• Lillian Gelberg, Ronald M Andersen, Abdelmonem A Afifi, Barbara D Leake, Lisa Arangua, Mani Vahidi, Kyle Singleton, Julia Yacenda-Murphy, Steve Shoptaw, Michael F Fleming, and Sebastian E Baumeister.
• David Geffen School of Medicine at UCLA, Department of Family Medicine, Los Angeles, CA, USA.
• Addiction. 2015 Nov 1; 110 (11): 1777-90.

AimsTo assess the effect of a multi-component primary care delivered brief intervention for reducing risky psychoactive drug use (RDU) among patients identified by screening.DesignMulticenter single-blind two-arm randomized controlled trial of patients enrolled from February 2011 to November 2012 with 3-month follow-up. Randomization and allocation to trial group were computer-generated.SettingPrimary care waiting rooms of five federally qualified health centers in Los Angeles County (LAC), USA.ParticipantsA total of 334 adult primary care patients (171 intervention; 163 control) with RDU scores (4-26) on the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) self-administered on tablet computers. 261 (78%) completed follow-up. Mean age was 41.7 years; 62.9% were male; 37.7% were Caucasian.Intervention(S) And MeasurementIntervention patients received brief (typically 3-4 minutes) clinician advice to quit/reduce their drug use reinforced by a video doctor message, health education booklet and up to two 20-30-minute follow-up telephone drug use coaching sessions. Controls received usual care and cancer screening information. Primary outcome was patient self-reported use of highest scoring drug (HSD) at follow-up.FindingsIntervention and control patients reported equivalent baseline HSD use at 3-month follow-up. After adjustment for covariates, in the complete sample linear regression model, intervention patients used their HSD on 3.5 fewer days in the previous month relative to controls (P<0.001), and in the completed sample model, intervention patients used their HSD 2.2 fewer days than controls (P < 0.005). No compensatory increases in use of other measured substances were found.ConclusionsA primary-care based, clinician-delivered brief intervention with follow-up coaching calls may decrease risky psychoactive drug use.© 2015 Society for the Study of Addiction.

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