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Area of Science:

  • Addiction Medicine
  • Clinical Psychology
  • Public Health

Background:

  • Opioid use disorder (OUD) frequently co-occurs with alcohol use disorder in the United States.
  • Limited research exists on the specific patterns of co-use between opioids and alcohol.

Purpose of the Study:

  • To investigate the relationship between alcohol consumption and opioid use in individuals seeking treatment for OUD.
  • To explore potential substitution effects in co-use patterns.

Main Methods:

  • Utilized baseline data from a multisite trial involving 567 participants with OUD who had used nonprescribed opioids recently.
  • Employed the Timeline Followback method for self-reported alcohol and opioid use over 30 days.
  • Applied mixed-effects logistic regression to analyze the impact of alcohol and binge drinking on opioid use, controlling for demographic factors.

Main Results:

  • Same-day opioid use was significantly less likely on days with any alcohol consumption (p < .001) and binge drinking (p = .01).
  • These associations remained significant after controlling for age, gender, ethnicity, and education.
  • Opioid use remained prevalent even on days when alcohol was consumed.

Conclusions:

  • Alcohol or binge drinking is associated with a reduced likelihood of daily opioid use among individuals with OUD.
  • Findings support a substitution model where alcohol may be used to alleviate opioid withdrawal symptoms.
  • Alcohol could play a secondary, substitutive role in the substance use patterns of individuals with OUD.