Screening and Brief Intervention in Substance Use Disorders: Its Clinical Utility and Feasibility Update from Available Literatures (original) (raw)
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Role of Early Brief Psychological Interventions in Substance Use Disorders
Journal of Bahria University Medical and Dental College, 2021
Objective: To assess the effects of early brief psychological interventions in patients of substance use disorders. Study Design and Setting: This descriptive prospective study was conducted at main reception centre filter clinic/ Emergency Department of PNS Shifa hospital from 1st July 2020 to 31st March 2021. Methodology: Total n=78 patients were identified after a simple screening question regarding substance abuse which was how many times the patient had used an illegal drug in the last one year. An answer of more than 1 was considered as a positive response and further screening was done with Drug and Alcohol screening test (DAST). Patients who showed low scores on DAST were recommended for brief interventions which were given as weekly sessions for 6 weeks and reassessment was done at 3rd month. The SPSS 20 package program was used for statistical analysis. The descriptive statistics were analyzed for all the variables evaluated in the study. Results: This study revealed that ...
Screening, treatment initiation, and referral for substance use disorders
Addiction Science & Clinical Practice, 2017
Substance use remains a leading cause of preventable death globally. A model of intervention known as screening, brief intervention, and referral to treatment (SBIRT) was developed decades ago to facilitate time-and resource-sensitive interventions in acute care and outpatient settings. SBIRT, which includes a psychosocial intervention incorporating the principles of motivational interviewing, has been shown to be effective in reducing alcohol consumption and consequences in unhealthy drinkers both in primary care and emergency department settings. Subsequently, SBIRT for unhealthy alcohol use has been endorsed by governmental agencies and professional societies in multiple countries. Although most trials support the efficacy of SBIRT for unhealthy alcohol use (McQueen et al. in Cochrane Database Syst Rev 8, 2011; Kaner et al. in Cochrane Database Syst Rev 2, 2007; O'Donnell et al. in Alcohol Alcohol 49(1):66-78, 2014), results are heterogenous; negative studies exist. A newer approach to screening and intervention for substance use can incorporate initiation of medication management at the index visit, for individuals willing to do so, and for providers and healthcare systems that are appropriately trained and resourced. Our group has conducted two successful trials of an approach we call screening, treatment initiation, and referral (STIR). In one trial, initiation of nicotine pharmacotherapy coupled with screening and brief counseling in adult smokers resulted in sustained biochemically confirmed abstinence. In a second trial, initiation of buprenorphine for opioid dependent individuals resulted in greater engagement in treatment at 30 days and greater self-reported abstinence. STIR may offer a new, clinically effective approach to the treatment of substance use in clinical care settings.
Addiction, 2012
Aims This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances, producing a score for each substance that falls into either a low-, moderate-or high-risk category. Design Prospective, randomized controlled trial in which participants were either assigned to a 3-month waiting-list control condition or received brief motivational counselling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score. Setting Primary health-care settings in four countries: Australia, Brazil, India and the United States. Participants A total of 731 males and females scoring within the moderate-risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants or opioids. Measurements ASSIST-specific substance involvement scores for cannabis, stimulants or opioids and ASSIST total illicit substance involvement score at baseline and 3 months post-randomization. Findings Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST total illicit substance involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for cannabis scores (P < 0.005 for both sites), as did the sites in Australia (P < 0.005) and Brazil (P < 0.01) for stimulant scores and the Indian site for opioid scores (P < 0.01). Conclusions The Alcohol, Smoking and Substance Involvement Screening Test-linked brief intervention aimed at reducing illicit substance use and related risks is effective, at least in the short term, and the effect generalizes across countries.
Brief Therapy Approaches in the Treatment of Substance Abuse and Addiction
2019
The use of brief intervention and brief therapy techniques that are focused on short-term, problem-specific approaches, has become an increasingly important part of the continuum of care in the treatment of substance abuse problems and addictive disorders. With the health care system changing to a managed model of care and with changes in reimbursement policies for substance abuse treatment, these short, problem-specific approaches can be valuable in the treatment of addictive disorders. They provide the opportunity for clinicians to increase positive outcomes by using these modalities independently as stand-alone interventions and, more commonly, as additions to other forms of substance abuse and mental health treatment. Furthermore, they can be used in diverse venues, including opportunistic settings (e.g., primary care, home health care) and specialized substance abuse treatment settings (inpatient and outpatient). Appropriate for a variety of substance abuse problems from at-risk use to dependence, brief interventions and brief therapies can help clients reduce or stop abuse, act as a first step in the treatment process to determine if clients can stop or reduce on their own, and/or act as a method to change specific behaviors before or during treatment. Currently, the psychotherapy of substance abuse utilizes a wide variety of treatment modalities based on diverse theoretical perspectives, including, cognitive-behavioral, strategic and interactional, humanistic and existential, psychodynamic, family systems and group therapy.
A Proposed Intervention for the Treatment of Substance Use Disorder
The effective treatment of substance abuse is one of the most urgent social policy issues of our time. There is a great deal of debate over what interventions are most effective. This analysis explores the options available during different aspects of the treatment continuum from the period of active substance use to the post-acute withdrawal phase.
Research Protocols,
Abstract Background Alcohol use is an important issue among problem drug users. Although screening and brief intervention are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users. Objectives To determine if a complex intervention, incorporating screening and brief intervention for problem alcohol use among problem drug users, is feasible and acceptable in practice and effective in reducing the proportion of patients with problem alcohol use. Methods PINTA is a pilot feasibility study of a complex intervention comprising screening and brief intervention for problem alcohol use among problem drug users with cluster randomisation at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Participants: Practices (N=16) will be eligible to participate if they are registered to prescribe methadone and/or at least 10 patients of the practice are currently receiving addiction-treatment. Patient inclusion criteria are: aged 18 or over and receiving addiction treatment / care (e.g. methadone) or known to be a problem drug user. Interventions: A complex intervention, supporting screening and brief intervention for problem alcohol use among problem drug users (experimental group) compared to an ‘assessment only’ control group. A delayed intervention being available to ‘control’ practices after follow up. Page 3 Outcome: Primary outcomes are feasibility and acceptability of the intervention to patients and professionals. Secondary outcome is the effectiveness of the intervention on care process (documented rates of screening and brief intervention) and outcome (proportion of patients with problem alcohol use at the follow up). Randomisation: Stratified random sampling of general practices based on level of training in providing addiction-related care and geographical area. Blinding: Single-blinded; GPs and practice staff, researchers and trainers will not be blinded, but patients and remote randomisers will. Discussion This is the first study to examine feasibility and acceptability of primary care based complex intervention to enhance alcohol screening and brief intervention among problem drug users. Results will inform future research among this high-risk population and guide policy and service development locally and internationally.
Canadian Journal of Community Mental Health, 2011
although brief intervention (bi) is an empirically validated treatment modality for alcohol dependence, it has generally failed to gain wide acceptance in practice. Most studies have focused exclusively on individuals with alcohol problems, and little is known about the effectiveness for patients with other drug problems. the objective of this study was to examine the effectiveness of bi compared to standard therapy for drug and alcohol dependence in an outpatient treatment program. the study was conducted at the addictions unit of the Mcgill university Health centre in Montreal. the trial compared 72 patients randomly assigned at intake to an individual 5-session brief intervention (bi) or a 6-month conventional treatment (ct) consisting of individual and group therapy. at 6 months' follow-up, the bi (N = 19) and ct (N = 20) groups were compared in terms of substance use, psychological, health, and occupational outcomes. there were approximately equivalent changes in both treatment groups compared to intake. under the conditions of the present trial, ct did not show superiority over bi, providing additional support for the notion that bi can be an effective first step in the treatment of alcohol and drug dependence in a variety of health care settings.
JMIR research protocols, 2013
Alcohol use is an important issue among problem drug users. Although screening and brief intervention (SBI) are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users. The objective of this study is to determine if a complex intervention including SBI for problem alcohol use among problem drug users is feasible and acceptable in practice. This study also aims to evaluate the effectiveness of the intervention in reducing the proportion of patients with problem alcohol use. Psychosocial intervention for alcohol use among problem drug users (PINTA) is a pilot feasibility study of a complex intervention comprising SBI for problem alcohol use among problem drug users with cluster randomization at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Practices (N=16) will be eligible to participate if they are registered to prescri...