title: Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: Cochrane Review.
abstract: BACKGROUND
  Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor in poor prognosis among drug users with hepatitis C virus (HCV) as it impacts progression to hepatic cirrhosis or opiate overdose in opioid users. The aim of this systematic review was to assess the effects of psychosocial interventions for problem alcohol use in adult illicit drug users with concurrent problem alcohol use (principally, problem drug users of opiates and stimulants).
  
  
  METHODS
  We searched the following databases (November 2011): Cochrane Library, PUBMED, EMBASE, CINAHL, PsycINFO and reference list of articles. We also searched conference proceedings and online registers of clinical trials. Two reviewers independently assessed risk of bias and extracted data from included randomized controlled trials.
  
  
  RESULTS
  Four studies (594 participants) were included in this review. Half of the trials were rated as having a high or unclear risk of bias. The four studies considered six different psychosocial interventions grouped into four comparisons: 1) cognitive-behavioral coping skills training versus 12-step facilitation (N = 41), 2) brief intervention versus treatment as usual (N = 110), 3) hepatitis health promotion versus motivational interviewing (N = 256), and 4) brief motivational intervention versus assessment-only group (N = 187). Differences between studies precluded any pooling of data. Findings are described for each trial individually. Most findings were not statistically significant except for comparison 2: decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment-as-usual group and comparison 4: reduced alcohol use in the brief motivational intervention (RR 1.67; 95% CI 1.08 to 2.60).
  
  
  CONCLUSIONS
  No conclusion can be made because of the paucity of the data and the low quality of the retrieved studies.
authors: Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland. jan.klimas@ucd.ie
authors: Jan
authors: J
authors: Klimas
authors: Catherine-Anne
authors: CA
authors: Field
authors: Walter
authors: W
authors: Cullen
authors: Clodagh Sm
authors: CS
authors: O'Gorman
authors: Liam G
authors: LG
authors: Glynn
authors: Eamon
authors: E
authors: Keenan
authors: Jean
authors: J
authors: Saunders
authors: Gerard
authors: G
authors: Bury
authors: Colum
authors: C
authors: Dunne
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control* / Q000628:therapy; D000437:Alcoholism / Q000150:complications*; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D019966:Substance-Related Disorders / Q000150:complications*