Home > Alcohol use among opiate users in methadone treatment.

Long, Jean (2009) Alcohol use among opiate users in methadone treatment. Drugnet Ireland , Issue 31, Autumn 2009 , p. 14.

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Ryder and colleagues estimated that 35% (95% CI = 28%–41%) of a sample of current or former heroin users attending general practice for methadone treatment were problem alcohol users, and that 14% of the sample were dependent users.1 According to data from the National Drug Treatment Reporting System, 24% of opiate users entering opiate treatment reported alcohol as an additional problem drug, which is lower than the estimate presented here. 

The authors surveyed 196 patients, which represented 8% of those on the Central Treatment List,2 31% of those sampled and 71% of those invited by their general practitioner to participate. The response rate was lower than desired – an indication of the difficulty than can be associated with doing research among patients attending private general practitioners in Ireland.
 
The survey questionnaire included the Alcohol Use Disorders Identification Test (AUDIT) to assess participants’ alcohol use. The questionnaire also collected data on socio-demographic, medical and substance use characteristics. The median age of the 196 participants was 32 years, 68% were male, 79% said that they had used one or more illicit drugs in the previous month, and 76% had ever injected drugs. Of those who knew their blood-borne viral status, 55% said that they were hepatitis C positive and 5% said that they were HIV positive. Other research indicates that self-reported hepatitis C and HIV status can both over- and under-estimate the prevalence of these infections and should be interpreted with caution.
 
The cases classified as problem alcohol users were significantly more likely to have attended a local emergency department in the previous year and less likely to have attended a hospital clinic in the previous year compared to those who were not problem alcohol users. Among the 107 respondents who reported that they were hepatitis C positive, those who were problem alcohol users were significantly less likely to have attended a specialist hepatology clinic than their counterparts.
 
The authors concluded that problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment, and that interventions that address this issue should be explored as a priority.
 
1. Ryder N, Cullen W, Barry J, Bury G, Keenan E and Smyth BP (2009) Prevalence of problem alcohol use among patients attending primary care for methadone treatment. BMC Family Practice, 10(42). Accessed on 14 July 2009 at www.biomedcentral.com/1471-2296/10/42
2. The Central Treatment List is a complete register of all patients in Ireland being prescribed methadone by a registered medical practitioner for the treatment of opiate misuse.
Item Type:Article
Issue Title:Issue 31, Autumn 2009
Date:October 2009
Page Range:p. 14
Publisher:Health Research Board
Volume:Issue 31, Autumn 2009
EndNote:View
Accession Number:HRB (Available)
Subjects:VA Geographic area > Europe > Ireland
G Health and disease > Substance use disorder > Alcohol use
HJ Treatment method > Substance disorder treatment method > Substance replacement method (substitution) > Methadone maintenance
G Health and disease > Substance use disorder > Multiple substance use (Poly-drug /Poly-substance)

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