Ineffectiveness of Brief Intervention for Drug Use

Ineffectiveness of Brief Intervention for Drug Use

There is little question that brief interventions, consisting of 1 or 2 sessions, for reducing drug use have little to no impact on using behavior. Two recent studies illustrate the futility of brief interventions in reducing illicit drug use or prescription drug misuse, known collectively as “problem drug use.”

Peter Roy-Byrne, MD, who was from the Department of Psychiatry and Behavioral Sciences at the University Of Washington School Of Medicine in Seattle at the time of the trial, led the research. In the randomized controlled trial, researchers enrolled 868 patients that had reported problem drug use in the past 90 days.

The participants were randomly assigned to receive a single intervention, which included a handout, a list of helpful resources, feedback, and discussion about options for change, and a 10-minute “telephone booster” two weeks later; or care as usual which included just the handout and a list of substance abuse resources. Both groups were assessed for drug use at baseline, 3, 6, 9 and 12 months later.

Results showed there were no significant differences between groups in 12-month post-intervention drug use, emergency department (ED) and inpatient hospital admissions, arrests and deaths.

The second study was led by Richard Saitz, MD, MPH, from the Department of Community Health Sciences at the Boston University School of Public Health in Massachusetts. In this study, researchers enrolled 528 adult patients and randomly assigned them to one of three groups.  They receive a structured interview conducted by health educators that lasted between 10 and 15 minutes in length, a structured interview that lasted 30 to 45 minutes and included a 20- to 30-minute booster from counselors, or receive no intervention at all as a control group.

Results showed that there were no significant between-group differences at 6 months for drug use consequences, injection drug use, hospitalizations and ED visits, or attendance at meetings of mutual help groups. Brief intervention did not have efficacy for decreasing unhealthy drug use in primary care patients identified by screening.

These studies confirm previous research indicating that addiction is a chronic and intractable problem that requires multiple levels of care to be managed effectively.

 

http://jama.jamanetwork.com/article.aspx?articleid=1892250

http://jama.jamanetwork.com/article.aspx?articleid=1892249

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