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Research Summary

Brief Interventions for Substance Use and Comorbid Health Conditions: What Is the Evidence?

Brief intervention (BI) decreases smoking and at-risk drinking in primary-care settings, but the utility of BI in other settings and in patients with comorbid conditions remains unclear. Researchers systematically reviewed the literature to assess the effect of BI for substance use in patients with a comorbid physical-health condition, a comorbid mental-health condition, or dual substance use. Fourteen trials met inclusion criteria.* Heterogeneity of the articles precluded quantitative synthesis.

  • Eight trials reported on co-occurring mental-health and substance-use conditions. Most reported no effect of BI for substance use on either condition; none reported between-group differences in mental-health status, and all consistently reported reductions in substance use among patients in both BI and control conditions.
  • Three trials including patients with co-occurring physical-health (hypertension or tuberculosis) and substance-use conditions reported improvements in both conditions after BI for substance use compared with controls.
  • Three trials targeting more than 1 type of substance use reported null findings.
*Studied BI (defined as talk-based therapy to promote behavioral change); participants had a recognized comorbid physical or psychological condition; and experimental study design. Settings varied (psychiatric hospital, community sample, outpatient referral, primary care, hospital, police service). BI ranged from a 30–45 minute motivational intervention to multiple 15–60 minute sessions with 1–10 follow-ups.

Comments:

This review suggests BI for substance use may be beneficial for patients with substance use and certain comorbid physical conditions but not for those with comorbid mental-health or dual-substance conditions. However, the 14 studies included in this review varied widely in quality, methodology (ranging from pilot studies to large-scale randomized clinical trials), duration, content of intervention, and follow- up period. Jeanette M. Tetrault, MD

Reference:

Kaner EFS, Brown N, Jackson K. A systematic review of the impact of brief interventions on substance use and co-morbid physical and mental health conditions. Ment Health Subst Use. 2011;4(1):38–61.

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