Purpose: There is an urgent need for novel and innovative advancements in alcohol research and treatment. Artificial intelligence (AI) is one such advancement that demonstrates promise, though not without important ethical concerns. This Perspective article examines current applications, ethical considerations, and future implications of integrating AI in alcohol research and treatment.
Search methods and results: A nonsystematic narrative review of peer-reviewed, English-language studies of contemporary applications of AI (specifically, large language models and machine learning) in alcohol research and treatment was conducted in December 2024 through January 2025, using searches of the PubMed, Google Scholar, Web of Science, and PsycInfo databases. Search terms included the following: "alcohol," "alcohol use," "alcohol use disorder," "drinking," "treatment," "screening," "artificial intelligence," "chatbot," "large language models," "research subject recruitment," "research subject enrollment," "electronic health records," "support vector machine," "neural network," "black-box," "random forest," and "machine learning." The article highlights studies that discussed the role of AI in bolstering recruitment and retention for human subjects research and in the application of advanced data analytic techniques for alcohol research. Further, the article examines studies that described current and prospective uses of AI in alcohol use disorder treatment, including assessment and identification of individuals who may benefit from treatment, and as an adjunct to evidence-based treatments for alcohol use disorder. Potential ethical concerns are highlighted alongside potential considerations for the safe and ethical use of AI across these domains.
Conclusions: Based on the identified primary and secondary sources, this review highlights the promises of AI in advancing both alcohol research and treatment, and how its successful implementation is supported by careful and ongoing attention to potential risks. The reviewed studies provide evidence that robust data security protocols, comprehensive informed consent, and ongoing monitoring for potential biases and harms can allow for these tools to advance scientific understanding while improving access to effective and equitable care. However, the current literature and the potential solutions suggested in this Perspective have limitations due to the pace of AI advancements that continue to accelerate at an unprecedent rate.
Future directions: Future research can advance the field by explicitly testing and evaluating the utility of these tools in real-world contexts, their risks for bias and privacy violations, and their ethical integration into alcohol research and treatment.
Purpose: Alcohol use disorder (AUD) and mild traumatic brain injury (mTBI) have a bidirectional, synergistic, and complicated relationship. Although it is difficult to definitively say that mTBI causes AUD, certain biological mechanisms that occur after trauma are also associated with hazardous alcohol use. Hazardous drinking is defined as any quantity or pattern of alcohol consumption that places people at risk for physical and/or psychological harm. This review explores how the physiological, emotional, and behavioral consequences of mTBI may lead to worse outcomes after hazardous alcohol use and increase the risk for AUD. AUD is one of the most common comorbid conditions that occurs after mTBI, and thus a clear understanding of the mechanistic changes that influence its onset may help to identify preventative and therapeutic measures for individuals who are at risk. This review provides an overview of recently published studies (from 2021 to 2024) and how these new findings fit into the existing literature.
Search methods: This review was conducted by searching "alcohol, traumatic brain injury, TBI" in PubMed, Google Scholar, and Medline databases in October and December 2024. Only articles in English were reviewed. Titles, abstracts, and methods of all articles were read to determine relevance, then the full texts of articles that met inclusion criteria were obtained. The search included articles published after March 2021; relevant papers published before 2021 were identified by consulting previously published reviews on this topic. Articles were excluded if they only discussed (1) moderate/severe TBI, (2) adolescent populations or TBI during adolescence, (3) populations with a history of AUD before TBI, (4) acute outcomes after TBI (less than 2 weeks), or (5) prevalence or effects of TBI while intoxicated. Also excluded were papers that did not specify if TBI preceded or followed hazardous alcohol use or did not discuss the relationship between TBI and alcohol use.
Search results: The search resulted in 196 articles for initial examination. Of those, 155 were excluded and 42 were included. Eight review papers about alcohol use after TBI published from 2009 to 2023 were also examined, which provided foundational and additional background information on publications from 1990 to 2021.
Discussion and conclusions: This review discusses mechanisms that contribute to negative outcomes after mTBI and hazardous alcohol use and to the development of AUD after mTBI. These include inflammation and immune signaling, neuroendocrine alterations, oxidative stress, neurodegeneration, dopamine signaling, and behavioral impairments. Although current literature on the role of the gut-microbiome axis in this context is limited, this topic is also explored.There has been significant research on the biological changes that occur after mTBI and on which mechanisms may precede
Purpose: Prenatal alcohol exposure (PAE) is a leading cause of persistent neurodevelopmental disability, with additional adverse consequences to the offspring's growth, metabolism, cardiovascular health, and immunity, among others. Alcohol disrupts offspring development through myriad mechanisms, many of which involve direct interactions between alcohol and the embryo and fetus (i.e., the conceptus). This limited narrative review instead focuses on mechanisms that are exogenous to the fetus. Many of these are relatively unexplored and are also mechanistically interrelated. Thus, they represent novel opportunities for the design of interventions that ameliorate alcohol-related pathologies.
Search methods: Literature from 2020 to October 2024 was searched using the terms "fetal alcohol spectrum disorder"[MeSH] OR "fetal alcohol"[Ti/Ab] with the filter "review." These reviews were inspected to extract nonfetal mechanisms of alcohol. Literature from 2000 to October 2024 was then searched in PubMed, Embase, and Google Scholar for seven mechanisms, using the search terms "fetal alcohol spectrum disorder OR fetal alcohol" AND one of the following: "placenta," "paternal," "metabolism OR insulin OR amino acid," "inflammation OR neuroinflammation OR cytokine," "epigenetic," "iron OR iron deficiency OR anemia," "microbiome." Only primary research articles, both clinical and preclinical, were included.
Search results: The literature scan identified seven mechanisms for which targeted literature searches were conducted. These searches yielded relevant studies that explored mechanisms involving the microbiome (n = 5 studies), inflammation (n = 72 studies), epigenetics (n = 30 studies), paternal alcohol exposure (n = 34 studies), placenta (n = 53 studies), metabolism (n = 37 studies), and functional iron deficiency (n = 23 studies).
Discussion and conclusions: Exogenous mechanisms of alcohol's teratogenicity are intertwined. Alcohol remodels the maternal enteric microbiome, with potential consequences to fetal immune function, nutrient availability, and brain development. Microbial endotoxins may further magnify alcohol's proinflammatory actions. This inflammation might also drive a fetal anemia associated with PAE. Alcohol alters maternal and fetal metabolism and could limit fetal nutrient availability. This altered metabolism could also reprogram placental and fetal epigenetics, as could paternal exposure to alcohol. Both epigenetic effects and inflammation can impair placental function and modulate the placenta-brain axis that modulates brain development. The review discusses limitations in the current understanding of these mechanisms and highlights future research avenues that would provide clarity and inform future interventions.
Purpose: Individuals with fetal alcohol spectrum disorders (FASD) or neurodevelopmental disorder associated with prenatal alcohol exposure (PAE) can experience a wide range of whole-body health conditions. A survey by the International Adult Leadership Collaboration (ALC) FASD Changemakers found that many adults with FASD have comorbidities relating to metabolic disorders; body composition; cardio-renal, reproductive, and/or immune health; as well as difficulties with hearing/vision and sleep. This review summarizes current knowledge of these health domains and provides an overview of the latest literature on the whole-body effects of PAE/FASD across the life span.
Search methods: The literature search was conducted on July 8, 2024, using CINAHL, PubMed, and Web of Science databases. To investigate the whole-body health of individuals with PAE, search terms were based on the findings of the ALC FASD Changemakers Health Survey and covered areas relating to sleep; hearing/vision; body composition; and metabolic, cardiovascular, renal, immune, and reproductive health. The search was conducted in two phases. To summarize current knowledge on these topics, the latest systematic reviews and other reviews were identified for each health domain (phase one). In addition, recent primary research articles published since these review searches were completed were identified for each domain (phase two). Inclusion/exclusion was based on article relevance to the physical health challenges reported in the ALC FASD Changemakers Health Survey.
Search results: In phase one, 744 reviews were identified in the initial search, of which 722 articles were excluded and 22 recent and relevant reviews were included. In phase two, 1,102 articles were identified, with 665 screened at the title/abstract level and 169 articles undergoing full-text review. A total of 1,066 articles were excluded. Following the addition of five articles from other sources, 41 recently published primary articles were included in the current review.
Discussion and conclusions: A growing body of evidence suggests that individuals with PAE/FASD may experience comorbidities relating to metabolism; body composition; cardio-renal, immune, and/or reproductive health; as well as hearing, vision, and sleep difficulties. These findings support the concept of FASD as a whole-body diagnosis, emphasizing the importance of a holistic approach that supports the overall health and well-being of those with PAE. There are opportunities for future clinical research to focus on further understanding these physical health challenges, how they evolve, and how effective intervention approaches could improve outcomes for individuals with PAE/FASD.
Background: Alcohol-related content (ARC) is pervasive across social media. Existing research suggests that posting of and exposure to such content may affect young adults' drinking and alcohol-related problems. However, a scoping review has yet to examine the literature within this field of research.
Objectives: This scoping review delineates and describes the existing peer-reviewed quantitative research examining the associations between ARC posting and exposure and drinking and alcohol-related problems among young adults ages 18 to 30. Specifically, the authors sought to investigate (1) methodological trends in how exposure to and posting of ARC is assessed; (2) potential moderators of the association between exposure to and posting of ARC and drinking outcomes; (3) how exposure to and posting of ARC is associated with alcohol consumption and alcohol-related problems; and (4) potential gaps in the literature.
Eligibility criteria: This review includes original, empirical, quantitative studies, published in English from 2006 to 2023, that measured alcohol consumption and/or alcohol-related problems and the use of ARC on social media in 18- to 30-year-olds.
Sources of evidence: The authors systematically searched the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Scopus databases on May 30, 2023, and reran the searches on November 1, 2023.
Charting methods: The authors designed a form to extract data and statistics related to alcohol drinking and ARC measures. Pairs of authors extracted the data for each study independently, and then a third author reviewed their work to resolve differences.
Results: In total, 3,112 papers were selected via preliminary search terms. After removing duplicates and other articles deemed ineligible based on screening articles at the title and abstract level as well as assessing full-text articles for eligibility (n = 3,079), the final review included 33 studies. Overall, the results of the scoping review revealed a lack of consistent definitions and standardized assessments related to ARC. Despite these factors, the authors uncovered robust positive relationships between posting ARCand drinking and alcohol-related problems. The literature also mostly found positive, significant linkages between exposure to ARC and drinking and alcohol-related problems.
Conclusions: This scoping review highlights the need for consistentoperationalization and empirically validated measures related to ARC. In addition, the authors propose a theoretical model that may serve as a road map for future interventions targeting young adults.
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