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Addressing heavy drinking in the drug-using population
Michael Farrell, Senior Lecturer and Consultant Psychiatrist, National Addiction Centre, Institute of Psychiatry, London
Abstract
The problem of heavy drinking among those on maintenance prescribing is considerable and estimated to occur in approx 20% of the treatment population. Recently this has been complicated by concomitant use of cocaine and crack. The heavy use of alcohol increases the risk of drug related toxicity and also the use of alcohol is associated with enzyme induction and increased metabolism and lower therapeutic levels of other medications such as opioids and benzodiazepines. It is important to note that the majority of people receiving maintenance opioid medication drink substantially less than the general population. The effects of alcohol and approaches to tackling heavy drinking will be explored and the intractable nature of severe alcohol dependence and its implication for short and long term treatment outcome will be discussed. The rise in the incidence of alcohol related liver cirrhosis
In the general population over the past decade will be reported on and the implications of alcohol consumption for long term outcomes from Hepatitis C and Chronic liver disease have serious implications for many people on MMT.
The future challenges of addressing alcohol problems with people with drug dependence are overviewed and approaches to the responses are discussed.
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Biography
Dr Michael Farrell is a Reader in Addiction Psychiatry and Consultant Psychiatrist at the National Addiction Centre and Institute of Psychiatry, Kings College London. He is Director of Post Graduate Medical Education for the South London and Maudsley NHS Foundation Trust. He is Chair of the Addictions Faculty of the Royal College of Psychiatrists and has recently been elected Chair of the Scientific Committee of the European Monitoring Centre for Drugs and Drugs Addiction. He is responsible for a large community drug and alcohol service. He has extensive research interests.
These include the social and epidemiological aspects of addictions with a particular interest in treatment evaluation, psychiatric co-morbidity and prison health and the prevention of blood borne disease among injecting drug users. He is a co-founder and editor of the Cochrane Collaboration Drug and Alcohol Group, and an assistant editor of the journal Addiction. He is a member of the World Health Organisation Expert Committee on Drug Dependence and has worked on numerous international projects with the UN, WHO, European Commission and the European Monitoring Centre on Drugs and Drug Abuse.
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