Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study

Nelson Feldman,Daniele Zullino,Riaz Khan,Anne Chatton,Yasser Khazaal

doi:10.1186/1747-597x-6-22

Nelson Feldman, Daniele Zullino + Show 3 more

Open Access

https://doi.org/10.1186/1747-597x-6-22

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Abstract

BackgroundDespite the importance of heavy drinking and alcohol dependence among patients with opiate and cocaine dependence, few studies have evaluated specific interventions within this group. The aim of the present study was to evaluate the impact of screening with the Alcohol Use Disorders Identification Test (AUDIT) and of brief intervention (BI) on alcohol use in a sample of patients treated for opioid or cocaine dependence in a specialized outpatient clinic.MethodsAdult outpatients treated for opioid or cocaine dependence in Switzerland were screened for excessive alcohol drinking and dependence with the AUDIT. Patients with AUDIT scores that indicated excessive drinking or dependence were randomized into two groups--treatment as usual or treatment as usual together with BI--and assessed at 3 months and 9 months.ResultsFindings revealed a high rate (44%) of problematic alcohol use (excessive drinking and dependence) among patients with opiate and cocaine dependence. The number of drinks per week decreased significantly between T0 (inclusion) and T3 (month 3). A decrease in average AUDIT scores was observed between T0 and T3 and between T0 and T9 (month 9). No statistically significant difference between treatment groups was observed.ConclusionsIn a substance abuse specialized setting, screening for alcohol use with the AUDIT, followed by feedback on the score, and use of alcohol BI are both possibly useful strategies to induce changes in problematic alcohol use. Definitive conclusions cannot, however, be drawn from the study because of limitations such as lack of a naturalistic group. An important result of the study is the excellent internal consistency of AUDIT in a population treated for opiate or cocaine dependence.

Highlights

Alcohol misuse and dependence is a major problem among opioid- and cocaine-dependent patients [1,2,3,4]
Measures The participants were assessed with the following instruments: 1. Alcohol Use Disorders Identification Test (AUDIT) The AUDIT [26] is a 10-item self-assessment questionnaire that presents good sensitivity and specificity for the screening of excessive alcohol use and dependence [26,27,28]
The main changes in alcohol consumption (AUDIT scores, number of drinks, and frequency) are observed at T3, but changes in frequency and number of drinks do not persist at T9

Summary

Introduction

Alcohol misuse and dependence is a major problem among opioid- and cocaine-dependent patients [1,2,3,4]. Alcohol consumption is common among cocaine users [12] It can trigger cravings for cocaine and relapse [12,13] and may reduce anxiety and dysphoria induced by cocaine withdrawal [12,13], leading to alcohol use. This clinical evidence increases interest in specific alcohol interventions for patients with cocaine dependence. Despite the importance of heavy drinking and alcohol dependence among patients with opiate and cocaine dependence, few studies have evaluated specific interventions within this group. The aim of the present study was to evaluate the impact of screening with the Alcohol Use Disorders Identification Test (AUDIT) and of brief intervention (BI) on alcohol use in a sample of patients treated for opioid or cocaine dependence in a specialized outpatient clinic

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