Clinical Edge

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Polysubstance Use Complicates Heroin Use Recovery

Am J Addictions; ePub 2018 Dec 12; Kenney, et al

Persons with opioid use disorder often do not expect to stop using other substances following withdrawal management, with very few planning cocaine cessation, a recent study found. Therefore, inpatient heroin withdrawal programs need to address and educate patients about how polysubstance use complicates recovery from heroin use. Between May and December of 2015, researchers surveyed 417 patients (71.9% male, 31.7 [±8.39] mean years old) initiating short‐term inpatient heroin withdrawal management who reported alcohol, cocaine, or benzodiazepine (BZD) use in the past 30 days. They found:

  • Approximately half of respondents reported past month alcohol (52%), cocaine (47.0%), or BZD (47.0%) use, and 25.9% reported using all 3 substances.
  • Approximately half of those reporting drinking, 6.6% reporting cocaine use, and 27% of reporting BZD use expected to abstain from using that substance following heroin withdrawal.
  • Prior opioid withdrawal was associated with a lower likelihood of expecting to stop using alcohol and BZDs, and more days of BZD use was associated with a greater likelihood of expecting to abstain from BZDs following discharge.


Kenney SR, Anderson BJ, Bailey GL, Stein MD. Expectations about alcohol, cocaine, and benzodiazepine abstinence following inpatient heroin withdrawal management. [Published online ahead of print December 12, 2018]. Am J Addictions. doi:10.1111/ajad.12834.

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