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Drug users' failure to modify alcohol consumption in response to hepatitis C

  • Angela Noonan (a1), Paul Kavanagh (a2) and Brion Sweeney (a3)


Objective: To measure (a) the prevalence of problem drinking in a population of methadone-treated drug users, (b) independent associations with problem drinking, (c) the effect of hepatitis C status on drinking behaviour, (d) the knowledge of drug users of their hepatitis C status and their perception of their drinking behaviour and (e) the attitude of drug users to the effect of alcohol on hepatitis C virus (HCV) related disease.

Method: A cross sectional survey of 130 drug users in treatment at the National Drug Treatment Centre, Dublin was carried out. A questionnaire incorporated the Alcohol Use Disorders Identification Test (AUDIT), and data were collected on sociodemographics, drug use history, perceived HCV status and drinking behaviour, and attitudes to the impact of drinking on HCV related disease. Hepatitis serology and drug urine data were collected from clinical records.

Results: The prevalence of problem drinking was 41% (95% CI 33-51%). Unstable accommodation, older age, male gender and longer duration of heroin use were independent associations with being a problem drinker. There was no significant difference in the prevalence of problem drinking across HCV status. Knowledge of HCV status was accurate, however 35% of those identified as AUDIT cases failed to recognise their problem drinking.

Conclusion: HCV infection among Irish drug users is compounded by a high prevalence of problem drinking with drug users failing to modify their drinking in response. Incorrect perception of problem drinking status could be a barrier to addressing this potentially remediable risk factor.


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1.Smyth, BPKeenan, E, O'Connor, JJ. Blood borne viral infection in Irish injecting drug users. Addiction 1998; 93: 16491656.
2.Smyth, R, Keenan, E, Dorman, A, O'Connor, JJ. Hepatitis C among drug users attending the National Dug Treatment Centre. Ir J Med Science 1995; 164: 267268.
3.Smyth, BP, O'Connor, JJ, Barry, J, Keenan, E. Retrospective cohort study examining incidence of HIV and hepatitis C infection among injecting drug users in Dublin. J Epidemiol Comm Health 2003; 57: 310311.
4.Freeman, AJ, Dore, GJ, Law, MJet al.Estimating progression to cirrhosis in chronic hepatitis C infection. Hepatology 2001; 34: 809816.
5.National Institutes of Health Consensus Development Conference Statement: Management of hepatitis C. Gastroenterology 2002; 123(6): 20822099.
6.Wasley, A, Alter, MJ. Epidemiology of hepatitis C: geographic differences and temporal trends. Semin Liver Dis 2000; 20(1): 116.
7.Alter, MJ. The epidemiology of acute and chronic hepatitis C. Clin Liver Dis 1997; 1(3): 559–68.
8.Charlton, M. Hepatitis C infection in liver transplantation. Am J Transplant 2001; 1 (3): 197203.
9.Wong, JB, McQuillan, GM, McHutchinson, JG, Poynard T, . Estimating future hepatitis C morbidity, mortality and costs in the United States. Am J Public Health 2000; 90: 15961601.
10.Deuffic, S, Buffat, L, Poynard, T, Valleron, AJ. Modelling the hepatitis C epidemic in France. Hepatology 1999; 31: 10141018.
11.Kavanagh, P, Moloney, J, Quinn, C, O'Kelly, E, McCormick, PA. High morbidity expected from cirrhosis in injecting drug users. Ir Med J 2003; 96(10): 303305.
12.Corrao, G, Arico, S. Independent and combined action of hepatitis C infection and alcohol consumption on the risk of symptomatic liver disease. Hepatology 1998; 27: 914919.
13.Westin, J, Lagging, LM, Spak, F el al. Moderate alcohol intake increases fibrosis progression in untreated patients with hepatitis C virus infection. J Viral Hepatology 2002; 9: 235–41.
14.Cox, G, Comiskey, C, Kelly, P. ROSIE Findings 4: Summary of 1-year outcomes: methadone modality. Dublin: National Advisory Committee on Drugs 2007.
15.MacManus, E, Fitzpatrick, C. Alcohol dependence and mood state in a population receiving methadone maintenance treatment. Ir J Psych Med 2007; 24(1): 1922.
16.Gelb, AM, Richman, BL, Peyser, NP. Alcohol use in methadone maintenance clinics. Am J Drug Alcohol Abuse 1979; 6(3): 367373.
17.Green, J, Jaffe, JH, Carlisi, JA, Zaks, A. Alcohol use in the opiate use cycle of the heroin addict. Int J Addiction 1978; 13(7): 10211033.
18.Hunt, DE, Strug, DL, Goldsmith, DS, Lipton, DS, Robertson, K, Truitt, L. Alcohol use and abuse: heavy drinking among methadone clients. Am J Drug Alcohol Abuse 1986; 12(1-2): 147164.
19.Stastny, D, Potter, M. Alcohol abuse by patients undergoing methadone treatment programmes. Br J Addict 1991; 86(3): 307310.
20.Hillebrand, J, Marsden, J, Finch, E, Strang, J. Excessive alcohol consumption and drinking expectations among clients in methadone maintenance. J Subst Abuse Treat 2001; 21(3): 155160.
21.Ottomanelli, G. Methadone patients and alcohol abuse. J Subst Abuse Treat 1999; 16(2): 113121.
22.McCusker, M. Influence of hepatitis C status on alcohol consumption in opiate users in treatment. Addiction 2001; 96: 10071014.
23.Best, D, Noble, A, Finch, E, Gossop, M, Sidwell, C, Strang, J. Accuracy of perceptions of hepatitis B and C status: cross sectional investigation of opiate addicts in treatment. BMJ 1999; 319:290291.
24.Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR, Grant, M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. II. Addiction 1993; 88(6): 791804.
25.Skipsey, K, Burleson, JA, Kranzler, HR. Utility of the AUDIT for identification of hazardous or harmful drinking in drug-dependent patients. Drug Alcohol Depend 1997; 45(3): 157163.
26.Gossop, M, Marsden, J, Stewart, Det al.Substance use, health and social problems of service users at 54 drug treatment agencies – intake data from the National Treatment Outcome Research Study. Br J Psychiatry 1998; 173: 166171.
27.Miller, WR. Motivational interviewing with problem drinkers. Behav Psychotherapy 1983; 11: 147172.
28.Vasilaki, El, Hosier, SG, Cox, WM. The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. Alcohol 2006; 41 (3): 328335.
29.Rubak, S, Sandbaek, A, Lauritzen, T, Christensen, B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 2005; 55(513): 305312.
30.Stein, MD, Charuvastra, A, Maksad, J, Anderson, BJ. A randomised trial of a brief alcohol intervention for needle exchangers (BRAINE). Addiction 2002; 97(6):691700.
31.Miller, WR, Wilbourne, PL. Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction 2002; 97(3): 265277.
32.van Beek, I, Dwyer, R, Dore, DG, Luo, K, Kaldor, JM. Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: retrospective cohort study. BMJ 1998; 317:433437.
33.Anderson, P, Baumberg, B. Alcohol in Europe, London: Institute of Alcohol Studies; 2006.
34.Kelleher, C, Nic Gabhainn, S, Friel, Set al. Survey of Lifestyle, Attitudes and Nutrition (SLAN) and The Irish Health Behaviour in School-Aged Children Survey (HBSC), Galway: Centre for Health Promotion Studies, NUI, 2003.
35.Morgan, K, McGee, H, Watson, Det al.SLAN 2007: Survey of lifestyle, attitudes and nutrition in Ireland. Main Report. Dublin: Department of Health and Children, 2007
36.Cleary, A, Nixon, E, Fitzgerald M, . Psychological health and well being among young Irish adults. Ir J Psych Med 2007; 24: 139144.
37.Anderson, RJ. Alcohol Aware Practice Pilot Study. Dublin. Irish College of General Practitioners, 2003


Drug users' failure to modify alcohol consumption in response to hepatitis C

  • Angela Noonan (a1), Paul Kavanagh (a2) and Brion Sweeney (a3)


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