title: Prevalence of problem alcohol use among patients attending primary care for methadone treatment.
abstract: BACKGROUND
  Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses.
  
  
  METHODS
  We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test ('AUDIT'), with a score of >7 considered abnormal (ie 'AUDIT positive cases') and socio-demographic, medical and substance use characteristics.
  
  
  RESULTS
  We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight 'AUDIT positive' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence.
  
  
  CONCLUSIONS
  Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this challenging.
authors.affiliation: UCD School of Medicine and Medical Science, Coombe Healthcare Centre, Dublin, Ireland. niamh.ryder@ucd.ie
authors.forename: Niamh
authors.initials: N
authors.lastname: Ryder
authors.forename: Walter
authors.initials: W
authors.lastname: Cullen
authors.forename: Joseph
authors.initials: J
authors.lastname: Barry
authors.forename: Gerard
authors.initials: G
authors.lastname: Bury
authors.forename: Eamon
authors.initials: E
authors.lastname: Keenan
authors.forename: Bobby P
authors.initials: BP
authors.lastname: Smyth
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000821:virology; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation* / Q000821:virology; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D012923:Social Class; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone