Patient description: The patient is a 57-year-old man with abdominal pain and vomiting. The pain started gradually about 20 hours ago in the epigastric and periumbilical regions, radiating to his back. He drinks around 60 units of alcohol per week and smokes 22 cigarettes per day. He is healthy with no history of allergies or using any medications. His family history is positive for type 2 diabetes (his father and sister). He lives alone and has no children. The abdomen is tender and soft. His bowel sounds are normal. His heart rate is 115/min and blood pressure 110/75 mmHg. The lab results are remarkable for leukocytosis (19.5), urea of 8.5, high CRP (145), high amylase (1200) and Glc level of 15. Cross-sectional imaging was negative for obstructive pancreatitis.

Clinical trial eligibility criteria: eligible ages (years): 21.0-65.0,  Alcohol Drinking Alcohol Drinking Related Problems age between 21 and 65 years inclusive Drinking at high levels for at least 10 different weeks during the last 90 days. High-level drinking for a given week can be either of the following:: --For women, more than 3 drinks on any single day that week, or more than 7 drinks that week For men, more than 4 drinks on any single day that week, or more than 14 drinks that week a score greater than or equal to 8 and less than or equal to 15 on the self-report version of the Alcohol Use Disorders Identification Test (AUDIT), with endorsement of at least one item other than 1-3, because 1-3 assess only consumption, not concern or consequences self-report of liking or having neutral feelings about the sight and smell of alcoholic beverages for women, practicing an effective method of birth control before entry and throughout the study (or postmenopausal for at least one year, or surgically sterile); negative urine pregnancy test at each visit. Effective methods of birth control are those approved by the Food and Drug Administration (FDA) used as described in the FDA Birth Control Guide These methods are: (1) intrauterine device (IUD) copper; (2) IUD with progestin; (3) implantable rod; (4) contraceptive shot/injection; (5) oral contraceptives (combined pill, progestin-only pill, or extended/continuous-use combined pill); (6) contraceptive patch; (7) vaginal contraceptive ring; (8) diaphragm with spermicide; (9) sponge with spermicide; (10) cervical cap with spermicide; (11) male condom; (12) female condom; (13) male partner with a vasectomy. Abstinence from sexual intercourse is also an effective method of birth control  -risk of alcohol withdrawal, as determined by any of the following: a score greater than or equal to 8 on the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) following a negative breath test for alcohol (i.e., BAC of 0.0), lifetime history of delirium tremens or seizures (related to alcohol or not), endorsement of a drinking to avoid withdrawal symptom on the SCID or M.I.N.I. (M.I.N.I. Section I, Alcohol Use Disorder, items k1 and/or k2 answered affirmatively with counselor s evaluation to verify that symptoms indicated in item k1 are related to the individual s cutting down on drinking and/or the response to item k2 refers to withdrawal symptoms and not hangover);or physician s judgment currently trying to quit drinking, or planning to quit or reduce alcohol drinking via formal treatment or support-group attendance in the next six months for women: pregnancy, breastfeeding, or planning to become pregnant during the experiment current liver disease or dysfunction, assessed by physical examination and medical history; and hepatitis C, chronic hepatitis B, or other current liver disease or dysfunction as assessed by physical examination and medical history or as reflected in blood levels more than 5 times the upper limit of normal in any of the following: aspartate transaminase (AST), alanine transaminase (ALT), or gamma-glutamyltransferase (GGT) any other medical illness or condition that in the judgment of the investigators is incompatible with alcohol consumption current use of prescription or over-the-counter medications or herbal products for which drinking alcohol is strictly prohibited. When the metabolic half-life of the medication/product is known, we will require at least 7 half-lives to have elapsed before any session involving alcohol consumption. If the half-life is not known (as might be the case for some herbal preparations), we will require at least 7 days to have elapsed since the last use before any session involving alcohol consumption substance-use disorder for any drug(s) other than alcohol or nicotine in the previous 12 months past or present diagnosis of bipolar disorder or any psychotic disorder; any history of suicide attempt or current suicidal ideation; present diagnosis of uncontrolled or untreated mood or anxiety disorder cognitive impairment severe enough to preclude informed consent or valid self-report