Concurrent Alcohol and Opioid Use Among Harm Reduction Clients

Background: Harm reduction services infrequently address alcohol use among clients using opioids, despite the evaluated risk of overdose or medical consequences for clients with viral infections. The purpose of this study is to assess concurrent alcohol and opioid use among syringe services and overdose prevention program participants predominately in southern Ohio and northern Kentucky. Methods: This is a cross-sectional study using self-report data (n = 1,142) pooled across regional overdose prevention programs and a mobile syringe services program. The outcome variable was concurrent use categorized as no concurrent alcohol, prescription opioid or heroin use; alcohol and heroin or prescription opioid use; and alcohol, prescription opioid and heroin use in the past three months. Results: The sample was predominantly white (95%), 56% were male and the mean age was 33 years old. Forty-seven percent of the clients had no concurrent use of alcohol and opioids; 20.1% reported concurrent use of alcohol and either heroin or prescription opioids; and 33.4% reported concurrent use of alcohol, heroin and prescription opioids in the past 3 months. Lifetime suicidal ideation and non-opioid drug use were associated with concurrent alcohol and opioid use in the multivariable model. Conclusion: Harm reduction clients with concurrent alcohol and opioid use may warrant enhanced overdose prevention services. Syringe services and overdose prevention program participants may benefit from education or a brief intervention on alcohol consumption.