title: The relationship between alcohol use and injecting drug use: impacts on health, crime and wellbeing.
abstract: OBJECTIVE
  People who inject drugs (PWID) are at risk of a variety of adverse outcomes. Previous research suggests that alcohol, when consumed with opioids, is a risk factor for overdose, but there has been less investigation of the effects of alcohol consumption on other health, criminogenic or life satisfaction outcomes. In this paper we explore the effects of alcohol on outcomes for PWID across a variety of life domains.
  
  
  METHODS
  Baseline data were drawn from the Melbourne Injecting Drug User cohort study, which is a cohort of 688 PWID. Drinking scores were generated from the AUDIT-C (0, 1-7, 8+) and associations between them and health (recent heroin overdose, Emergency Department use), criminogenic (violent and nonviolent crime) and life satisfaction (personal wellbeing) outcomes were examined using logistic and linear regression.
  
  
  RESULTS
  While around 36% of the cohort reported past-month abstinence from alcohol, 44% scored between 1 and 7 and 20% above 7 on the AUDIT-C. A score above 7 was associated with perpetration of violent crime and lower personal wellbeing ratings than a score of 0, after adjusting for potential confounders. There was no association between alcohol and other outcomes examined, after adjustment for confounders.
  
  
  CONCLUSIONS
  Cohort participants who drink heavily were more likely to report engaging in violent crime and poorer life satisfaction. The relationship between alcohol and the offending behaviours of the cohort was consistent with the effects of alcohol on violent offending in the broader community.
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria 3004, Australia. pauld@burnet.edu.au
authors.forename: Paul
authors.initials: P
authors.lastname: Dietze
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jenkinson
authors.forename: Campbell
authors.initials: C
authors.lastname: Aitken
authors.forename: Mark
authors.initials: M
authors.lastname: Stoové
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
authors.forename: Matthew
authors.initials: M
authors.lastname: Hickman
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D003415:Crime / Q000523:psychology; D057237:Criminals / Q000523:psychology*; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D010549:Personal Satisfaction; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014754:Violence / Q000523:psychology