Developments and Updates for Biological and Medical Considerations in Treatment and Recovery

In this issue of Alcoholism Treatment Quarterly, we focus on recovery in the community as well as recent biomedical components of alcohol and substance use disorders.The conceptualization of recovery as a process involves intentional and sustained engagement in a lifestyle that promotes the improvement of health and wellness.We open with an article by Apsley, Ren, Lancaster, et al. on the use of a daily diary in recovery community center visits and activities.The daily diary allows the assessment of how recovery community centers are used, including the activities and services they offer.Attending recovery meetings was the most frequently endorsed activity, while self-care classes were the least attended.Sanders follows with an exploratory qualitative study of older female members of Alcoholics Anonymous (AA).This generation of women has recovery experiences that were characterized by issues of feeling safe and comfortable in what were then male-dominated meetings, and these experiences have subsequently led to the development of women-only meetings.She presents members' insights into stigma, guilt, stereotypes, and aging and discusses help-seeking behaviors outside the AA programs.The next section focuses on biological and medical issues and updates in the field.Alcohol-related brain damage (ARBD) is a term used for a range of neuropsychological and functional deficits associated with chronic excessive alcohol use.Smith and Willenborg evaluated a 12-week recovery program designed to improve cognition, social skills, and community engagement to address health, addictive behaviors, housing, and care needs, and to promote independence, connection, autonomy, and sobriety.Participants were recruited from a step-down residential unit for people with ARBD.The authors report on its effectiveness in improving cognition and reducing ED visits and inpatient admissions.Alcohol-related liver disease (ALRD), which can progress from fatty liver to cirrhosis and hepatocellular carcinoma, affects liver function and hemostasis.Kademani, Subramanian, & Nelaturi investigated the platelet proteome in 23 patients with ARLD and identified 441 proteins, 73 of which they consider potential biomarkers for disease progression.They found rapid platelet cell apoptosis using Annexin V protein with FITC staining among ARLD patients compared to controls.Maness, Shaw, Posick, et.al. used a subsample of data from the first two waves of the National Longitudinal Study of Adolescent to Adult Health to explore the interaction of gene and environment in peer substance use and early onset alcohol use.Controlling for multiple risk and protective factors, like poverty, victimization, religiosity, etc., they found that genotype is a significant variable for adolescent alcohol use in youth reporting a moderate degree of peer substance use.The gene-environment interaction has implications in interventions to shield youth who may be more susceptible to the influence of substance-using peers.