Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review

Abstract

BackgroundThe purpose of this systematic review is to assess the effectiveness of brief interventions (BIs) as part of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances.MethodsBibliographic databases (including MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO to April 2012) and gray literature sources were searched. We included randomized controlled trials that opportunistically screened adolescents or adults and then provided a one-to-one, verbal BI to those at risk of substance-use harm. Of interest was the nonmedical use of psychoactive substances (for example, drugs prohibited by international law), excluding alcohol, nicotine, and caffeine. Interventions comprised four or fewer sessions and were compared with no/delayed intervention or provision of information only. Studies were assessed for bias using the Cochrane risk of bias tool. Results were synthesized narratively. Evidence was interpreted according to the GRADE framework.ResultsWe identified 8,836 records. Of these, five studies met our inclusion criteria. Two studies compared BI with no BI, and three studies compared BI with information only. Studies varied in characteristics such as substances targeted, screening procedures, and BI administered. Outcomes were mostly reported by a single study, leading to limited or uncertain confidence in effect estimates.ConclusionsInsufficient evidence exists as to whether BIs, as part of SBIRT, are effective or ineffective for reducing the use of, or harms associated with nonmedical use of, psychoactive substances when these interventions are administered to nontreatment-seeking, screen-detected populations. Updating this review with emerging evidence will be important.Trial registrationCRD42012002414

Uso de substâncias psicoativas entre trabalhadores da enfermagem

“…Tais intervenções consistem em encontros presenciais e breves para fornecer informações e aconselhamento para evitar o uso de substâncias, ou ensinar habilidades de mudança de comportamento. Há evidências cientí-ficas que as intervenções breves realizadas na atenção primária reduzem as probabilidades de sofrer consequências negativas, tais como lesões, doenças e incapacidades associadas ao uso não-médico de substâncias psicoativas (Young et al, 2014). Estudo acrescenta que os programas de redução de danos para o consumo de substâncias psicoativas devem ser inseridos nos estabelecimentos de saúde, sobretudo nos ambientes hospitalares, considerando que os programas voltados aos hábitos de vida apresentam uma grande resistência pelos trabalhadores.…”

Readiness to change is a predictor of reduced substance use involvement: Findings from a randomized controlled trial of patients attending South African emergency departments

“…This suggests that although brief interventions may be adequate for helping individuals reduce their alcohol use, they may not be sufficient for helping people change their drug use. This finding is not altogether surprising given evidence from other settings that brief interventions in non-treatment seeking populations are efficacious for reducing alcohol use [13][14][15][16], but not for reducing illicit drug use [19][20][21][22][23]. However, it remains unclear why these interventions are effective for reducing alcohol use only.…”

“…In contrast, there is currently insufficient evidence to draw conclusions about the effectiveness of BIs for reducing illicit drug use among non-treatment-seeking populations [19]. Recent trials conducted predominantly in the U.S. found that BIs had no significant effect on illicit drug use [20][21][22][23], although one study [24] found that individuals with more severe drug use problems had improved utilization of substance abuse treatment and lower utilization of emergency services subsequent to receiving a BI.…”

Cannabis and Young Users—A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care

“…40,41 We hypothesized that a brief intervention conducted in primary care by general practitioners among young users aged 15 to 25 years, regardless of their initial level of consumption, would lead to a decrease in their consumption at 1 year relative to usual care.…”

“…39 More research is therefore needed to assess the efficacy of a brief intervention for the reduction of cannabis use in primary care. 40,41 We hypothesized that a brief intervention conducted in primary care by general practitioners among young users aged 15 to 25 years, regardless of their initial level of consumption, would lead to a decrease in their consumption at 1 year relative to usual care.…”