholism definition of hazardous alcohol use (i.e., > 14 drinks/week or > 4 drinks on one occasion for men, and > 7 drinks/week or > 3 drinks on one occasion for women.) We used multivariable generalized estimating equations to identify factors associated with hazardous alcohol use. Results Between 2006 and 2012, 1114 HIV-negative individuals were recruited, and 186 (16.7%) reported hazardous alcohol use in the previous six months at baseline. In multivariable GEE analyses, having multiple sex partners (Adjusted Odds Ratio [AOR] = 1.25), history of sexually transmitted infection (AOR = 1.50), experiencing violence (AOR = 1.36) and incarceration (AOR = 1.29) were each independently associated with hazardous alcohol use. Caucasian ethnicity (AOR = 0.56), ≥ daily heroin injection (AOR = 0.81) and engagement in addiction treatment (AOR = 0.84) were negatively associated with hazardous alcohol use (all p <0.05). Conclusions A considerable proportion of PWID reported hazardous alcohol use, which was independently associated with reporting sexual, but not drug-related, HIV risk behaviours and experiencing recent violence. Findings suggest a need to integrate regular screening and evidence-based alcohol interventions into treatment efforts for PWID.

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Section: Discussionmentioning

confidence: 99%

Hazardous Alcohol Use Associated with Increased Sexual Risk Behaviors Among People Who Inject Drugs

Fairbairn

Hayashi

Milloy

et al. 2016

Alcoholism Clin & Exp Res

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“…We rst explore the consumption of medication that treats nicotine or alcohol dependence. This class of medication is prescribed to individuals engaged in chronic smoking or excessive drinking for lengthy periods, who wish to cease their unhealthy behavior or to switch to a less damaging substitute (Siu 2015;Swift and Aston 2015). 32 As such, evidence of prompt increases in their consumption would suggest they are likely taken for treating preexisting conditions (rather than for treating newly-acquired conditions that may have been caused by spousal death).…”

Section: Health Awareness and Common Health Behaviorsmentioning

confidence: 99%

Family Health Behaviors

Fadlon

Nielsen

2017

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and the 2016 NBER Summer Institute for helpful comments and discussions. Jonathan Leganza provided excellent research assistance. We gratefully acknowledge funding from the Economic Policy Research Network (EPRN). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

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“…Moreover, longitudinal studies demonstrate that alcohol abuse precedes poor outcomes, suggesting that it is the cause, rather than a consequence, of these problems [2] . However, drugs that adequately control alcohol use disorders have yet to be developed, in part because the biology that motivates alcohol consumption is incompletely understood [3] .…”

Section: Introductionmentioning

confidence: 99%

FGF21, a liver hormone that inhibits alcohol intake in mice, increases in human circulation after acute alcohol ingestion and sustained binge drinking at Oktoberfest

Søberg¹,

Andersen

Dalsgaard

et al. 2018

Molecular Metabolism

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ObjectiveExcessive alcohol consumption is a leading cause of global morbidity and mortality. However, knowledge of the biological factors that influence ad libitum alcohol intake may be incomplete. Two large studies recently linked variants in the KLB locus with levels of alcohol intake in humans. KLB encodes β-klotho, co-receptor for the liver-derived hormone fibroblast growth factor 21 (FGF21). In mice, FGF21 reduces alcohol intake, and human Fgf21 variants are enriched among heavy drinkers. Thus, the liver may limit alcohol consumption by secreting FGF21. However, whether full-length, active plasma FGF21 (FGF21 (1–181)) levels in humans increase acutely or sub-chronically in response to alcohol ingestion is uncertain.MethodsWe recruited 10 healthy, fasted male subjects to receive an oral water or alcohol bolus with concurrent blood sampling for FGF21 (1–181) measurement in plasma. In addition, we measured circulating FGF21 (1–181) levels, liver stiffness, triglyceride, and other metabolic parameters in three healthy Danish men before and after consuming an average of 22.6 beers/person/day (4.4 g/kg/day of ethanol) for three days during Oktoberfest 2017 in Munich, Germany. We further correlated fasting FGF21 (1–181) levels in 49 healthy, non-alcoholic subjects of mixed sex with self-reports of alcohol-related behaviors, emotional responses, and problems. Finally, we characterized the effect of recombinant human FGF21 injection on ad libitum alcohol intake in mice.ResultsWe show that alcohol ingestion (25.3 g or ∼2.5 standard drinks) acutely increases plasma levels of FGF21 (1–181) 3.4-fold in fasting humans. We also find that binge drinking for three days at Oktoberfest is associated with a 2.1-fold increase in baseline FGF21 (1–181) levels, in contrast to minor deteriorations in metabolic and hepatic biomarkers. However, basal FGF21 (1–181) levels were not correlated with differences in alcohol-related behaviors, emotional responses, or problems in our non-alcoholic subjects. Finally, we show that once-daily injection of recombinant human FGF21 reduces ad libitum alcohol intake by 21% in mice.ConclusionsFGF21 (1–181) is markedly increased in circulation by both acute and sub-chronic alcohol intake in humans, and reduces alcohol intake in mice. These observations are consistent with a role for FGF21 as an endocrine inhibitor of alcohol appetite in humans.

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Pharmacotherapy for Alcohol Use Disorder

Cited by 78 publications

References 144 publications

Hazardous Alcohol Use Associated with Increased Sexual Risk Behaviors Among People Who Inject Drugs

Hazardous Alcohol Use Associated with Increased Sexual Risk Behaviors Among People Who Inject Drugs

Family Health Behaviors

FGF21, a liver hormone that inhibits alcohol intake in mice, increases in human circulation after acute alcohol ingestion and sustained binge drinking at Oktoberfest

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