The personal and societal costs of alcohol use disorders (AUD) are tremendous. In 2019, it was estimated that approximately 14.1 million US adults, 5.6% of those 18 years or older, and an estimated 414,000 adolescents between 12 and 17 years of age, met criteria for AUD in the past year. 1 Further, there have been alarming increases in problematic drinking in older drinkers. 2 Worldwide, about 5% of both deaths and burden of disease are attributed to alcohol consumption. AUD is heritable (h 2 = 50%–60%) and polygenic, and results from the contributions of many genes and environmental factors. 3 , 4 , 5 , 6 This genetic liability manifests, in part, through variability in neurobiology. 7 Due to the etiological complexity underlying the typical fluctuating course of alcohol use and AUD over the lifetime course, research that weaves together genomic, neurobiological, environmental and developmental influences is most likely to provide insights into the mechanisms underlying risk and resilience, and entry points for prevention and treatment.
