Feasibility of alcohol screening among patients receiving opioid treatment in primary care.
Identifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting.



A randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use.



Of 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group.



Alcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices.
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.
Anne Marie
AM
Henihan
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.|UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.
Geoff
G
McCombe
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.|UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.|British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Jan
J
Klimas
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.|UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.|Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK.
Davina
D
Swan
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.
Dorothy
D
Leahy
Addiction Counsellor, Suite 33, The Morrison Chambers, 32, Nassau Street, Dublin 2, Ireland.
Rolande
R
Anderson
UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.
Gerard
G
Bury
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.
Colum P
CP
Dunne
Addiction Services, Health Services Executive, Dublin, Ireland.
Eamon
E
Keenan
UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.
John S
JS
Lambert
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.
David
D
Meagher
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.
Clodagh
C
O'Gorman
Brown-Alpert Medical School, Providence, Rhode Island, USA.|Department of Veterans' Affairs, Washington DC, USA.
Tom P
TP
O'Toole
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.|CSTAR Centre, University of Limerick (UL), Limerick, Ireland.
Jean
J
Saunders
Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
Gillian W
GW
Shorter
Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.|Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland.
Bobby P
BP
Smyth
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Eileen
E
Kaner
Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland. Walter.Cullen@ucd.ie.|UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland. Walter.Cullen@ucd.ie.|Department of Veterans' Affairs, Washington DC, USA. Walter.Cullen@ucd.ie.
Walter
W
Cullen
D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D001291:Attitude of Health Personnel; D065187:Controlled Before-After Studies; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000193:education / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy*; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000379:methods*; D016730:Program Development; D012017:Referral and Consultation
D009294:Narcotics; D008691:Methadone
Agonist treatment; Alcohol; Brief intervention; Feasibility; General practice; Implementation; Methadone; Primary care; SBIRT; Screening