Dual dependence: assessment of dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems

FRANÇAIS :
Des entretiens en face à face et une évaluation de la dépendance vis-à-vis de l'alcool et des drogues (à l'aide du SDS) ont été pratiqués dans un échantillon de 735 usagers de drogues en recherche de traitement, et consommateurs d'alcool. Trois groupes de buveurs ont été identifiés : les non dépendants à l'alcool et usagers de drogues (63%), les moyennement dépendants (19%) et les fortement dépendants (18%). Chez les usagers de drogues, la dépendance à l'alcool est associée au type d'usage de l'alcool et des drogues. Les buveurs fortement dépendants sont moins souvent usagers d'héroïne, et de crack, mais plus souvent usagers de benzodiazépines, d'amphétamines et de cocaïne poudre. Ils présentent également plus de problèmes de santé physique et psychologique.
ENGLISH :
Aims. The study investigates severity of alcohol dependence among drug misusers. Specifically, it investigates the inter-relationship of alcohol and drug dependence and associations with alcohol consumption, drug consumption and substance-relatcd problems. Design, setting, participants. The sample comprised 735 people seeking treatment for drug misuse problems, who were current (last 90 days) drinkers. Measurements Data were collected by structured face-to-face interviews. Dependence upon illicit drugs and upon alcohol was measured by the Severity of Dependence Scale (SDS). Findings. Three groups of drinkers were identified: non-alcohol-dependent drug misusers (63%); low-dependence (19%); and high-dependence (18%). Many drug misusers were drinking excessively and alcohol dependence was related to patterns of alcohol and drug consumption. High-dependence drinkers were more likely to drink extra-strength beer; they were less frequent users of heroin and crack cocaine but more frequent users of benzodiazepincs, amphetamines and cocaine powder; they reported more psychological and physical health problems. The SDS was found to have good reliability and validity as a measure of alcohol dependence. SDS scores for alcohol and drug dependence were unrelated. Conclusions. Alcohol use is an important and under-rated problem in the treatment of drug misusers. A comprehensive assessment of alcohol use among drug misusers should include separate assessments of alcohol consumption, alcohol-related problems and severity of alcohol dependence. (Author' s abstract)