Abstract
BackgroundA substantial body of research has established the effectiveness of brief interventions for problem alcohol use. Following these studies, national dissemination projects of screening, brief intervention (BI), and referral to treatment (SBIRT) for alcohol and drugs have been implemented on a widespread scale in multiple states despite little existing evidence for the impact of BI on drug use for non-treatment seekers. This article describes the design of a study testing the impact of SBIRT on individuals with drug problems, its contributions to the existing literature, and its potential to inform drug policy.Methods/designThe study is a randomized controlled trial of an SBIRT intervention carried out in a primary care setting within a safety net system of care. Approximately 1,000 individuals presenting for scheduled medical care at one of seven designated primary care clinics who endorse problematic drug use when screened are randomized in a 1:1 ratio to BI versus enhanced care as usual (ECAU). Individuals in both groups are reassessed at 3, 6, 9, and 12 months after baseline. Self-reported drug use and other psychosocial measures collected at each data point are supplemented by urine analysis and public health-related data from administrative databases.DiscussionThis study will contribute to the existing literature by providing evidence for the impact of BI on problem drug use based on a broad range of measures including self-reported drug use, urine analysis, admission to drug abuse treatment, and changes in utilization and costs of health care services, arrests, and death with the intent of informing policy and program planning for problem drug use at the local, state, and national levels.Trial registrationClinicalTrials.gov NCT00877331
Highlights
A substantial body of research has established the effectiveness of brief interventions for problem alcohol use
This study will contribute to the existing literature by providing evidence for the impact of brief intervention (BI) on problem drug use based on a broad range of measures including self-reported drug use, urine analysis, admission to drug abuse treatment, and changes in utilization and costs of health care services, arrests, and death with the intent of informing policy and program planning for problem drug use at the local, state, and national levels
This study was designed to evaluate the impact of a BI on patients with problem drug use in a primary care setting within a safety net system of care
Summary
A substantial body of research has established the effectiveness of brief interventions for problem alcohol use. A substantial body of research has established the efficacy and effectiveness of brief (one to two sessions) interventions (BI) for excessive or hazardous alcohol use in patients seen in medical settings, both primary care and emergency department (ED) [1,2,3] Following these studies, national dissemination projects of screening, brief intervention, and referral to treatment (SBIRT) for alcohol and drugs have been implemented on a According to a recent epidemiological study, a disproportionate number of individuals with drug abuse or dependence are from lower socioeconomic strata [10], where access to specialized substance abuse treatment is difficult and, as a result, exacerbates the motivational challenges and follow-through that BI targets. Ambulatory primary care is an important setting to test the effectiveness of BI on drug abuse since, were it effective, modest effects for a large number of patients would yield a sizable public health benefit [15]
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