Abstract
Aims. This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances,producing a score for each substance that falls into either a ‘low’, ‘moderate’ or ‘high’ risk category.
Design. Prospective, randomized controlled trial in which participants were either assigned to a 3-month wait-list control condition or received brief motivational counseling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score.
Setting. Primary health care settings in four countries: Australia, Brazil, India and the United States of America.
Participants. 731 males and females scoring within the moderate risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants, or opioids.
Measurements. ASSIST Specific Substance Involvement Scores for cannabis, stimulants or opioids, and, ASSIST Total Illicit Substance Involvement Score at baseline and 3 months post randomization.
Findings. Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST Total Illicit Substance Involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for Cannabis Scores (p < 0.005 for both sites); as did the sites in Australia (p < 0.005) and Brazil (p < 0.05) for Stimulant Scores, and the Indian site for Opioid Scores (p < 0.01).
Conclusions. The ASSIST-linked brief intervention aimed at reducing illicit substance use and related risks is effective at least in the short-term, and the effect generalises across countries.