Study backs screening heroin users for alcohol issues

A new study of people being treated for heroin use found that some of those who also had drink issues cut their alcohol intake when screened for excessive drinking by a GP.

A new study, published in recent weeks in the BMC Family Practice journal, found that alcohol screening among people receiving treatment for the use of opioids seemed feasible, although it said a definitive trial was needed.

The study involved patients at 16 practices with 129 patients and found that alcohol screening rates in the intervention group was double that of the control group. Some 81 patients were also interviewed.

The GP practices, based in the HSE Mid-West and Dublin Mid-Leinster regions, were asked to recruit 10 patients who were receiving addiction treatment or care, such as methadone.

There were then staggered interventions aimed at screening for problem alcohol use among the patient group. GPs rated the importance of each of five barriers to alcohol screening, specifically: Lack of training and education, lack of time, lack of specialist staff, poor service availability, and attitude of patients.

It found there was a positive attitude among GPs to caring for patients with problem alcohol use, and found training heightened GPs’ awareness of how to manage the problem.

“The need for specialist staff was the most important barrier further highlighting the importance of implementing the provision of additional support and resources for a less motivated cohort of GPs,” it said.

“The findings suggested that while a complex intervention seems feasible and acceptable, the barriers highlighted must be overcome to enable consistent, regular and accurate screening by GPs.

“Although screening for problem alcohol use is a prevention priority in primary care for adults (especially high risk groups such as people receiving opioid agonist treatment), thus far it has one of the lowest delivery rates, with screening or intervention typically completed only when a risk factor is evident.”

It found that 18% reduced their problem drinking in the intervention group, compared with two people in the control group.

The research team was led by Prof Walter Cullen of the School of Medicine Health Sciences at University College Dublin.

Another member of the research team, HSE consultant child and adolescent psychiatrist, Dr Bobby Smyth, said a significant cohort of people with a heroin addiction, as many as 30%, have a problem with alcohol.

He said the role of alcohol should not be underestimated in increasing the chance of relapses in those clients, contributing to liver damage, or developing an alcohol dependence at a point when the heroin problem may be under control. Dr Smyth also said the area of treatment for alcohol consumption needed to be fully resourced if more people were going to be screened.


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