Helping methadone patients who drink excessively to drink less: Short-term outcomes of a pilot motivational intervention

Opiate addicts receiving methadone treatment who drink alcohol excessively tend not to reduce their drinking, which may imperil continued treatment as well as increasing health risks. The first study asked 136 methadone patients in a community treatment service about their alcohol consumption and requested the 116 who reported drinking during the previous year to complete the AUDIT. Thirty-two (24% of all) reported drinking above 'safe limits' (< 21 units per week for men, < 14 for women) during the previous week: 49 (36% of all) had AUDIT scores of 8 or more. A significant minority are potentially at risk. The second study explored the possibility of helping such patients to drink less by offering nine sessions of focussed help (involving the Drinkers' Check-up) using motivational interviewing techniques. Of the 39 patients referred, 22 attended for assessment, were identified as having a drinking problem, and were offered the structured intervention. Fourteen took up the offer, of whom 11 had good short-term outcomes (10 stopped drinking, and one reduced weekly consumption from 90 units to 30); three did not reduce their consumption. These short-term results encourage the development of ways of helping this group: the experience of providing the service suggests ways of doing this.