Brief Interventions for Harmful Alcohol Use in Opioid-dependent Patients on Maintenance Treatment With Buprenorphine: A Prospective Study From India

Introduction: Harmful/hazardous alcohol use is common among individuals receiving opioid substitution therapy (OST). The World Health Organisation (WHO) recommends use of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked Brief Interventions (BI) for managing harmful alcohol use. However, the feasibility and effectiveness of BI in addressing harmful alcohol use among buprenorphine-maintained OST recipients has not been studied, which was the objective of the present study. Methods: Using a prospective study design, OST recipients were screened with WHO-ASSIST, and those in the harmful/hazardous use category were administered BI sessions. The feasibility of BI was assessed using BI process rating form. Alcohol-related quantitative variables were assessed with WHO-ASSIST and Rutgers Alcohol Problem Index at baseline and 12 weeks post-BI, and compared for measuring BI effectiveness. Results: Thirty-six (of 138 OST recipients screened) had ASSIST scores in the harmful hazardous category at baseline, and underwent 2 BI sessions at 1 to 2 weeks apart. Of these, 35 patients completed all BI sessions, and baseline and end-line assessments. The average time taken for 1 BI session was 26.43 minutes; 54% reported a "significant influence'' of BI on alcohol consumption; 88% reported that they attempted to cut down alcohol use; 14% completely stopped drinking; and another 14% reported significant reduction in alcohol consumption. ASSIST and Rutgers Alcohol Problem Index scores were significantly reduced at end-line assessment. Conclusion: BI is a feasible and effective intervention to address harmful/hazardous drinking among buprenorphine-maintained opioid-dependent patients.