In this episode of What the Health, we explore the pervasive role of alcohol in American life, the devastating health impacts and the complexities of alcohol use disorder (AUD). Dr. Yngvild Olsen, the Director of the Center for Substance Abuse Treatment, provides insights into the evolution of terms used to describe AUD, the genetic and environmental risk factors and the health consequences associated with excessive alcohol consumption. Dr. Olsen also discusses treatment options, including behavioral and pharmacological interventions, and emphasizes the importance of early identification. Additionally, this episode highlights the inaugural launch of Substance Use Disorder Treatment Month, aimed at raising awareness and offering hope to those affected. Join us for an in-depth conversation on breaking the grip of alcohol use disorder.

00:00 Introduction: Alcohol in American Life

01:48 Understanding Alcohol Use Disorder

03:57 Current Trends and Statistics

06:59 Genetic and Environmental Factors

10:13 Health Impacts of Alcohol

16:38 Identifying and Addressing Alcohol Use Disorder

30:53 Treatment Options and Misconceptions

36:31 Hope and Future Initiatives

39:29 Conclusion and Resources

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It's no surprise that alcohol is part of the fabric of American life. After all, it's estimated that 80 percent of the population over 12 years old has had at least one drink at some point in their lifetime, and probably a lot more. For many people, maybe most, it's a relatively harmless diversion that is ingrained in a variety of social events.

The unfortunate reality for some, however, is that alcohol is also a devastating drug that can rip apart individuals and their families through dangerous and deadly health consequences. The proof? While consumption may be leveling off, related fatalities have surged over the last two decades. The reasons are complex, at times seemingly overwhelming.

But there is also hope for those facing the challenge alcohol brings. Our upcoming guest is perfectly placed to explain why alcohol is able to maintain its grip on so many, and what we can all do to break it.

Today we are dealing with, alcohol use in this country. That's the topic of the conversation. And we're delighted to have Dr. Ingeveld Olson, Director of the Center for Substance Abuse Treatment with us to discuss what's happening in this country and maybe what we can do about it.

So, Dr. Olson, welcome to our broadcast.

Thank you so much. Great to be here.

One of the things we wanted to start with is really how we're describing what many people would say alcoholism, alcohol abuse. And I know that in some ways there's a move to describe it differently or to label it differently. So maybe you could sort of explain where we are with that or why we're looking at those sort of things.

Yeah. No, this is such a great question. I think for many years, people use terms like alcoholism, alcohol abuse, and even the diagnoses were kind of called alcohol abuse and alcohol dependence. That was very confusing. And, because there are lots of people who use alcohol who actually don't have kind of the diagnosis of an alcohol use disorder and alcohol use disorder is now the term that we use. And it also became clear many, many years ago that when we use the word abuse, it actually carries negative connotations and a lot of stigma. Around, the behavior around the health condition that people have, of alcohol use disorder.

I do think though, that people are, slowly recognizing that an alcohol use disorder is really a health condition that people don't necessarily have control over kind of their use of alcohol.

It impacts many different aspects of their lives and that it's not a moral failure. Because that was kind of what was associated with that term abuse, for many years.

And if I slip during the interview, feel free to correct me. And I, I don't say that lightly because, there is alcohol use disorder in my family, and we obviously always refer to it as alcoholism. Whether we stigmatize people or not personally, but we did. So if I, if I slip. You're there to correct me.

What's the level right now of the status of disorder in the country?

We know that alcohol use is very common. Alcohol use disorder among the people who actually, drink alcohol that that is less common. And certainly when you think about just alcohol use and then we can talk about some of the risk factors for people to develop an alcohol use disorder, but for people who, and the levels of kind of alcohol consumption that has been, kind of relatively stable for many, many years.

Even declining a little bit. And then with the COVID pandemic, we saw, a pretty significant increase. Often people drink alcohol in response to stress and those negative emotions, even though we know that also it is used in lots of social interactions, right?

People use it and drink among friends and, parties, et cetera. That's kind of very, well known. But we also know that, in a given month, only about 52 percent of adults over 18 drink any alcohol. And that's according to something called the National Survey on Drug Use and Health that we, at Sam said, run every year. But, when you actually look at heavy drinking, like, this really excessive drinking that is defined by the National Institute on alcohol and, NIAAA at NIH as having more than four drinks on any occasion for women or five drinks on any occasion for men. So that's what's called binge drinking. Heavy drinking is then also defined as binging on five or more occasions in the past month. So When we look at that population of people who engage in that kind of excessive, that really binge or heavy drinking that they're about 24% of adults, binged, on alcohol, in any given month.

So it's about half of the half. And about 6% of people have that heavy alcohol use. So what we define the alcohol use disorder that some of those individuals who have that binge or heavy drinking may meet criteria for like a mild alcohol use disorder or even a severe alcohol use disorder.

And we can talk a little bit about what kind of how those are defined, but it's about 11 percent of people over the age of 18 in the U. S. have an alcohol use disorder.

Is that rising or flat? And I know it may be difficult to get a, just a simple answer to that.

The disorder, is it psychologically driven? Is it genetically driven? It's often said, Oh, the disorder or the older term alcoholism was in your family. Is this disorder driven by genetics or

Yeah, When we talk about some of the risk factors for developing a substance use disorder, in this case, an alcohol use disorder, the genetic component accounts for about 40 to 60 percent or almost half of that risk. Now, we know that there are a number of different genes, that are involved in that development, but which ones, are exactly involved in which specific use disorder?

What combination of genes? Because it's probably not just one. And so, there's still a lot of research happening to really identify specifically what are some of those genes and the genetic combinations. But I think it's important for people to understand that when we say that it runs in families, It can absolutely run in families because of that risk of that, about 50 percent is genetically based does not mean that people who have that predisposition from their families are destined to actually develop an alcohol use disorder because we know that, It also is really an interaction between the genetics and the environment and other things that can happen in people's lives.

So, for example, we know that, there's a lot of really great research that has found that people who have high levels of something called adverse childhood experiences. So, if you have experienced physical or sexual abuse as a child, if you've, had, traumatic events happen to you as a kid, right?

That actually increases people's risk of not only starting to use substances early in adolescents, but also then to go on and have a higher risk of developing that substance use disorder, that alcohol use disorder. People who also have other, psychiatric conditions.

So depression, anxiety, PTSD, all those types of, health conditions also increase the risk. And for many people, that combination of depression and alcohol use disorder can also complicate not just the presentation and kind of increases the risk of both, but it also complicates treatment. So we can talk about that a little bit.

The other piece that, we know that men are at higher risk for developing a substance use disorder than women. Although that, looks like women are catching up, in some of the data that we have, and, depending on, some of the genetic, predispositions also relate to how alcohol in particular is metabolized in people.

So, it's the brain receptor genetics and how people respond to alcohol in their brains, but also just in how alcohol is metabolized in the body by the liver. People from, Asian backgrounds, for example, have a gene that metabolizes alcohol differently so that they actually have a lower risk of developing an alcohol use disorder compared to other, racial, ethnic individuals.

Wow. So we, see a usage is relatively flat. And if I'm not wrong, we've seen recent reports that alcohol related deaths have doubled in the last two decades. Why is that occurring?

It's a really an incredibly important piece to understand. And you're absolutely right that, alcohol related deaths have gone up. The centers for disease control estimates that alcohol is attributable to mortality in some way, and accounts for over 175, 000 deaths per year.

They have other health conditions that can get exacerbated by alcohol, long term use of alcohol. I think that's the other piece is unlike opioids, for example, that has also been contributing so much to the overdose crisis in this country. The mortality from opioids is much more sudden, it can happen immediately, right?

Alcohol related deaths though, it can take some time before all the harmful effects of alcohol accumulate in someone's body. It can take time to develop liver disease, cancers, heart disease, all those health conditions that alcohol can contribute to.

And, you know, I think one of the things that we are really paying a lot of attention to and starting, to pay more attention to are all of those alcohol related deaths. People now are using, , multiple substances at a time, including alcohol. So it's not just that alcohol by itself is contributing to some of these deaths, but it can also be partly part of kind of that polysubstance use that we're seeing and and increases in the polysubstance use among the population.

Interesting. Do we see a difference in demographic use in terms of age? Are younger people drinking more than they had in the past?

It actually looks like some of the surveys that we have showed that the younger population now is actually drinking less and slightly declining particularly when you look back 30 40 years that the alcohol ,consumption in the U. S. Particularly among that younger population has declined.

That's interesting. Is that a matter of awareness, or just a general move towards health?

I think that's it's a little hard for me to kind of speculate on exactly why I think it may be combinations of things. I do think that there has been a recognition around the younger generation that alcohol, much like, tobacco, we've seen declines in tobacco use that there is an element of awareness.

The other thing that has happened though, which I think is also important to recognize is that cannabis use has gone up among that younger population. And so, now, when we've had a lot of focus on drinking and driving, and having dry January, right? Really thinking about and messaging around the negative social effects also of alcohol in addition to the negative health effects that we see now cannabis use going up.

From a social standpoint, when I went to school, university, a million years ago It was a very heavy drinking environment, excessively heavy drinking environment. And I think that I have to go to a Jesuit university. And so you have a Catholic background there. And I think there was an element of it's okay.

I don't care how much Johnny drinking as long as he's not taking drugs. So that sort of brings me to my next point is, is alcohol disorder or just drinking. Is that seen as less harmful, let's say, than cigarettes and drugs and that's why it may be more, more acceptable. And is it less harmful?

Yeah, I think it really depends on kind of how you ask that question. Because, we have seen that in so 1 of the large studies that looks at kind of, adolescent perceptions of dangers of various different substances is something called monitoring the future. study that that is run by the National Institute on Health, the National Institute on Drug Abuse.

And when they've looked at high school seniors, for example, that smoking a pack of cigarettes a day was seen as harmful by more students than drinking four servings of alcohol a day. There are also surveys of adults that have shown that people perceive cigarettes to be more harmful than alcohol.

But we also now have seen that perceptions of cannabis use as harmful. That has declined in some of those surveys. Among adolescents. And so, again, it's hard to say whether there's, something that is now being seen as less harmful, more harmful, as all of these social mores change, but I think we do see that, between cigarettes, alcohol nicotine, there have been some changes recently in how people are perceiving the harm of those.

I will say you asked the question about is alcohol more harmful than the nicotine and cigarettes? We know that cigarettes, nicotine vaping and alcohol, they all contribute to health problems and to public health consequences.

And with alcohol, you have impairment. I'm assuming with nicotine, and I may be wrong, you don't have impairment. So if you have buzz driving, or drunk driving, it's a different issue. Dr.

With alcohol use, so excessive alcohol use, and then particularly with alcohol use disorder, that inability to control one's drinking, continuing to drink despite harmful consequences. That's a good way of thinking about it.

That absolutely that has both public health and individual health consequences. Nicotine and tobacco use disorder has different consequences right both for the individual, but also second hand smoke. And so I think we just need to think about them differently, but they all, I think, have that public health and individual health impacts.

And we're going to get into, how to identify problems and also what current treatment looks like and all of those things. But, I wanted to just also touch on, we have the disorder, someone who has a. A use disorder and but then you also mentioned people who may be drinking excessively at times.

Okay, the holiday party may have too much as long as someone's driving. It's probably not a problem. My, my point is, how do we differentiate between? Okay, you may not have a disorder. Technical disorder, but you're drinking too much on a regular basis. How do you define those differences?

Some of the the definitions of heavy drinking or binge drinking are based on quantity and the reason we look at the quantity is because those are then associated with the potential for impairment and potential for associated consequences, right?

So, getting in a car and having impaired function reaction time, those types of things as well as the, That what happens, when people then wake up the next morning and they may have blacked out, they may have engaged in some behaviors that they really didn't they can't remember those types of things .Now, that may be a consequence that happens once right as a result of kind of a binge drinking episode or maybe something that then kind of, persists and is more persistent when alcohol use disorder really is not defined by how much one drinks. It's not the quantity, but it's really about how it's impacting a person's life.

And we know that that is alcohol use disorder and kind of alcohol addiction is this chronic brain disease where it's characterized by people compulsively continuing to drink. Even though it's causing them harm, right? So even though, they lose control over their drinking, it's interfering with incredibly important pieces of their life.

They may have had several blackouts where they are engaging in risky sexual behaviors or, Changing personality, so people can get violent, right? Like, there's a lot of those types of impacts that really are defining alcohol use disorder more so than, just the alcohol use. People, who have an alcohol use disorder, particularly a severe alcohol use disorder they may have health conditions like liver failure, like, brain changes that cause memory issues.

They may have heart disease and different kinds of cancers, but they're continuing to drink because it's this compulsive nature Of just in cravings that they cannot just are unrelenting and and kind of nonstop. And so it's those types of things. They may have gotten arrested, they may have gotten car in car crashes, et cetera, but that compulsive kind of nature of that alcohol addiction is really what is then the characteristic of the alcohol use disorder.

there was a term that has been used and I, I know it's, A functioning alcoholic, and I know we're using the term disorder, but a functioning alcoholic, and this sort of begs the question, one, how many people are in denial over this and , what are some of the symptoms you would say that, okay, you may have a disorder versus, you drank too much at a Super Bowl party

right, right, No, they're great questions. And so a couple of things. One is that when we look at those diagnostic symptoms, the kind of diagnostic criteria that are laid out in that it's called the diagnostic statistical manual but from the American Psychiatric Association, there are 11 criteria that we look at as health professionals.

And there are, depending on how many of those criteria a person meets, then we categorize also the alcohol use disorder as either being mild, moderate, or severe. So there are some people who they may only have kind of a couple, two to three of those criteria that they meet. They may have a mild disorder.

And that sometimes it's harder to really tease out. When people then compared to people who have really the severe disorder, where like, really, it is pretty clear that someone's, life is just really significantly and negatively impacted by by alcohol. One of the proven public health approaches that was developed within the last 20, 30 years is something called screening and brief intervention and referral to treatment and it was designed really for alcohol and to identify people who may have that kind of hazardous, like that milder alcohol use disorder that often gets seen in primary care by your primary care physician.

And in doing the screening and using Very standardized screening tools that have been tested across different age ranges different demographics You can start to identify whether someone is just too old Not at risk at all for any of these kind of negative consequences or whether they fall in that like risky area mild kind of alcohol use disorder.

The brief intervention piece that really uses techniques to help identify and create a Awareness on the part of the individual that, yeah, maybe I am having a little bit of a problem with alcohol. Maybe some family member has said, I'm worried about your drinking because your personality changes when you drink or, you we're late to work and you've been late to work multiple times because you're so hung over in the morning you've missed uh, critical family events because of the alcohol and the consequences of drinking a lot.

So those are some of the things that people can become aware of around the person. Even when it is that more subtle milder alcohol use disorder. So that is one thing to pay attention to, is when other people around them are starting to be concerned about someone's alcohol use.

I would assume a lot of people are in denial about this. So whether you're in a severe disorder or a mild disorder, saying, well, I don't have a problem. I don't need to be screened. Yeah. I had too much to drink, but I'm fine.

So how do we reach those people? And family members can talk to them, but sometimes there's resistance.

you bring up a really good point because part of that kind of denial part of the challenge around, people who may have even a mild alcohol use disorder, or even a severe one that sometimes it is hard for the individual to really see the impact that's having on their own health and on the health of the people around them.

And one of the things I think that screening and brief intervention and this motivational interviewing technique, that motivational interviewing technique that I've described is trying to help people see the connections between their drinking and their behavior.

You don't have to be a healthcare professional in order to really learn how to do that. And there are a number of different resources that SAMHSA also helps provide. So there are some campaigns that we have called Talk, They Hear You. That is an app and some digital materials that people can actually download on their phone to really then help get concrete messages of, how you talk to family members, what you're doing.

Can you say and express your concerns for things that are happening with that individual. It also has applicability to teachers and schools. And so that talk, they hear you campaign has really been a good way for folks to, to be able to get some of those resources to be able to have those conversations.

I think the digital age also makes easier to self screen. So people can go to SAMHSA's Screen for Success. So screen with the number four success, which is a free 10 minute screening that can connect people to resources. And so I think one of the things that we often find as a healthcare professional myself is that sometimes when a healthcare provider, or if someone in your family, just raises a concern or starts to have that conversation. It sometimes, won't necessarily in that one particular moment the person may say, no, no, I don't have a problem, but it can help plant a seed of doubt. and it may actually get that person to start thinking about, Hmm.

Maybe I do have a problem. And if it's then kind of brought up again and again and again, at some point that person may start to see that connection between their drinking and the consequences of that alcohol use.

and we were talking about someone who may have a mild disorder. What about someone who has a progressively more significant disorder? How are we identifying it and then how do we begin to get them into a treatment plan?

I think one of the things also that we know is that many people who have a mild disorder, or even a severe disorder that peer support and having people with lived experience of alcohol use disorder or other substance use disorders, for example, they can also be a really, really important And helpful touch point.

So there are mutual support groups in every community the alcoholics anonymous mutual support group. So, those can be helpful for individuals. The other piece is that for individuals who have that really severe disorder, often what will happen is that there will be some type of health consequence.

So they'll be in an emergency department or they may end up in the hospital as a consequence of whether it is liver disease or they've been in an accident or some other issue has arisen. And in those situations whether it's in the emergency department or in the hospital, or even in a primary care setting or another healthcare setting that really being able to do that screening and have that screening and brief intervention.

And then those referrals to treatment baked into the healthcare setting. That's really important. And that is something that increasingly, we have seen also that adoption across those healthcare settings that aren't necessarily specialty substance use disorder treatment facilities, but really in just general healthcare.

This recognition that substance use disorders in general have such incredible impact on people's health and well being more broadly than just the alcohol use disorder itself.

What are the health impacts, both physical and mental? And certainly can, we can have an impact on your family, obviously, and your loved ones, but what are the health impacts?

Mm-hmm

So alcohol really has a number of different individual health impacts, both in terms of those mental health conditions, that, that depression that I talked about anxiety, it often goes along with those. It can make the depression worse. It can exacerbate anxiety for example.

It. Impacts a whole range of different organs. And so I'm not going to list all of them, but some of the more frequent ones are heart. So alcohol contains a lot of calories and so it can contribute to obesity and heart disease and other types of metabolic disorders. It can raise people's blood pressure.

And over many years of alcohol use, it can cause heart failure in individuals affects your brain. So we've talked about some of the the just addiction piece itself, right? So the alcohol use disorder alcohol can cause seizures. So, that's one of the pieces if you're really excessively drinking or even in withdrawal from alcohol that that seizures is often a complication that that we see.

Increases your risk of injury, right? So, we've talked about kind of accidents and falls and particularly in older individuals, falls from alcohol use is is very common. There are memory issues that can happen as a result alcohol. So it can really exacerbate and cause a disorder related to memory as well as.

The liver problems, right? So we've talked about cirrhosis, liver disease. There are a whole host of different cancers that are really associated with alcohol. So from breast cancer and esophageal cancer, so different kinds of gastrointestinal cancers, liver cancer are big ones.

And we know that more than 30, 000 Americans die each year from cirrhosis that is caused by by alcohol. Finally, it can also really affect people's sleep. So alcohol disrupts kind of that that kind of deep sleep, that REM sleep cycle that is really important and, and people's, just overall appearance when Alcohol can cause an alcohol withdrawal in particular, can also cause dehydration and kind of volume depletion, electrolyte imbalances and disturbances that also then become problematic.

And the 1 thing that I also just really want to make sure to highlight is that. Alcohol, obviously during pregnancy is something that has long been known to be , a significant issue, not only for the mother, but also for them for the developing fetus and so fetal alcohol syndrome is, is something that I think we don't necessarily talk enough about and is becoming also, increasingly recognized as something that that affects a lot of people across the country.

And it doesn't necessarily always. Result from a mother who has a severe alcohol use disorder, it can be depending on when in the pregnancy, the woman is drinking how much kind of at a given time various different factors and genetic factors that that also is one of those big kind of health consequences that we need to be paying attention to.

Yeah. And I assume this is all made worse because Americans are just increasingly overweight and unhealthy. And this just adds to it, even if you were not in bad shape to begin with. So this all begs the question, how do we begin to treat these issues and are these treatments evolving?

We've talked about the importance of screening and also that brief intervention piece so that we're really identifying people who who may be at risk for those negative consequences and really then helping to intervene early and before something gets much more serious for people then who have that moderate to severe alcohol use disorder.

There are some medications along with many of those behavioral interventions. So, using motivational interviewing techniques. So, that's a really important piece of that behavioral intervention. And then there's something called cognitive behavioral therapy which really also helps to provide people with a lot of understanding of how an alcohol use disorder can be triggered by then all of the various different settings and people and things that kind of emotions, for example, that trigger those cravings.

That is a very well tested and well, evidenced approach that really can help people reshape and reset their thinking around, around the alcohol use and provide some different options for how they can then actually manage all of those triggers and those cravings that will happen but in a different way.

And that's where a lot of this peer support comes in a lot of the other pieces of social connectedness, social support. I mentioned also the medications we do have, some FDA approved medications things like something called disulfiram, or other people might know it as Antabuse that is one of those older medications that really is designed to essentially make people sick because it interferes with the metabolism of the alcohol in the liver, but it will make people sick if they drink a while they're taking that medication.

That isn't used as much anymore because when people do get sick from from taking disulfiram or antabuse and and then drink or even have any kind of exposure to alcohol that often, can land them in the hospital or in the emergency room. Now for people who are very, very motivated to really completely abstain from alcohol, that may be an option.

There's another medication called naltrexone that also comes in a tablet as well as a monthly injection that w as FDA approved several decades ago, really, for the prevention of, recurrence for alcohol use disorder. And that that seems to have some good effect in in.

Several different individuals. And then finally, there's another medication called a campersate. That also, then people can take to help reduce some of those cravings that they get from alcohol. The challenge with all these medications is that the, the effectiveness of them is is not perhaps as great as we would like.

Particularly when you compare it to some other medications that we have for other types of substance use disorders, but they can certainly provide some benefit to individuals. There's not a lot of great evidence of who will do best with which medication, and so to some extent, some of the recommendations are that an individualized decision between the individual and their health care provider as to which one they might want to try and then, You can always kind of switch between them to see which one might have the most effect. And in combination with all those other things that we talked about,

Are these treatments, have they evolved? Are we evolving better treatments?

I think there's always room for more, as I said, these medications and abuse that does self harm was the oldest one for a long time. That was really the primary one that we had. And then came along naltrexone, a campersate. There is now some signal that some of the newer obesity related medications also may have some benefit, particularly for alcohol use disorder.

But I think that there's a lot more research that needs to be done there before we can , say that's something that we should be adding to our arsenal.

What are the biggest misconceptions tied to this disorder?

Yeah. So I think, one of the, the biggest misconceptions is that people who have an alcohol use disorder, particularly that moderate to severe form, that they can just stop on their own. And that, this is something that is their choice. It's a, that it's somehow their fault, their moral failing that they have this use disorder. this is a health condition. It is a health condition that has risk factors that we've talked about that is not anyone's fault. But it also is something where there are significant consequences and mortality related to alcohol use disorder. The other really important thing for people to understand is that we also do have effective treatments.

And there's a lot of interest in looking for additional treatments. As well that that can be even more effective than the ones we have to date and that recovery happens and people can and do recover from this. Some of the data that we have from SAMHSA is that there are millions and millions of Americans who are thriving and living, healthy and, productive lives in recovery.

And experiencing well being. And so there is hope. There's a, a lot of reason for hope. And that if people are worried about someone they love or their friend or a coworker, there are also resources out there to really be able to help support those individuals to then further help their loved one and really help understand that this is a chronic health condition often that can have recurrences and, but the people really can and do recover. I think one of the things that that we're really excited about is that for the first time we're launching something called January substance use disorder treatment month in January.

For the first time, that will be a national month to really help raise awareness around what substance use disorders are, including alcohol use disorder, and some of the treatment options that are available, and what family and friends can do, as well as what the individual, can be thinking about.

And then also really importantly, what the healthcare professional can do, to be a big part of the solution to all of this. So, and to really be able to treat this health condition as the health condition that it is.

Well, that's, that's a hopeful message. To end on, for a serious problem that everyone recognizes but may not deal with effectively. So, Dr. Olson, the Director of the Center of Substance Abuse Treatment, thank you so much for everything, your insights and your guidance and whatnot. I think this will do people a lot of good.

So, thank you very much.

Thank you.

Okay, we are doing alcohol part three product pitch and rap

before we move on We want to again encourage listeners to take advantage of the hundreds of exclusive discounts Well, well offers on a range of health and wellness products and services now these cover everything from fitness and athletic equipment to dietary supplements personal care products organic foods and beverages and more Signing up is easy and free.

Just visit us at WellWellUSA. com, go to Milton's Discounts in the top menu bar, and the sign up form will appear. Signing up will take just seconds, but the benefits can last for years. Ultimately, it is essential to understand that the way we envision alcohol is evolving for the better. There is more evidence and awareness of its negative impact, whether that involves excessive social consumption, or or varying degrees of alcohol abuse disorder.

There is also growing acceptance that the disorder is not a sign of individual weakness, but rather something much more profound. Treatments have also grown and evolved, some of which have been outlined in this podcast. They include greater resources via improved drug programs, stronger therapeutic procedures, and more effective early assessment efforts.

Combined, they offer individuals suffering from disorder, along with their friends and family, substantial hope. These positive vibes are perhaps best underscored by the federal launch of the first Substance Use Disorder Treatment Month this January. This gives new hope to all involved. That's it for this episode.

We'd, of course, like to thank Dr. Olson, and Dr. Olson. of the Substance Abuse and Mental Health Services Administration for laying out the challenges alcohol presents and how these burdens can be lifted. If you'd like to learn more, please visit SAMHSA. That is S A M H S A dot com. Again, thanks for listening, and we hope you'll join us again soon on What the Health.