Background: High prevalence of risky behaviors in alcohol dependents have been shown in several studies, but correlation between alcohol abuse and risky behaviors and relapse in patients with opiate dependence has been less investigated. This study aimed to determine the effect of alcohol abuse in rate of risk-taking behaviors in opiate dependents patients treated on maintenance program in North Khorasan addiction rehabilitation clinics in northeastern of Iran.
Methods: We conducted a cross sectional survey of patients sampled from North khorasan addiction rehabilitation clinics database. Data was collected using an interviewer-administered questionnaire, which included the alcohol abuse self-report and risk-taking behaviors checklist and socio-demographic and substance use characteristics. Chi-square test was used for comparison of results.  Statistical analyses were performed using the SPSS 22 software. Differences were considered significant at P<0.05.
Results: We interviewed 7133 patients (82.5% were men). The median age was 32.4 years. 953 patients (13.4%) had a history of risk-taking behavior in last year. Risk-taking behavior in patients with alcohol abuse was significantly higher compared with patients without history of alcohol abuse (49.7% vs. 12.3 %, P < 0.001). History of being in jail in last year was significantly higher in alcohol abusers compared to non-abuser group (12.7% vs. 5.1% P<0.05). The prevalence of risk-taking behaviors in patients with opium dependence was 9.6%, with heroin dependence was 35.9% and in subjects with concomitant use of heroin and methamphetamine was 54.6%.
Conclusion: Alcohol abuse among patients undergoing MMT is associated with an increased rate of risky behaviors. Moreover, risky behaviors were significantly correlated with type of substance abused. Concurrent treatment of alcohol-related problems including systematic monitoring of alcohol use is recommended to reduce the risk for relapse into illicit drug use and improve harm reduction program.