Screening, Brief Intervention, and Referral to Treatment for Drug Use
Condition: Drug Abuse
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive,
      integrated public health approach to identify and deliver a spectrum of early detection and
      intervention services for substance use in general medical care settings. These settings,
      such as emergency department visits, offer a potential "teachable moment" because patients
      may have perceptions of vulnerability about their health, and therefore be particularly
      receptive to screening and counseling. There is mounting scientific evidence suggesting SBIRT
      is effective in reducing alcohol use at varying levels of severity in a myriad of health care
      settings including primary care, emergency departments, and trauma centers. Although the
      SBIRT approach has shown promise for alcohol, relatively little is known about its
      effectiveness for adult illicit drug use specifically.

      This will be among the first studies to rigorously test the SBIRT approach for drug use. It
      will evaluate the effectiveness of SBIRT for drug use and related factors for 700
      multi-ethnic ED patients using a two-group randomized repeated-measures design in which
      biologically-validated drug use abstinence and related outcomes of an intervention group are
      compared to those of an attention-placebo control group. Over a 14-month period,
      bilingual/bicultural Health Educators recruited participants who reported past 30-day illicit
      drug use in excess of risky alcohol use from the waiting areas of two large hospital's ED and
      trauma units. Following consent procedures and standardized baseline assessments, Health
      Educators randomly assigned participants to one of the two conditions. The intervention group
      received "Life Shift," an SBIRT drug use intervention matched to the participant's drug use
      risk level. The control group received the same type and quantity of intervention in an
      unrelated area-Driving and Traffic Safety ("Shift Gears" program), also matched to their
      driving/traffic risk level. A 6-month face-to-face follow-up visit by trained measurement
      technicians blind to the participant's assigned condition collected standardized self-report
      past 30-day drug use measures (ASI-Lite)and hair samples for validating self-reported
      abstinence. Additional outcome variables are changes in the frequency of drug use, functional
      status measures (i.e., medical problems, psychiatric problems, and alcohol use), and health
      care utilization.
    


Intervention name(s): Screening/motivational drug intervention; Motivational placebo intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Screening and brief motivational intervention delivered in the ER to reduce drug use; Screening and brief motivational intervention delivered in the ER to reduce driving and traffic risk
Other intervention name(s): SBIRT
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: drug use; emergency department; brief intervention