Much of the recent discourse in the addiction treatment and recovery community has touched upon the record-breaking rise in overdose deaths in the United States, as well as the sharp uptick in alcohol use that came about at the beginning of the COVID-19 pandemic. But very rarely is alcohol discussed as being a part of the overdose crisis.
While data is still being compiled for details of more recent overdose deaths, we can look to past data to see that alcohol is sometimes present during an overdose, and many people who struggle with opioid use disorders (OUD) also suffer from an alcohol use disorder (AUD).
Looking at the Data
In 2017, 15% of opioid overdose deaths also involved alcohol. In a 2019 study of syringe service recipients, 33.4% of those surveyed reported concurrent use of alcohol, heroin, and prescription opioids. Between 2012 and 2014, over 2 million people who misused prescription opioids were also found to be using alcohol excessively. This is defined as more than five drinks for a man and more than four drinks for a woman over the course of two hours or less. It also has been found that 23% with an OUD also have a coexisting AUD.
This combined data shows us that a portion of people who regularly use opioids are using alcohol concurrently. This is a fact that has really not been addressed at all in the national conversation about the opioid and overdose epidemic. And while it is not affecting a majority of people who use opioids, lives could be saved by implementing screening and education about concurrent opioid and alcohol use.
How Do We Address Concurrent Opioid and Alcohol Use?
It’s important that clinicians do brief screening for concurrent substance use disorders such as OUD and AUD. If one is found to be present, other substance use should also be screened for. Thinking of substance use from a harm reduction perspective, it’s crucial that clinicians are prepared to educate patients about the increased risk of substance use when paired with alcohol use, especially if they do not choose to go into treatment for substance use disorder.
It’s also important that harm reduction organizations, such as syringe services programs, are addressing the dangers of mixing opioids with alcohol with their clients. As it stands, harm reduction services infrequently address the use of alcohol among clients. Research has shown that clients with concurrent alcohol and opioid use may benefit from education or brief intervention specific to alcohol consumption.
As we continue to lose more people to overdose every day, it’s important we do anything we can in order to decrease the likelihood of lethal substance combinations. Educating people who use drugs about the health consequences of concurrent alcohol use will raise awareness and save lives.
