title: Former Heroin-Dependent Alcohol Use Disorder Patients. Prevalence, Addiction History and Clinical Features.
abstract: OBJECTIVE
  To examine the prevalence of former heroin dependence (FHA) in Alcohol Use Disorder (AUD) patients; to compare the clinical characteristics of FHA-AUD patients versus AUD patients without any past use of heroin at alcohol treatment entry; to document the heroin dependence history of FHA-AUD patients, and review treatment strategies for this group.
  
  
  METHODS
  Retrospective case review of 448 consecutive AUD patients.
  
  
  RESULTS
  The annual entry of FHA-AUD showed stability over the study period of 3 years overall 60/448 (13.3%). FHA-AUD patients showed higher concomitant use of cocaine, benzodiazepines, cannabis and hallucinogens than other heroin addicts. They consumed higher amounts of alcohol at the beginning of their alcohol dependence history, and reached a high maximum level of alcohol consumption, than other AUD patients, and tended to have more physical disorders. The most important signals of FHA-AUD were polyabuse and older age at the time of presentation. FHA-AUD patients tended to have had a severe pattern of heroin dependence associated with inadequate agonist opiate treatment.
  
  
  CONCLUSIONS
  The prevalence of FHA-AUD patients is not negligible. This may relate to previous inadequate treatment of heroin addiction contributing to the development of severe AUD. For these patients we propose a reconsideration of 'soft' (low dose) agonist opiate treatment.
authors.affiliation: G. De Lisio Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Pacini
authors.affiliation: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa, Italy AU-CNS, Association for the Application of Neuroscientific Knowledge to Social Aims, Pietrasanta, Lucca, Italy.
authors.forename: Angelo Giovanni Icro
authors.initials: AG
authors.lastname: Maremmani
authors.affiliation: Centre for the Assessment and Treatment of Alcohol-Related Pathology, La Sapienza University, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Ceccanti
authors.affiliation: G. De Lisio Institute of Behavioural Sciences, Pisa, Italy Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa, Italy AU-CNS, Association for the Application of Neuroscientific Knowledge to Social Aims, Pietrasanta, Lucca, Italy maremman@med.unipi.it.
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D055815:Young Adult