School of Psychology, Deakin University, Burwood, VIC, Australia.
Addiction. 2013 Jul;108(7):1188-93. doi: 10.1111/j.1360-0443.2012.04075.x. Epub 2012 Oct 17.
Despite recognition of the harms related to alcohol misuse and its potential to interfere substantially with sustained recovery from drug dependency, research evaluating drug treatment outcomes has not addressed the issue comprehensively. It has been overlooked possibly because treatment research has been framed according to the primary drug of choice, rather than investigating the interactions between different combinations of drugs and/or alcohol use. This paper reports on a systematic review investigating whether concurrent alcohol use could impede recovery from illicit drug use in two potential ways: first, alcohol could become a substitute addiction and/or secondly, alcohol misuse post-treatment may place an individual at risk for relapse to their primary drug problem.
A systematic search of four relevant databases was undertaken to identify peer-reviewed, quantitative drug treatment outcome studies that reported alcohol use pre-, post-treatment and follow-up.
The search revealed 567 papers, of which 13 were assessed as fulfilling the key inclusion criteria.The review indicated inconsistent and therefore inconclusive support for the substitution hypothesis. However, the data revealed consistent support for the hypothesis that alcohol use increases relapse to drug use.
(i) The potential negative impact of alcohol misuse on drug treatment outcomes remains under-researched and overlooked; (ii) alcohol consumption post-drug treatment may increase the likelihood that an individual will relapse to their primary drug; (ii) existing evidence regarding the substitution hypothesis is inconclusive, although there was an indication that a subgroup of participants will be vulnerable to alcohol becoming the primary addiction instead of drugs. We argue that future drug treatment outcome studies need to include detailed analysis of the influence of alcohol use pre- and post-drug treatment.
尽管人们已经认识到酗酒及其对药物依赖持续康复的潜在严重干扰，但评估药物治疗结果的研究并未全面解决这一问题。这可能被忽视了，因为治疗研究是根据主要药物选择来制定的，而不是调查不同药物组合和/或酒精使用之间的相互作用。本文报告了一项系统评价，该评价调查了同时饮酒是否可能通过两种潜在方式阻碍非法药物使用的康复：首先，酒精可能成为替代成瘾物；其次，治疗后酒精滥用可能使个体面临复发主要药物问题的风险。
对四个相关数据库进行了系统检索，以确定报告治疗前、治疗中和随访期间酒精使用情况的同行评议、定量药物治疗结果研究。
搜索结果显示有 567 篇论文，其中 13 篇被评估为符合关键纳入标准。该综述表明，替代假说的支持不一致，因此没有定论。然而，数据一致支持酒精使用增加药物使用复发的假说。
（i）酒精滥用对药物治疗结果的潜在负面影响仍未得到充分研究和忽视；（ii）药物治疗后饮酒可能增加个体复发主要药物的可能性；（iii）关于替代假说的现有证据尚无定论，尽管有迹象表明，一部分参与者可能容易受到酒精成为主要成瘾物而不是药物的影响。我们认为，未来的药物治疗结果研究需要包括对治疗前后酒精使用影响的详细分析。
