Alcohol: A Catalyst for Relapse

Staiger, Richardson, Long, Carr, and Marlatt (2012) believe that research looks closely at specific substance use disorders, but fails to see an individual’s use of multiple substances at one time. Past research has found that alcohol use was a problem during the treatment of substance users. Because of the overlook of this issue, Staiger et al. (2012) ask two questions in their study: “does alcohol become a substitute for the primary drug(s) of choice and does alcohol consumption play a role in relapse to illicit drug use?” (p. 1189). To determine the answers, the study looked at multiple systematic review papers of users over 18 years of age, who reported using alcohol before or after their drug treatment. There were no significant effects of alcohol being a substitution substance. Instead, the results were mixed, with some research supporting the idea, while others were unclear.  In regards to relapse of drugs and alcohol use after the treatment, a positive correlation was found. One study by Mckay (1999) found that 98 cocaine users that stayed away from alcohol use had better drug use after their treatment. In addition, studies revealed that the use of alcohol post treatment was found consistent with the use of cocaine 6 months later. It is appropriate to say that using alcohol after treatment may be a trigger for relapse. With that being said, there is a need for treatment groups to highlight the triggers of possible relapse. These could include smoking, legal drugs, and as previously discussed, alcohol. The researchers strongly believe that the use of these substances should be stressed in treatment programs in order to prevent the risk of relapse. Although the implications are reasonable, there are a couple of limitations to the study. The main concern is the limited amount of research. The several studies discussed conclude a positive correlation between alcohol use post-treatment and relapse, but that is not enough information to determine causation. In addition, the systematic reviews did not specifically describe the characteristics of the users, and the underlying motivation for alcohol use after their treatment. One does not necessarily know if an individual turned to alcohol to fulfill a craving or as casual drinking. Although several limitations are found, the overlooked evidence gives researchers a gap to strive to fill.  

Abstract

Staiger, P. K., Richardson, B., Long, C. M., Carr, V., & Marlatt, G. (2013). Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence. Addiction, 108(7), 1188-1193.