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A randomized trial of brief assessment interventions for young adults who use drugs in the club scene.

ABSTRACT: BACKGROUND:Efficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the literature. We tested interviewer- (CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions compared to waitlist control. METHODS:750 men and women ages 18-39 with multidrug use and heterosexual behavior were randomized in equal proportions to the three conditions. Instrumentation included well-tested measures of drug use, risky sex, mental distress and substance dependence. RESULTS:The sample was 56% male; mean age=25. Reported risk behaviors and health consequences did not differ by assessment modality. Adjusted HLM analyses showed a significant main effect of assigned condition on all outcomes. CAPI participants had greater reductions in drug use, risky sex, mental distress and substance dependence symptoms, and greater increases in abstinence, compared to ACASI intervention or control participants at 12months, except that the CAPI and ACASI conditions had similar efficacy for reductions in drug use. Effect sizes for CAPI versus ACASI participants were d=0.2-0.3, and between CAPI and controls d=0.2-0.4. Effect sizes for improved outcomes between ACASI compared to controls were small to non-significant. CONCLUSIONS:The study established the therapeutic benefit of interviewer interaction in reducing risky behavior among this young drug using population. The study demonstrated the efficacy and acceptability of a low threshold intervention in reducing drug use, sexual risk and related co-morbidities among a not-in-treatment young adult population that exhibits severe and complex levels of drug use, but that is also highly resistant to intervention.

SUBMITTER: Kurtz SP

PROVIDER: S-EPMC5516962 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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A randomized trial of brief assessment interventions for young adults who use drugs in the club scene.

Kurtz Steven P SP Buttram Mance E ME Pagano Maria E ME Surratt Hilary L HL

Journal of substance abuse treatment 20170512

<h4>Background</h4>Efficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the literature. We tested interviewer- (CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions compared to waitlist control.<h4>Methods</h4>750 men and women ages 18-39 with multidrug use and heterosexual behavior were randomized in equal proportions to the three conditions. Instrumentation included well-t ...[more]

PMID: 28554606

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Project description:BackgroundAdolescents and young adults (AYA) have an increased risk for Internet use disorders (IUD) compared to older individuals that may lead to functional impairments in daily life. To date, evidence-based brief interventions are lacking. This study aimed to test the efficacy of a low-threshold counseling approach based on Motivational Interviewing (MI) in a vocational school setting.MethodsOf 8.230 vocational students (age M=20.56, SD=4.68; 51.85% female) being proactively screened for IUD, 937 with positive screenings took part in telephone-based diagnostic interviews. IUD were assessed in line with the criteria of the Internet Gaming Disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Readiness to change, self-efficacy, and impairments in daily life were additionally assessed with standardized screening instruments. Participants fulfilling at least two IUD criteria were randomized to the intervention group (n=240, up to three MI-based counseling sessions via telephone) or the control group (n=257, information brochure on responsible Internet use). Follow-up interviews were conducted after five and ten months. The primary outcome was the reduction of IUD criteria. Secondary outcomes were improvements of readiness/ self-efficacy to change and the reduction of daily impairments. Data were analyzed with Intention-to-Treat (ITT) and complier average causal effect (CACE) analyses.ResultsOverall, 153 (63.75%) individuals assigned to the intervention group participated at least in one counseling session (=compliers). Both groups reduced the number of IUD criteria over time. In ITT analyses, however, we did not find intervention effects for primary and secondary outcomes. Bayes statistics were inconclusive. Based on low participation rates in the intervention group, explorative CACE analyses were conducted to compare compliers in the intervention group to potential compliers in the control group. Again, we did not find intervention effects apart from improvements in self-efficacy after five months.DiscussionTelephone-based counseling seems not appropriate to address AYA at risk for IUD. Low participation rates in the intervention group caused underpowered analyses. Besides, dealing with the own Internet use during intensive assessments and receiving an information brochure led to behavioral changes also in the control group. Since the efficacy of brief interventions under the condition of higher participation rates cannot be fully ruled out, further research is required by taking the implications of this study into account.

Project description:Rates of cannabis use are highest during emerging adulthood (age 18-25), with the prevalence of near daily and daily increasing among this age group. Emerging adults are clinically challenging in terms of harmful cannabis use due to perceptions of high rates of peer use, social acceptance, and low risk of harm. Brief interventions to increase awareness and promote motivation to change are therefore particularly important for this age group. There is existing evidence on the effectiveness of brief interventions for alcohol in emerging adults, but it is not clear if comparable evidence is present for cannabis. The objective of this systematic review is to summarize and critically appraise the existing literature of brief interventions for cannabis use both narratively, to describe the content and delivery of existing interventions, and meta-analytically, to determine the aggregated efficacy of these interventions on cannabis use and other outcomes (e.g., other substance use, mental health, help-seeking behaviors, and academic and occupational outcomes).A systematic search of randomized controlled trials, quasi-experimental trials, and pre-post designs will be conducted in the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Ongoing trials will be identified using the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov , and Current Controlled Trials. Unpublished trials will be identified using Proquest Dissertations, OpenGrey, Google Scholar, and brief interventions on the Substance Abuse and Mental Health Services Administration webpage. Two authors will independently screen and extract data from articles using a predetermined screening and extraction forms (which will include risk of bias assessments). Calibration exercises will be performed prior to full screening and extraction. Disagreements will be resolved through discussion or consultation with a third reviewer. All studies will be reported narratively, and if appropriate, we will perform random effects meta-analyses with subgroup analyses and meta-regression.Results of this review are expected to provide guidance on the content, delivery methods, and effectiveness of brief interventions for cannabis use to assist post-secondary institutions in identifying brief intervention strategies to implement prior to or in response to legalization.CRD42018085412.

Project description:BackgroundBehavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, particularly for individuals with low levels of environmental reward.MethodsParticipants were 393 college students who reported at least 2 heavy-drinking episodes in the past month. Participants were randomly assigned to 1 of 3 conditions following a baseline assessment: a standard alcohol-focused brief motivational intervention plus relaxation training session (BMI + RT), BMI plus Substance-Free Activity Session (BMI + SFAS), or an assessment-only control condition (AO). In a secondary analysis of the data from this study, we used person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up and examined whether environmental reward levels moderated the effectiveness of the interventions.ResultsPiecewise growth mixture modeling identified 2 trajectories of reward availability: low increasing (LR; n = 120) and high stable (HR; n = 273). Depressive symptoms, cannabis use, sensation seeking, and low life satisfaction were associated with a greater probability of classification in the LR trajectory. Alcohol severity was greater in the LR trajectory than the HR trajectory. For students in the LR trajectory, at 1, 6, and 12 months, BMI + SFAS led to greater increases in reward availability and reduced levels of alcohol severity compared with the BMI + RT and AO conditions and at 16 months compared with AO.ConclusionsYoung adults with low levels of environmental reward are at heightened risk for greater alcohol severity and may show greater benefit from brief alcohol interventions that focus on increasing substance-free reward than individuals who are not deficient in reward availability.

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A randomized trial of brief assessment interventions for young adults who use drugs in the club scene.

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A randomized trial of brief assessment interventions for young adults who use drugs in the club scene.

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