Psychopathological syndromes and risk of alcoholism in Heroin Use Disorder patients compared with substance non-user peers

In our research group, a history of alcohol use is commonly reported by heroin addicts at treatment entrance, whatever treatment option has been applied for, but alcohol use is also quite frequent among addicts who are not currently using heroin on a regular basis. In addition, alcohol use seems to be correlated with the severity and level of activity of Opioid Use Disorder. Methods: In this study, we tested the influence of opioid dependence on psychopathology, drinking habits and the risk of alcoholism in Heroin Use Disorder (HUD) patients compared with people with very similar demographic and logistic characteristics, but without the use of opioids (Substance Non-User Peers - SNUP). Using the VARA test and the Maremmani's 5-dimensional version of Derogatis's Symptomathological Check List, we compared, both at the univariate and multivariate levels, 73 HUD patients with a sample of 45 SNU peers who were selected after their respective sociodemographic data had been matched. Results: Regarding psychological profiles, HUD patients and SNU peers differed, at univariate level, in total score and in all the psychopathological syndromes investigated, with the single exception of Panic Anxiety, with HUD patients showing greater severity. At multivariate level, strong Somatic Symptoms and low Panic Anxiety scores distinguished HUD patients. Regarding drinking habits and the risk of alcoholism, HUD patients obtained higher values in total score and all VARA dimensions except 'modality' and 'quantity' of alcohol drinking', and 'environmental situation for drinking'. At multivariate level, despite a less abundant and harmful drinking pattern, somatic symptoms and somatic consequences of drinking appeared more severe in HUD than in SNUP subjects. Conclusions: With a similar modality and quantity of alcohol drinking and the same environmental drinking situation, HUD patients showed more severe drinking consequences, despite slightly less abundant and aberrant drinking patterns, so confirming a negative impact of HUD on the risk of alcoholism. In SNUP subjects the risk of alcoholism seems to be more closely related to the presence of a more severe Panic-Anxiety syndrome.