Orexin Receptor Antagonists as Modulators of Threat Sensitivity in Individuals With Alcohol Use Disorder

Inclusion Criteria: Age 18-65. Participant is able to give informed consent. Generally medically and physically healthy as confirmed by medical history. Meet DSM-5 diagnostic criteria for current moderate or severe AUD. Engage in heavy alcohol use defined as drinking equal or greater than 14 standard drinks per week if male and equal or greater than 7 standard drinks per week if female. Exclusion Criteria: Clinically significant medical or neurological condition (e.g., liver disease, narcolepsy, complex sleep behaviors, severe hepatic impairment, COPD, severe obstructive sleep apnea). Current cognitive dysfunction (traumatic brain injury, mental retardation, organic mental syndrome, pervasive developmental disorder, or dementia). Current use of antihistamines, strong or moderate inhibitors of CYP3A liver enzymes, strong CYP3A inducers, or digoxin. Current or past DSM-5 diagnosis of mania, schizophrenia, psychosis, suicidality, major depressive disorder, or obsessive compulsive disorder. Current substance use disorder other than alcohol or mild cannabis use disorder. Treatment seeking for AUD. Recent psychotropic medication use in the past 2 months. Currently smokes 5 or more cigarettes (or electronic equivalent) per day. BMI equal or greater than 35. Engage in night-shift work. Lack of fluency in English. Presence of ferrous-containing metal in the body. Inability to tolerate small, enclosed spaces. Deafness in one or both ears. Currently pregnant (positive pregnancy test), lactating, or not agreeing to use birth control methods during the duration of the trial.