In lecturers and treatment design I often discuss the more positive outcomes and shorter treatment duration for primary drinkers as opposed to drug users. This is often connected tot he age of onset, where 70 per cent of problem drinking occurs after the age of 30. These individuals experience a collapse in the adult identity that they have constructed. In contrast, as drug use tends to occur in adolescence, these individuals often fail to establish an adult identity. As such, recovery is markedly different as drug users have to learn to operate in the adult world for the very first time. A recent study has found a similar pattern, but did not examine the age of onset of the problems.
New research indicates that opioid misuse and the use of cannabis and other drugs may compromise the effectiveness of treatments for alcohol use disorder. In an Alcoholism: Clinical and Experimental Research study, individuals with alcohol dependence who misused opioids and those who used cannabis and other drugs were more likely to drink heavily and frequently during and following treatment.
On average, individuals with opioid misuse engaged in heavy drinking 48 days earlier in treatment, drank heavily on approximately 8% and 13% more days in the last month of treatment and one year following treatment, respectively, and consumed 4 more drinks per peak drinking occasion than individuals without opioid misuse and no other drug use.
"This study provides evidence that we cannot ignore alcohol and other drug use when discussing potential impacts of the opioid epidemic," said lead author Dr. Katie Witkiewitz, of the University of New Mexico.
Individuals who misuse opioids have poorer outcomes in multiple domains, and the current study identified a much higher risk of alcohol relapse among those with opioid misuse in alcohol treatment."
Materials provided by Wiley.
Katie Witkiewitz, Victoria R. Votaw, Kevin E. Vowles, Henry R. Kranzler. Opioid Misuse as a Predictor of Alcohol Treatment Outcomes in the COMBINE Study: Mediation by Medication Adherence. Alcoholism: Clinical and Experimental Research, 2018; DOI: 10.1111/ACER.13772