Alcoholism as a risk factor in methadone maintenance. A randomized controlled trial

Area of Science:

• Addiction Medicine
• Clinical Psychology
• Public Health

Background:

• Methadone maintenance is a key treatment for opioid use disorder.
• Co-occurring alcoholism is common among individuals in treatment for opioid addiction.
• The impact of active alcoholism on methadone maintenance outcomes requires further investigation.

Purpose of the Study:

• To evaluate the influence of active alcoholism on the rehabilitative process in patients undergoing methadone maintenance.
• To determine if co-occurring alcoholism necessitates detoxification from methadone treatment.

Main Methods:

• A randomized controlled trial involving 625 patients on methadone maintenance.
• Classification of patients into active alcoholic, inactive alcoholic, and nonalcoholic groups.
• Follow-up for up to 29 months to assess changes in alcohol consumption, productive activity, and behavioral indexes.

Main Results:

• Alcohol consumption significantly decreased in active alcoholics during the study (p < 0.001).
• No significant differences in productive activity were found between active alcoholics and other patients, except for alcohol-related hospitalizations (p < 0.001).
• Behavioral indexes improved across all groups, with the greatest improvement seen in active alcoholics (p < 0.01).

Conclusions:

• Active alcoholism does not appear to significantly impede rehabilitation from narcotic use in patients on methadone maintenance.
• Alcoholism should not be an automatic reason for detoxification from methadone maintenance.
• Continued methadone treatment may be beneficial for individuals with co-occurring opioid use disorder and alcoholism.