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Keywords:

  • brief intervention;
  • alcohol;
  • methadone;
  • patient

Abstract

Introduction and Aims.An implementation study to test the feasibility and effectiveness of brief interventions (BIs) to reduce hazardous and harmful alcohol consumption in opiate-dependent methadone-maintained patients.

Design and Methods.Before and after intervention comparison of Alcohol Use Disorders Identification Test (AUDIT-C) scores from baseline to 3 month follow up. Seven hundred and ten (82%) of the 863 eligible methadone-maintained patients within three urban addiction treatment clinics were screened. A World Health Organization protocol for a clinician-delivered single BI to reduce alcohol consumption was delivered. The full AUDIT questionnaire was used at baseline (T1) to measure alcohol consumption and related harms; and in part as a screening tool to exclude those who may be alcohol-dependent. AUDIT-C was used at 3 month follow up (T2) to assess any changes in alcohol consumption.

Results.One hundred and sixty (23% of overall sample screened) ‘AUDIT-positive’ cases were identified at baseline screening with a mean total full AUDIT score of 13.5 (SD 6.7). There was a statistically significant reduction in AUDIT-C scores from T1 (inline image, SD = 2.35) to T2 (inline image, SD = 2.66) for the BI group (z = −3.98, P < 0.01). There was a statistically significant decrease in the proportion of men who were AUDIT-positive from T1 to T2 (χ2 = 8.25, P < 0.003).

Discussion and Conclusions.It is feasible for a range of clinicians to screen for problem alcohol use and deliver BI within community methadone clinics. Opiate-dependent patients significantly reduced their alcohol consumption as a result of receiving a BI. [Darker CD, Sweeney BP, El Hassan HO, Smyth BP, Ivers J-HH, Barry JM. Brief interventions are effective in reducing alcohol consumption in opiate-dependent methadone-maintained patients: Results from an implementation study. Drug Alcohol Rev 2012;31:348–356]