Precision medicine in alcohol use disorder: Mapping etiologic and maintenance mechanisms to mechanisms of behavior change to improve patient outcomes.

Experimental and Clinical Psychopharmacology, Vol 31(4), Aug 2023, 769-779; doi:10.1037/pha0000613Precision medicine has been advanced as a potential solution to the problem of alcohol use disorder heterogeneity and modest alcohol use disorder treatment efficacy. The success of precision medicine lies in our ability to first identify the etiologic and maintenance mechanisms at play for a given person and then choose the treatment that is most likely to address such mechanisms. There exist several frameworks that describe empirically supported substance use disorder (SUD) etiologic and maintenance mechanisms (e.g., the Etiologic, Theory-based, Ontogenetic, Hierarchical [ETOH] Framework). There also exists a large literature on mechanisms of behavior change in alcohol use disorder treatment. However, the mechanism of behavior change literature on alcohol use disorder treatments has focused broadly on mechanisms of change rather than more specifically on core alcohol use disorder etiologic and maintenance mechanisms. Thus, the two types of mechanisms have never been integrated or systematically evaluated for their overlap. As such, the aim of the present brief review is to demonstrate how commonly used alcohol use disorder treatments may overlap with and directly target certain alcohol use disorder etiologic and maintenance mechanisms (specifically those described by the ETOH framework). We delineate empirically plausible overlapping mechanisms and theoretically plausible overla...
Source: Experimental and Clinical Psychopharmacology - Category: Psychiatry & Psychology Source Type: research