Prevalence of Alcohol consumption among Opioid Substitution Treatment (OST) clients in Golestan Province, Northern part of Iran

Background: It is reported that a third of patients on OST have alcohol related problems. As production and consumption of alcohol are illegal in Muslim majority countries, the estimation may not apply to these countries. In this study, prevalence of alcohol consumption among OST clients in Golestan province in the northern part of Iran is estimated. Methods: In a cross-sectional study in 2018, a random sample of 750 clients who were on OST for at least one month were selected from 150 OST centers in Golestan province. The outcomes of interest were ever consumption of alcohol and alcohol consumption during the last month . History of alcohol consumption was based on self-report. To validate participants responses on recent substance use, urine samples were tested for some illicit drugs (i.e. morphine, amphetamine, methamphetamine, tramadol, hashish, and benzodiazepines). Survey analysis was used to estimate prevalence of current and past alcohol consumption.Results: The majority of participants were male (93.6%) and mostly on methadone maintenance treatment (methadone 89.2%, buprenorphine 9.1%, and opium tincture 1.7%). Prevalence of ever consumption of alcohol and alcohol consumption during the last month were 39.2% (95% CI; 29.5 – 48.9) and 17.7% (95% CI; 9.6 – 25.8), respectively. Urine samples of 8.1% (3.6% – 12.6%) was positive for amphetamines. In comparison to the participants with negative urine amphetamine test, participants with positive urine test reported more alcohol consumption; ever alcohol consumption and excessive use of alcohol in a single day . Moreover, this group had significantly more years of alcohol consumption compare to those with negative AST test result; 7.3 (95% CI; 5.3 – 9.4) years compare to 4.2 (95% CI; 3.4 – 4.9) years.Conclusion: As it was expected, our findings show lower prevalence of alcohol consumption among OST clients in Iran compare to OST clients in countries where alcohol is not illegal. As prevalence of alcohol consumption is higher among ATS users, it is imperative to closely monitor their compliance to the treatment at OST centers.

Keywords:

Alcohol , Opioid Substitution Treatment