Morris J, Boness C L, Witkiewitz K
Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom.
Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico.
Drugs (Abingdon Engl). 2024;31(2):271-281. doi: 10.1080/09687637.2023.2187681. Epub 2023 Mar 31.
The highly heterogeneous nature of alcohol use and problems has presented significant challenges to those attempting to understand, treat or prevent what is commonly termed alcohol use disorder (AUD). However, any attempts to capture this complex phenomenon, including the various current criterion of AUD, come with a number of limitations. One particular limitation has been how alcohol problems are represented or understood in ways which do not capture the broad spectrum of alcohol use and harms and the many potential routes to prevention, treatment, and recovery. One possible response to this has been proposed as more explicitly framing or conceptualizing a continuum model of alcohol use and harms. In this commentary, we attempt to identify the key implications of a continuum model for policy and practice, examining the historical and current context of alcohol problem classifications and models. We argue a continuum model of alcohol use and problems holds a number of advantages for advancing public health goals, but also some potential limitations, both of which require further examination.
酒精使用及其问题的高度异质性给那些试图理解、治疗或预防通常所说的酒精使用障碍（AUD）的人带来了重大挑战。然而，任何试图捕捉这一复杂现象的尝试，包括当前AUD的各种标准，都存在一些局限性。一个特别的局限在于，酒精问题的呈现或理解方式未能涵盖酒精使用和危害的广泛范围以及预防、治疗和康复的众多潜在途径。对此，一种可能的应对方法是更明确地构建或概念化酒精使用和危害的连续体模型。在这篇评论中，我们试图确定连续体模型对政策和实践的关键影响，审视酒精问题分类和模型的历史与当前背景。我们认为，酒精使用和问题的连续体模型在推进公共卫生目标方面有诸多优势，但也存在一些潜在局限，这两者都需要进一步审视。
