"Effectiveness of a Brief Intervention for Substances Consumption Linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): A Randomized Control Trial in Chilean Primary Care."
Condition: Alcohol-Related Disorders; Substance-Related Disorders; Substance Abuse
MeSH terms: Substance-Related Disorders; Alcohol-Related Disorders
Study type: Interventional
Phase: Phase 3

Summary: 
      Alcohol and drugs consumption are among the highest risk factor for health in Chile and
      abroad. In Chile, harmful use of alcohol continues to be a major contributor to the burden of
      disease while lost years of healthy life are higher than many other risk factors such as
      hypertension, overweight and obesity, and hyperglycemia. It is important to say that the
      impact of alcohol consumption is greater in younger age groups where fatal injuries occur
      relatively early in life, as well.

      In Chile, the consumption pattern in 2008 showed that 49.8 % consumed at least once in the
      last month for alcohol, 3.5 % for marihuana and 1.3 % for cocaine. This prevalence was even
      greater in young adults and adolescents and is associated with other mental health issues and
      poorer life quality. Those who have consumed marihuana during the last year, 25% report
      dependence symptoms. For cocaine derives, dependency rises up to 50% among the consumers.
      This data reinforce the need to design and implement strategies for reducing alcohol and
      drugs consumption in our population.

      Also, it is well known that a high number of those who suffers from any addiction problem do
      not get attention in a specialized center. The are many barriers to do so, such as lack of
      motivation, lack of resources, social problems, access to care problems, and so on.

      Chile has a shortage of preventive interventions for those at risk to develop an addiction at
      an early stage of substance use because front line health services (Primary health care and
      emergency care) and other social services (police stations, local justice courts) do not have
      a screening system and a model of brief intervention.

      The Pontificia Universidad Catolica de Chile, through its Addiction Studies Center (CEDA UC)
      and its Department of Family Medicine, is working in conjunction with SENDA (Servicio
      Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol ) to design,
      implement and evaluate a communal system for early detection, brief intervention and referral
      to treatment (SBIRT), in people older than 18 years, with substance consumption in five
      municipalities in the country.

      The aid of this study is to demonstrate that a model of brief intervention is more effective
      than the approach currently used in patients with substance use at moderate risk
      (i.e.follow-up). It is a multicentric randomized controlled trial, single blind, with a group
      to receive brief intervention and a control group that is kept in control and waiting list
      being re-evaluated three months later.

      The target population is composed by users whose ASSIST screening scores place them in the
      moderate risk group, for which there has not been defined a structured intervention yet by
      our health system. The information will be obtained from the scores obtained after the
      application of the ASSIST-WHO questionnaire.
    


Intervention name(s): ASSIST-linked brief intervention for hazardous and harmful substance use.; Observation
Intervention type(s): Other; Other
Intervention description(s): ASSIST-linked brief intervention will be applied to users achieving moderate risk scores in the ASSIST questionnaire. If after randomization are selected to enter the intervention group, they will receive a ten minute counseling carried immediately after the screening instrument. This intervention group will be re-evaluated after 3 months with the same ASSIST screening instrument.; Subjects who obtain a moderate risk score in the ASSIST screening questionnaire and after randomization are selected for the control group, will receive a brochure with substance-abuse information without any further conversation about the subject with the caregiver. This observation group will be re-evaluated after 3 months with the same ASSIST screening instrument.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Alcohol; Abuse; Drugs; Brief intervention; ASSIST