How common is problem drinking among people on methadone in Irish primary care?

What is it about?

People receiving methadone maintenance treatment for opioid dependence in primary care settings have elevated rates of problematic alcohol use, which can worsen health outcomes, complicate treatment and increase mortality risk. This study used baseline data from the PINTA (Psychosocial Interventions for Problem Alcohol Use in Primary Care Settings) feasibility study to examine the prevalence of problem alcohol use and how it was being addressed among people attending general practices in Ireland for methadone maintenance treatment. The AUDIT was used to screen for hazardous and harmful drinking. The study collected data on alcohol use patterns, current treatment provision for alcohol problems, and the characteristics of this population, providing a detailed baseline profile of the dual burden of opioid dependence and problem alcohol use in an Irish primary care context.

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Why is it important?

Problem alcohol use among people on methadone is a clinically significant and underaddressed comorbidity. Alcohol can accelerate liver disease, which is already elevated in people with opioid dependence due to hepatitis C exposure, and it increases the risk of fatal overdose. Primary care is the setting where most people in Ireland receive methadone maintenance, making it the natural location to identify and address alcohol problems in this population. At the time this study was conducted, little was known about the actual prevalence of problem drinking in this group in Irish primary care or about whether and how practitioners were responding to it. Baseline feasibility data of this kind is the necessary foundation for designing and testing interventions, and this study directly informed subsequent work on developing alcohol brief interventions tailored to people on methadone in primary care.