Influence of hepatitis C status on alcohol consumption in opiate users in treatment

Aims. To estimate the prevalence of (a) hazardous and/or harmful drinking, (b) alcohol consumption, (c) perceived hepatitis C status (HCV) in opiate users in treatment and (d) assess the influence of perceived HCV status on consumption and attitudes to risk. Design. Cross-sectional survey. Setting. A methadone maintenance clinic and a drug treatment centre within a British substance misuse service in London. Participants. A random sample of 93 opiate users in treatment. Measurements. Hazardous and/or harmful drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Alcohol consumption was assessed using several indicators. Data on clinical and demographic characteristics, perceived HCV status, change in consumption and attitudes to alcohol consumption were also collected. Findings. A third of the sample were identified as AUDIT cases, 17% drank more than one unit/day and 15% were drinking above the weekly, recommended units for safe drinking (21 for men, 14 for women). Perceived HCV positive status was estimated at 70%. HCV status influenced consumption with fewer HCV positive than HCV negative clients drinking any alcohol in the previous year. Also, more HCV positive clients than HCV negative clients, reduced their consumption after the HCV test result. HCV status had some influence on attitudes to drinking for HCV positive people, although most were aware that abstinence was important for those with HCV positive status. Conclusion. Perceived HCV positive status has some influence on alcohol consumption. Despite these findings, training on harm reduction advice on alcohol consumption, particularly in HCV positive clients, should be extended. More intense interventions, within drug treatment services, may be required for those drinkers for whom advice is insufficient.