Alcohol Abuse and Smoking: Dual Recoveries.

Between 80 and 95 percent of all alcohol abusers smoke cigarettes, leading to enormous public health problems. Little is known, however, about how changes in drinking and/or smoking affect recovery from both of these problems. A long-term study of alcohol abusers who also had been smokers at some point in their lives found that most of these people had recovered from both alcohol abuse and smoking and that these recoveries were very stable. Continued smoking, however, generally was associated with an increased risk for relapse to alcohol abuse.

The Link Between Alcoholism and Eating Disorders.

The comorbidity between alcoholism and eating disorders, especially in young women, is well documented. Alcohol and other drug (AOD)-use disorders are particularly common in women with bulimia nervosa. Although the mechanisms underlying the coexistence of these disorders remain unknown, recent family epidemiology studies suggest that bulimia nervosa and AOD dependence are transmitted independently in families. Furthermore, bulimia nervosa generally develops before the onset of AOD dependence. Thus, factors other than addictive behavior may contribute to the development of bulimia nervosa in a substantial proportion of women. The comorbidity of AOD-use disorders with eating disorders has implications for the treatment of the affected patients.

Treating Alcohol Problems in the Context of Other Drug Abuse.

People seeking treatment for alcohol problems frequently abuse other drugs as well, such as tobacco, cocaine, marijuana, methamphetamine, and opiates. The problem of polydrug use raises important issues for treatment providers. A person who abuses multiple drugs may have a more difficult time stopping drinking and a higher risk for relapse to alcohol use after treatment. Conversely, a person who successfully stops drinking may offset this achievement by substituting another drug for alcohol. Successful treatment must take into account both alcohol- and drug-related issues, with particular emphasis on assessment, motivation, treatment design, and outcome evaluation.

Alcohol-Use Disorder and Severe Mental Illness.

Alcohol-use disorders (AUD's) commonly occur in people with other severe mental illnesses, such as schizophrenia or bipolar disorder, and can exacerbate their psychiatric, medical, and family problems. Therefore, to improve detection of alcohol-related problems, establish correct AUD diagnoses, and develop appropriate treatment plans, it is important to thoroughly assess severely mentally ill patients for alcohol and other drug abuse. Several recent studies have indicated that integrated treatment approaches that combine AUD and mental health interventions in comprehensive, long-term, and stagewise programs may be most effective for these clients.