Misuse of Alcohol During Opiate Substitution Treatment

Although alcohol misuse is a common phenomenon during opiate substitution treatment, the etiologic explanations advanced for it are generally no more than speculative. To identify differences in alexithymia, self-esteem, and temperament among patients undergoing methadone or buprenorphine substitution treatment having excessive alcohol consumption from those who have not. This was an open prospective study conducted from September 2007 to January 2008. The cohort was recruited from 9 drug addiction treatment centers in 2 regions of France, Alsace and Moselle. The study was based on 203 patients on opiate substitution programs whose dosage had been stable for at least 1 month and who had given their consent to take part. The participants completed a series of self-administered questionnaires in the treatment centers: Alcohol Use Disorders Identification Test (AUDIT), Toronto Alexithymia Scale (TAS-20), Coopersmith's Self-Esteem Inventory (SEI), Temperament and Character Inventory (TCI-R). We observed high alexithymia scores, low self-esteem scores, and low self-directedness scores among patients with excessive alcohol consumption. We make some recommendations for new therapeutic approaches.