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Open Access Study Protocol

Testing the effects of brief intervention in primary care for problem drug use in a randomized controlled trial: rationale, design, and methods

Antoinette Krupski1*, Jutta M Joesch1, Chris Dunn1, Dennis Donovan12, Kristin Bumgardner1, Sarah Peregrine Lord1, Richard Ries1 and Peter Roy-Byrne1

Author Affiliations

1 Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA

2 Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA

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Addiction Science & Clinical Practice 2012, 7:27  doi:10.1186/1940-0640-7-27

Published: 14 December 2012

Abstract

Background

A substantial body of research has established the effectiveness of brief interventions for problem alcohol use. Following these studies, national dissemination projects of screening, brief intervention (BI), and referral to treatment (SBIRT) for alcohol and drugs have been implemented on a widespread scale in multiple states despite little existing evidence for the impact of BI on drug use for non-treatment seekers. This article describes the design of a study testing the impact of SBIRT on individuals with drug problems, its contributions to the existing literature, and its potential to inform drug policy.

Methods/design

The study is a randomized controlled trial of an SBIRT intervention carried out in a primary care setting within a safety net system of care. Approximately 1,000 individuals presenting for scheduled medical care at one of seven designated primary care clinics who endorse problematic drug use when screened are randomized in a 1:1 ratio to BI versus enhanced care as usual (ECAU). Individuals in both groups are reassessed at 3, 6, 9, and 12 months after baseline. Self-reported drug use and other psychosocial measures collected at each data point are supplemented by urine analysis and public health-related data from administrative databases.

Discussion

This study will contribute to the existing literature by providing evidence for the impact of BI on problem drug use based on a broad range of measures including self-reported drug use, urine analysis, admission to drug abuse treatment, and changes in utilization and costs of health care services, arrests, and death with the intent of informing policy and program planning for problem drug use at the local, state, and national levels.

Trial registration

ClinicalTrials.gov NCT00877331

Keywords:
Problem drug use; Screening; Brief Intervention and Referral to Treatment (SBIRT); Motivational Interviewing (MI); Addiction Severity Index (ASI); Safety net; Public health benefit; Cost effectiveness