The treatment of alcoholic methadone patients: a review.

Alcoholism is a major problem among methadone maintenance patients. Although alcoholism in the methadone patient is recognized as a problem, few treatment studies have been conducted. Treatment studies have examined abstinence oriented and controlled drinking therapies, voluntary disulfiram treatment, and combined behavioral-pharmacological treatment. The first three treatments were shown to be ineffective in impacting alcohol consumption. The ineffectiveness reported by these studies was attributed to patients' lack of motivation. However, the combined behavioral-pharmacological treatment, which made methadone treatment contingent on antabuse consumption, resulted in decreases in both alcohol consumption and arrests, with increases occurring in employment. Future research should examine the generality of the findings from combined treatment as well as examine whether other contingency management procedures may reduce alcohol consumption in the alcoholic methadone patient.