Cited by 77Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

Alcohol Use Disorders in Opioid Maintenance Therapy: Prevalence, Clinical Correlates and Treatment

Soyka, Michael·2015·European Addiction Research

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.

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  • Most studies have not found a change in comorbid alcohol, cocaine, or benzodiazepine use after initiation of opioid maintenance therapy.

    “Since most studies have not found a change in co-morbid alcohol use, cocaine or benzodiazepine use after initiation of opioid maintenance therapy”

    From Effects of a trauma-informed mindful recovery program on comorbid pain, anxiety, and substance use during primary care buprenorphine treatment: A proof-of-concept study (2023) · cites this paper as [56]

    The Conclusions (p. 6) say that, according to most studies, opioid maintenance therapy does not change alcohol consumption. The paper does not make the same claim about cocaine or benzodiazepine use; it instead reports one study in which benzodiazepine abuse decreased over time (Role of Opioid Maintenance Therapy in Alcohol Consumption, p. 4). (LLM, conf=0.90)

    Experimental — accuracy not yet measured
  • Patients receiving opioid maintenance treatments frequently misuse other drugs, including alcohol, benzodiazepines, cannabis, and gabapentinoids.

    “In addition, patients receiving opioid maintenance treatments frequently misuse other drugs, including alcohol, benzodiazepines, cannabis, and gabapentinoids (81, 82).”

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  1. 38 Babor TF, Grant M: From clinical research to secondary prevention international collaboration in the development of the Alcohol Use Disorders Identification Test (AUDIT). Alcohol Health Res World 1989; 13: 371-374.
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  3. 62 Wittchen HU, Buhringer G, Rehm JT, Soyka M, Trader A, Mark K, Trautmann S: Der Verlauf und Ausgang von Substitutionspatienten unter den aktuellen Bedingungen der deutschen Substitutionsversorgung nach 6 Jahren. Suchtmed 2011; 13: 232-246.
  4. 100 Wittchen HU, Buhringer G, Rehm JT, Klotsche J: Die Stabilität der 6-Jahres-Langzeitbefunde in Premos: Ein Vergleich mit den 7-Jahresdaten ein Jahr später. Suchtmed 2011; 13: 269-271.
  5. 123 Houdret N, Asnar V, Szostak-Talbodec N, Leteurtre E, Humbert L, Lecomte-Houcke M, Lhermitte M, Paris JC: Hepatonephritis and massive ingestion of buprenorphine (in French). Acta Clin Belg Suppl 1999; 1: 29-31.

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Authors
Soyka, M.
Affiliations
Privatklinik Meiringen (CH)
Corresponding author
Soyka, Michael
Venue
European Addiction Research
Publisher
S. Karger AG
Published
2014-11-19
Volume
21
Issue
2
Pages
78-87
ISSN
  • 1022-6877 (ISSN-L)
  • 1421-9891
OpenAlex
W2048849975
Cited by
77
References
129
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 7 · 2019: 10 · 2018: 9 · 2017: 9 · 2016: 4 · 2015: 1 · 2014: 1
FWCI
0.78
Type
journal article
Language
en
Open access
closed
Locations
  • European Addiction Research (publishedVersion)
  • PubMed (publishedVersion)
  • Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
alcoholism, opioid maintenance treatment, opioid use disorder, methadone, buprenorphine, alcohol consumption, comorbidities, hepatotoxicity, treatment non-adherence, brief intervention, prevalence, mortality risk
MeSH terms
Alcohol Drinking, Brain, Buprenorphine, Humans, Methadone, Opioid-Related Disorders, Narcotics, Comorbidity, Prevalence, Alcohol-Related Disorders, Chemical and Drug Induced Liver Injury, Opiate Substitution Treatment

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