Orexin Receptor Antagonism for the Treatment of Alcohol Use Disorder and Stress-Related Drinking

Inclusion Criteria: * Generally medically and neurologically healthy; * Age 18 to 65 at the time of consent; * Willing and able to give informed consent; * Current DSM-5 diagnosis of moderate to severe alcohol use disorder; * Engages in heavy alcohol use defined as drinking ≥14 standard drinks per week if male, and ≥7 standard drinks per week if female; * Self-reported treatment-seeking for alcohol use disorder Exclusion Criteria: * Clinically significant medical or neurologic condition or neurocognitive dysfunction that would affect function, and/or task performance, and/or interfere with the study protocol, and/or be contraindicated for suvorexant including sleep disorders (e.g., narcolepsy; severe obstructive sleep apnea), hepatic impairment, compromised respiratory function, renal impairment, and endocrine disorders; * Lifetime DSM-5 diagnosis of schizophrenia, bipolar disorder, or any psychotic disorder; * Current substance use disorder (SUD) other than alcohol or mild cannabis use disorder; * Currently pregnant (positive pregnancy test), lactating, or not agreeing to use birth control methods during the duration of the trial (women); * Any use of medications for alcohol use disorder or any psychotropic medications (e.g., psychostimulants and benzodiazepines, some antidepressants); * Current antihistamines use or medication use that may increase risk including, prescribed, over-the-counter, and herbal preparations, as determined by the study physician; * Current use of strong or moderate inhibitors of CYP3A liver enzymes; * Current use of strong CYP3A inducers; * Current use of digoxin; * Liver function tests more than 3 times the upper limit of normal or elevated bilirubin; * Engages in night shift work; * Smoke 10 or more cigarettes (or electronic equivalent) per day and are thus susceptible to acute nicotine withdrawal during lab visits; * Obesity as defined by a body-mass index (BMI) equal or greater than 30, as calculated from weight and height self-report; * Clinically significant alcohol withdrawal symptoms the day of the lab sessions, defined as a score \>10 on the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar); * Unwilling/unable to sign the informed consent document; * Under 18 years old or over 65 years old at the time of enrollment; * Have attempted suicide in the past 3 years and/or have current suicidal ideation determined as greater than moderate via the Columbia Suicide Severity Rating Scale (C-SSRS)