A randomized controlled trial of a brief intervention for alcohol and drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary health care in Chile.

Abstract

To study the effectiveness of a brief intervention (BI) associated with the ASSIST (Alcohol Smoking and Substance Involvement Screening Test) for alcohol and illicit drug use as part of a systematic screening program implemented in primary care. A multi-center randomized open-label trial stratified using the ASSIST-specific substance involvement score (for alcohol, scores ranged from 11 to 15 and 16 to 20; and for the other substances from 4 to 12 and 13 to 20). A total of 19 primary care centers (n=520), eight emergency rooms (n=195) and five police stations (n=91) were evaluated. A total of 12217 people aged between 19 and 55years were screened for moderate alcohol and drug use risk as defined by the ASSIST Chilean version. A total of 806 non-treatment-seekers were randomized. ASSIST-linked BI (n=400) compared with an informational pamphlet on risk associated with substance use (n=406). Total ASSIST alcohol and illicit involvement score (ASSIST-AI), and ASSIST-specific score for alcohol, cannabis and cocaine at baseline and at 3-month follow-up. Sixty-two per cent of participants completed follow-up. An intention-to-treat analysis showed no difference between the two groups for the ASSIST-AI score [mean difference (MD)=-0.17, confidence interval (CI)=-1.87, 2.20], either for specific scores alcohol (MD=0.18, CI=-1.45, 1.10), cannabis (MD=-0.62, CI=-0.89, 2.14) or cocaine (MD=-0.79, CI=-2.89, 4.47). It is not clear whether a brief intervention associated with the Alcohol Smoking and Substance Involvement Screening Test is more effective than an informational pamphlet in reducing alcohol and illicit substance consumption in non-treatment-seeking, primary care users with moderate risk.