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

• Published in: Addiction (Abingdon, England) England), 2017-08, Vol.112 (8), p.1462-1469
• Main Authors: Poblete, Fernando, Barticevic, Nicolas A., Zuzulich, Maria Soledad, Portilla, Rodrigo, Castillo‐Carniglia, Alvaro, Sapag, Jaime C., Villarroel, Luis, Sena, Brena F., Galarce, Magdalena
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Alcohol use; Alcohol-Related Disorders - diagnosis; Alcoholic beverages; brief intervention; Brief interventions; Brochures; Cannabis; Chile; Clinical trials; Cocaine; Drug abuse; Drug use; Emergency medical care; Emergency medical services; Evidence-based medicine; Female; Health care; Health services utilization; Help seeking behavior; Humans; illicit substances; Male; Marijuana; Medical screening; Middle Aged; Motivation; Narcotics; Police; Police stations; Primary care; Primary Health Care - methods; randomized controlled trial; Referral and Consultation; screening; Smoking; Substance abuse; Substance Abuse Detection - methods; Substance Abuse Detection - statistics & numerical data; Substance use; Substance-Related Disorders - diagnosis; Surveys and Questionnaires; Treatment Outcome; Young Adult
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/add.13808

Aim 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. Design 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). Setting A total of 19 primary care centers (n = 520), eight emergency rooms (n = 195) and five police stations (n = 91) were evaluated. Participants A total of 12 217 people aged between 19 and 55 years 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. Intervention and comparison ASSIST‐linked BI (n = 400) compared with an informational pamphlet on risk associated with substance use (n = 406). Measurements 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. Findings 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). Conclusion 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.