A randomised controlled trial of a brief intervention for illicit drug use linked to ASSIST screening in a primary healthcare setting: results from the Australian component of the World Health Organization Phase III ASSIST studies
Rachel Humeniuk A B , David A. L. Newcombe B C D , Victoria Dennington A and Robert Ali A B
+ Author Affiliations
- Author Affiliations
A Drug and Alcohol Services South Australia, 91 Magill Road, Stepney, SA 5069, Australia.
B World Health Organization Collaborating Centre for Research in the Treatment of Drug and Alcohol Problems, Discipline of Pharmacology, Faculty of Health and Medical Science, University of Adelaide, SA 5005, Australia.
C Centre for Addiction Research and School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
D Corresponding author. Email: d.newcombe@auckland.ac.nz
Australian Journal of Primary Health 24(2) 149-154 https://doi.org/10.1071/PY17056
Submitted: 30 April 2017 Accepted: 17 November 2017 Published: 27 February 2018
Abstract
This report presents the findings from the Australian component of the Phase III World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) randomised controlled trial investigating the effectiveness of a 5–10-min brief intervention (BI) for illicit drug use delivered in primary healthcare (PHC) settings. Participants (n = 171) recruited from a South Australian PHC setting (sexual health clinic) who scored in the ‘moderate risk’ range on the ASSIST were randomly allocated to an intervention group or wait-list control group at baseline and were followed up 3 months later. The ASSIST was administered to both groups at baseline and follow up as a measure of relative risk. Those in the intervention group received a prescribed 10-step BI at baseline. The majority (n = 63) of participants received the BI for amphetamine-type stimulants (ATS) or cannabis (n = 17). There was a significant reduction in total illicit substance (P < 0.001) and ATS Involvement (P < 0.01) for those receiving the ASSIST-linked BI, compared with control participants. There was no significant effect on cannabis involvement. The results of this study demonstrate that the ASSIST-linked BI may be a reasonably easy and effective way of reducing illicit substance use by Australian PHC clients.
Additional keywords: brief counselling, risky substance use, screening and brief interventions, sexual health clinic.
References
Aldridge A, Dowd W, Bray J (2017) The relative impact of brief treatment versus brief intervention in primary health-care screening programs for substance use disorders. Addiction 112, 54–64.| The relative impact of brief treatment versus brief intervention in primary health-care screening programs for substance use disorders.Crossref | GoogleScholarGoogle Scholar |
Barry KL, Blow FC, Willenbring M, McCormack R, Brockmann LM, Visnic S (2004) Use of alcohol screening and brief interventions in primary care settings: implementation and barriers. Substance Abuse 25, 27–36.
| Use of alcohol screening and brief interventions in primary care settings: implementation and barriers.Crossref | GoogleScholarGoogle Scholar |
Bashir K, King M, Ashworth M (1994) Controlled evaluation of brief intervention by general practitioners to reduce chronic use of benzodiazepines. The British Journal of General Practice 44, 408–412.
Copeland J, Swift W, Roffman RA, Stephens RS (2001) A randomised controlled trial of brief cognitive-behavioural interventions for cannabis use disorder. Journal of Substance Abuse Treatment 21, 55–64.
| A randomised controlled trial of brief cognitive-behavioural interventions for cannabis use disorder.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrgtlWhug%3D%3D&md5=d32da1c406dfdcce39ee453fd8522093CAS |
Córdoba R, Delgado MT, Pico V, Altisent R, Fores D, Monreal A, Frisas O, del Val AL (1998) Effectiveness of brief intervention on non-dependent alcohol drinkers (EBIAL): a Spanish multi-centre study. Family Practice 15, 562–568.
| Effectiveness of brief intervention on non-dependent alcohol drinkers (EBIAL): a Spanish multi-centre study.Crossref | GoogleScholarGoogle Scholar |
Dennington V, Humeniuk R, Newcombe D, Ali R, Vial R (2007) ‘Results from the Australian Arm of an International RCT of a Brief Intervention for Illicit Drug Use Linked to the Scores on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).’ (Drug and Alcohol Services South Australia: Adelaide, SA, Australia)
Hingson R, Compton WM (2014) Screening and brief intervention and referral to treatment for drug use in primary care: back to the drawing board. Journal of the American Medical Association 312, 488–489.
| Screening and brief intervention and referral to treatment for drug use in primary care: back to the drawing board.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXhvVejt77K&md5=16de4b4f1264efaae056673c8b6d85faCAS |
Humeniuk R, Ali R, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, De Lacerda RB, Ling W, Marsden J, Monteiro M, Nhiwatiwa S, Pal H, Poznyak V, Simon S (2008) Validation of the alcohol, smoking and substance involvement screening test (ASSIST). Addiction 103, 1039–1047.
| Validation of the alcohol, smoking and substance involvement screening test (ASSIST).Crossref | GoogleScholarGoogle Scholar |
Humeniuk R, Henry-Edwards S, Ali R, Poznyak V, Monteiro MG (2010) ‘The ASSIST-linked brief Intervention for Hazardous and Harmful Substance Use: a Manual for Use in Primary Care.’ (World Health Organization: Geneva, Switzerland)
Humeniuk R, Ali R, Babor T, Souza‐Formigoni MLO, de Lacerda RB, Ling W, McRee B, Newcombe D, Pal H, Poznyak V (2012) A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health‐care settings in four countries. Addiction 107, 957–966.
| A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health‐care settings in four countries.Crossref | GoogleScholarGoogle Scholar |
Institute of Medicine (1990) ‘Broadening the Base of Treatment for Alcohol Problems.’ (National Academic Press: Washington, DC, USA)
Kaner EF, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, Saunders JB, Burnand B, Heather N (2009) The effectiveness of brief alcohol interventions in primary care settings: a systematic review. Drug and Alcohol Review 28, 301–323.
| The effectiveness of brief alcohol interventions in primary care settings: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Kaner E, Bland M, Cassidy P, Coulton S, Dale V, Deluca P, Gilvarry E, Godfrey C, Heather N, Myles J, Newbury-Birch D, Oyefeso A, Parrott S, Perryman K, Phillips T, Shepherd J, Drummond C (2013) Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial. British Medical Journal 346, e8501
| Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW (2009) Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug and Alcohol Dependence 99, 280–295.
| Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later.Crossref | GoogleScholarGoogle Scholar |
Maisto SA, Conigliaro J, McNeil M, Kraemer K, Conigliaro RL, Kelley ME (2001) Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. Journal of Studies on Alcohol 62, 605–614.
| Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MnltVaksQ%3D%3D&md5=5e13df622dca78cb5ba3fffc7c62c866CAS |
Miller W, Rollnick S (2002) ‘Motivational Interviewing: Preparing People for Change.’ (Guilford Publications: New York, NY, USA)
Newcombe DAL, Humeniuk RE, Ali R (2005) Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site. Drug and Alcohol Review 24, 217–226.
| Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site.Crossref | GoogleScholarGoogle Scholar |
Poblete F, Barticevic NA, Zuzulich MS, Portilla R, Castillo-Carniglia A, Sapag JC, Villarroel L, Sena BF, Galarce M (2017) 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. Addiction 112, 1462–1469.
| 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.Crossref | GoogleScholarGoogle Scholar |
Roche AM, Freeman T (2004) Brief interventions: good in theory but weak in practice. Drug and Alcohol Review 23, 11–18.
| Brief interventions: good in theory but weak in practice.Crossref | GoogleScholarGoogle Scholar |
Saitz R, Palfai TP, Cheng DM, Alford DP, Bernstein JA, Lloyd-Travaglini CA, Meli SM, Chaisson CE, Samet JH (2014) Screening and brief intervention for drug use in primary care: the ASPIRE randomized clinical trial. Journal of the American Medical Association 312, 502–513.
| Screening and brief intervention for drug use in primary care: the ASPIRE randomized clinical trial.Crossref | GoogleScholarGoogle Scholar |
Saunders B, Wilkinson C, Phillips M (1995) The impact of a brief motivational intervention with opiate users attending a methadone programme. Addiction 90, 415–424.
| The impact of a brief motivational intervention with opiate users attending a methadone programme.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3lt12hsg%3D%3D&md5=3ab01c6843b402479b096e734851a5e2CAS |
Stotts AL, Schmitz JM, Rhoades HM, Grabowski J (2001) Motivational interviewing with cocaine-dependent patients: a pilot study. Journal of Consulting and Clinical Psychology 69, 858–862.
| Motivational interviewing with cocaine-dependent patients: a pilot study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrntlSquw%3D%3D&md5=2af96492f53364e7a3d40c24d521435fCAS |
Stout RL (2008) Regression to the mean in addiction research. Addiction 103, 53–53.
| Regression to the mean in addiction research.Crossref | GoogleScholarGoogle Scholar | [Commentary].
WHO Assist Working Group (2002) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction 97, 1183–1194.
| The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility.Crossref | GoogleScholarGoogle Scholar |
WHO Brief Intervention Study Group (1996) A randomized cross-national clinical trial of brief interventions with heavy drinkers. American Journal of Public Health 86, 948–955.
| A randomized cross-national clinical trial of brief interventions with heavy drinkers.Crossref | GoogleScholarGoogle Scholar |
World Health Organization (2009) ‘Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks.’ (World Health Organization: Geneva, Switzerland).
