title: Alcohol use disorders in opioid maintenance therapy: prevalence, clinical correlates and treatment.
abstract: Maintenance therapy with methadone or buprenorphine is an established and first-line treatment for opioid dependence. Clinical studies indicate that about a third of patients in opioid maintenance therapy show increased alcohol consumption and alcohol use disorders. Comorbid alcohol use disorders have been identified as a risk factor for clinical outcome and can cause poor physical and mental health, including liver disorders, noncompliance, social deterioration and increased mortality risk. The effects of opioid maintenance therapy on alcohol consumption are controversial and no clear pattern has emerged. Most studies have not found a change in alcohol use after initiation of maintenance therapy. Methadone and buprenorphine appear to carry little risk of liver toxicity, but further research on this topic is required. Recent data indicate that brief intervention strategies may help reduce alcohol intake, but the existing evidence is still limited. This review discusses further clinical implications of alcohol use disorders in opioid dependence.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany; Private Hospital Meiringen, Willigen, Meiringen, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Soyka
mesh_terms: D000428:Alcohol Drinking / Q000188:drug therapy* / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D001921:Brain / Q000187:drug effects; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology; D015897:Comorbidity; D006801:Humans; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone