Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

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.

This Week's Must Reads

Early-Life Stress Linked with Cytomegalovirus in MDD , JAMA Psychiatry; ePub 2019 Mar 6; Ford, et al

Collaborative Intervention for Obesity, Depression , JAMA; 2019 Mar 5; Ma, Goldman Rosas, Lv, et al

Body Weight Predicts Risk for Depressive Symptoms , J Affect Disord; ePub 2019 Mar 5; Vittengl

Slow-Wave Activity and Mood Disturbance in MDD, Psychol Med; 2019 Mar; Goldschmied, et al

Marijuana Use in MDD May Be Contraindicated, Cogn Affect Behav Neurosci; ePub 2019 Feb 26; Radoman, et al

Must Reads in Addiction Medicine

Eating Disorders and Substance Use in Adolescents, Int J Eat Disord; ePub 2019 Jan 14; Kirkpatrick, et al

Young Adult Patterns of Marijuana Use in the US, Addiction; ePub 2019 Jan 4; Terry-McElrath, et al

Sexual Minority Youth and Substance Use Patterns, Arch Sex Behav; ePub 2019 Jan 2; Talley, et al