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Though it accounts for 4.1% of the national disease burden, it remains under\u2010prioritised in health policy, prevention and treatment. Most of this harm is downstream of hazardous alcohol consumption and untreated alcohol use disorder (AUD), a common but stigmatised condition that is under\u2010recognised and rarely treated with evidence\u2010based therapies. Alcohol\u2010related harm falls disproportionately on First Nations peoples, rural communities and socioeconomically disadvantaged Australians. Epidemiological trends are alarming: hospitalisations for alcohol\u2010related liver disease are rising, and emerging data show a causal link between alcohol and early\u2010onset colorectal cancer. These findings underscore alcohol's role as both a hepatotoxin and a multisystem carcinogen, with harms manifesting at younger ages and lower levels of consumption than previously recognised. Despite clear evidence that no level of alcohol use is safe, misconceptions persist, fuelled by industry influence and inconsistent public health messaging. Evidence\u2010based treatments exist but are underused: only 2.9% of Australians with AUD receive approved pharmacotherapy, and delays to treatment average 18\u2009years. Population\u2010level strategies such as taxation, pricing and marketing restrictions remain the most effective levers, but progress is weak, as illustrated by the repeal of minimum unit pricing in the Northern Territory. Clinicians play a central role in reframing hazardous drinking and AUD as the root cause of alcohol\u2010related disease and in advocating for evidence\u2010based, patient\u2010centred care and policy. Addressing AUD directly offers the clearest path to reducing Australia's alcohol burden.<\/jats:p>","DOI":"10.1111\/imj.70378","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:17:35Z","timestamp":1772965055000},"page":"521-532","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol use disorder: an Australian perspective on screening, diagnosis, treatment and prevention"],"prefix":"10.1111","volume":"56","author":[{"given":"Andrew J.","family":"Palmer","sequence":"first","affiliation":[{"name":"Alcohol and Drug Assessment Unit Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology &amp; Hepatology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason 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