Alcohol and Cannabis Use Disorders: Clinical Challenges and Advances (2022)

Introduction

In a 2022 commentary in the American Journal of Psychiatry, Dr. Ned H. Kalin highlights the pressing need to improve understanding and treatment approaches for alcohol and cannabis use disorders. Despite their prevalence, these conditions remain under-researched and undertreated.

Key Points

  1. Epidemiology and Social Context:
    • Alcohol use disorder (AUD) and cannabis use disorder (CUD) are significant contributors to morbidity, yet stigma and societal acceptance often obscure their clinical recognition.
    • The increasing legalization of cannabis adds complexity to CUD identification and treatment.
  2. Neurobiological Underpinnings:
    • Both substances affect the reward pathways in the brain, leading to dependency.
    • Chronic use may result in neuroplastic changes that hinder recovery efforts.
  3. Current Treatment Landscape:
    • AUD benefits from pharmacological interventions like naltrexone and acamprosate, while CUD lacks FDA-approved treatments.
    • Behavioral therapies, including cognitive-behavioral therapy and motivational interviewing, are mainstays for both conditions.
  4. Research Gaps:
    • There’s a need for targeted therapies addressing the unique neurobiology of CUD.
    • Integrating psychosocial and pharmacological strategies could enhance outcomes.
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