The impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among people who use heroin

Hdl Handle:
http://hdl.handle.net/10147/610734
Title:
The impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among people who use heroin
Authors:
Klimas, Jan; Wood, Evan; Nguyen, Paul; Dong, Huiru; Milloy, Michael John; Kerr, Thomas; Hayashi, Kanna
Citation:
The Impact of Enrolment in Methadone Maintenance Therapy on Initiation of Heavy Drinking among People Who Use Heroin 2016, 22 (4):210 European Addiction Research
Journal:
European Addiction Research
Issue Date:
6-Apr-2016
URI:
http://hdl.handle.net/10147/610734
DOI:
10.1159/000444513
Additional Links:
http://www.karger.com/?doi=10.1159/000444513
Item Type:
Article
Language:
en
Description:
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% confidence interval (CI) = 6.4–9.5] per 100 person-years. The incidence density of heavy drinking was significantly lower among those reported MMT enrolment 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 = 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.
Keywords:
DRUGS MISUSE; ADDICTION; ALCOHOL MISUSE; REHABILITATION
ISSN:
1022-6877; 1421-9891

Full metadata record

DC FieldValue Language
dc.contributor.authorKlimas, Janen
dc.contributor.authorWood, Evanen
dc.contributor.authorNguyen, Paulen
dc.contributor.authorDong, Huiruen
dc.contributor.authorMilloy, Michael Johnen
dc.contributor.authorKerr, Thomasen
dc.contributor.authorHayashi, Kannaen
dc.date.accessioned2016-05-25T14:22:41Zen
dc.date.available2016-05-25T14:22:41Zen
dc.date.issued2016-04-06en
dc.identifier.citationThe Impact of Enrolment in Methadone Maintenance Therapy on Initiation of Heavy Drinking among People Who Use Heroin 2016, 22 (4):210 European Addiction Researchen
dc.identifier.issn1022-6877en
dc.identifier.issn1421-9891en
dc.identifier.doi10.1159/000444513en
dc.identifier.urihttp://hdl.handle.net/10147/610734en
dc.descriptionBackground: 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% confidence interval (CI) = 6.4–9.5] per 100 person-years. The incidence density of heavy drinking was significantly lower among those reported MMT enrolment 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 = 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.en
dc.language.isoenen
dc.relation.urlhttp://www.karger.com/?doi=10.1159/000444513en
dc.rightsArchived with thanks to European Addiction Researchen
dc.subjectDRUGS MISUSEen
dc.subjectADDICTIONen
dc.subjectALCOHOL MISUSEen
dc.subjectREHABILITATIONen
dc.titleThe impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among people who use heroinen
dc.typeArticleen
dc.identifier.journalEuropean Addiction Researchen
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