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Randomized Controlled Trial
. 2017 May;112(5):818-827.
doi: 10.1111/add.13701. Epub 2017 Feb 7.

Receipt of addiction treatment as a consequence of a brief intervention for drug use in primary care: a randomized trial

Theresa W Kim  1 , Judith Bernstein  2 , Debbie M Cheng  1   2 , Christine Lloyd-Travaglini  2 , Jeffrey H Samet  1   2 , Tibor P Palfai  3 , Richard Saitz  1   2
Affiliations
Randomized Controlled Trial

Receipt of addiction treatment as a consequence of a brief intervention for drug use in primary care: a randomized trial

Theresa W Kim et al. Addiction. 2017 May.

Abstract

Background and aims: Screening, brief intervention and 'referral to treatment' programs have been promoted widely as US federal policy. Little is known about the efficacy of the RT component (referral to treatment) of brief intervention for motivating patients with unhealthy drug use identified by screening to use addiction treatment. This study aimed to compare receipt of addiction treatment following two types of brief intervention for drug use versus a no-intervention control group among primary care patients screening positive for drug use.

Design: Secondary analyses from a single-site randomized controlled trial.

Setting: Massachusetts, USA.

Participants: A total of 528 adults with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) drug-specific scores ≥ 4.

Interventions: Random assignment to: (1) a 10-15-minute brief negotiated interview (BNI) conducted by health educators (n = 174), (2) a 30-45-minute adaptation of motivational interviewing by Masters-level counselors (MOTIV) (n = 177) or (3) no BI (n = 177). All received a list of treatment and mutual help resources; both intervention protocols included dedicated staff for treatment referrals.

Measurements: Receipt of any addiction treatment within 6 months after study entry, assessed in a state-wide database and hospital electronic medical record linked to trial data.

Findings: Among 528 participants, the main drugs used were marijuana (63%), cocaine (19%) and opioids (17%); 46% met past-year drug dependence criteria (short form Composite International Diagnostic Interview); and 10% of MOTIV, 18% of BNI and 17% of control participants had any addiction treatment receipt within 6 months after study entry. There was no significant difference in addiction treatment receipt for BNI versus control [adjusted odds ratio (AOR) = 1.11; 95% confidence interval (CI) = 0.57, 2.15, Hochberg adjusted P = 0.76]. The MOTIV group had lower odds of linking to treatment (AOR = 0.36, 95% CI = 0.17, 0.78, Hochberg adjusted P = 0.02) compared with the no BI group.

Conclusion: Brief intervention delivered in primary care for screen-identified drug use did not increase addiction treatment receipt significantly; a motivational interviewing approach appeared to be counterproductive.

Keywords: Addiction treatment; brief intervention; health services research; illicit drug use; motivational interviewing; primary care; randomized trial; referral to treatment.

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References

    1. Gelberg L, Andersen RM, Afifi AA, Leake BD, Arangua L, Vahidi M, et al. Baumeister SE. Project QUIT (Quit Using Drugs Intervention Trial): A randomized controlled trial of primary care-based multi-component brief intervention to reduce risky drug use. Addiction. 2015;110:1777–90. - PMC - PubMed
    1. Roy-Byrne P, Bumgardner K, Krupski A, Dunn C, Ries R, Donovan D, et al. Zarkin GA. Brief interventions for problem drug use in safety-net primary care settings. JAMA. 2014;312:492–501. - PMC - PubMed
    1. Saitz R, Palfai TPA, Cheng DM, Alford DP, Bernstein JA, Lloyd-Travaglini C, et al. Samet JH. Screening and brief intervention for drug use in primary care: The ASPIRE randomized clinical trial. JAMA. 2014;312:502–513. - PMC - PubMed
    1. Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, brief intervention, and referral to treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abus. 2007;28:7–30. - PubMed
    1. Department of Health and Human Services. Centers of Medicare and Medicaid Services, Medicare Learning Network Series: Screening and Brief Intervention and Referral to Treatment. [Accessed October 14, 2016]; Available at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN....

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