No major long term followup study has concluded that alcohol will become a substitute addiction among recovered opioid addicts, although some addicts do develop alcohol problems. The samples studied showed moderate use of alcohol post-treatment. The extent of post-treatment alcohol problems seems to be related to pre-treatment alcohol use and to the length of stay of prior treatment. Clinical management of alcohol problems in drug abusers should be guided by a perspective which integrates what is known from clinical experience, outcome research, and the recovery process itself. These include the fact that maintaining sobriety involves a change in the whole person, that recovery is always the responsibility of the individual, and that messages to substance abusers concerning alcohol use and recovery must be credible in terms of who delivers it and what they say. It should be remembered that relapse is the rule in the recovery process. Substance abusers are at risk for alcohol problems and given this risk factor recovering chemical abusers should remain abstinent from all substances including alcohol. Effective strategies for treating hidden alcohol problems should include method of assessment, diagnosis, and detection. Since drug abusers may admit to alcohol use but deny problems with this substance, treatment personnel must use their diagnostic skills to detect varieties of alcohol abusers. 7 references.