Alcohol Use among Persons on Methadone Treatment

We read with interest Dr Varshney et al.'s article on brief interventions for alcohol use among persons on maintenance treatment published ahead-of-print on August 11, 2015. While alcohol is found in the majority of drug-related deaths that involve illicit drugs, around the globe, maintenance therapy with methadone (MMT), or buprenorphine, reduces morbidity and mortality among people who use opiates. Although one common clinical challenge is comorbid alcohol use and opioid use disorder, with guidelines often recommending withholding methadone in this context given the potential for fatal overdose due to drug interactions, alcohol's impact on the health outcomes of MMT patients has been 'overlooked and underestimated'. Therefore, we examined the impact of heavy alcohol use on mortality among MMT patients.