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The Impact of Enrolment in Methadone Maintenance Therapy on Initiation of Heavy Drinking among People who Use Heroin
Author(s)
Date Issued
2016-04
Date Available
2016-05-17T12:06:58Z
Abstract
Background: There is equivocal evidence regarding whether people who use heroin substitute heroin for alcohol upon entry to methadone maintenance therapy (MMT). We aimed to examine the impact of MMT enrolment on the onset of heavy drinking among people who use heroin. Methods: We derived data from prospective, community-based cohorts of people who inject drugs in Vancouver, Canada, between December 1, 2005, and May 31, 2014. Multivariable extended Cox regression analysis examined the effect of MMT enrolment on the onset of heavy drinking among people who used heroin at baseline. Results: In total, 357 people who use heroin were included in this study. Of these, 208 (58%) enrolled in MMT at some point during follow-up, and 115 (32%) reported initiating heavy drinking during follow-up for an incidence density of 7.8 events (95% CI 6.4-9.5) per 100 person-years. The incidence density of heavy drinking was significantly lower among those enrolled in MMT at some point during follow-up compared to those who did not (4.6 vs. 16.2; p < 0.001). MMT enrolment was not significantly associated with time to initiate heavy drinking (adjusted relative hazard (ARH) 1.27; 95% CI 0.78-2.07) after adjustment for relevant demographic and substance-use characteristics. Age and cannabis use were the only variables that were independently associated with the time to onset of heavy drinking (ARH 0.74; 95% CI 0.58-0.94 and ARH 2.06; 95% CI 1.32-3.19, respectively). Conclusion: In this study, MMT enrolment did not predict heavy drinking and may even appear to decrease the initiation of heavy drinking. Our findings suggest younger age and cannabis use may predict heavy drinking. These findings could help inform on-going discussions about the effects of opioid agonist therapy on alcohol consumption among people who use heroin.
Sponsorship
European Commission
Health Research Board
Irish Research Council
Other Sponsorship
Canada Research Chairs program
US National Institutes of Health
Marie Cure Actions
Canadian Institutes of Health Research New Investigator Award
Type of Material
Journal Article
Publisher
Karger
Journal
European Addiction Research
Volume
22
Issue
4
Start Page
210
End Page
214
Copyright (Published Version)
2016 S. Karger AG, Basel
Language
English
Status of Item
Peer reviewed
This item is made available under a Creative Commons License
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