Efficacy of a Single-Session Brief Intervention for Unhealthy Alcohol and Drug Use Among South African Young Adults

Most studies investigating the efficacy of brief motivational interventions for unhealthy alcohol and drug use among young adults have been conducted in college students. Researchers screened patients aged 18–24 years from a low-income primary care clinic in South Africa with single-item instruments for alcohol and drug use. Patients with positive screens were randomized to a single-session, nurse practitioner-delivered brief motivational intervention (n = 190; 56% female, 48% black, 52% mixed-race. At-risk use* in 54% for alcohol, 22% for cannabis, and 11% for other drugs), or to usual care (n = 173; 47% female, 50% black, 50% mixed-race. At-risk use in 49% for alcohol, 19% for cannabis, and 15% for other drugs).

• At 3 months, the intervention and usual care groups did not differ in prevalence of at-risk use of alcohol (33% versus 32%) and drugs (18% versus 19%), or heavy drinking** (51% versus 55%).
• At 3 months, the intervention group had a greater decrease in the mean ASSIST alcohol score (13 to 8) compared with the usual care group (11.5 to 9.1), but both groups decreased to scores (≤10) that do not require intervention.

Comments:

Despite its commendable aims, this study ultimately did not show an intervention effect at 3 months. The importance of the slightly greater decrease in ASSIST alcohol score among intervention participants is uncertain since both groups decreased to scores considered to be lower-risk. A larger study with a minimal assessment group, booster intervention sessions, biological outcomes, and longer follow-up may settle the issue.

Kevin L. Kraemer, MD, MSc

Reference:

Mertens, JR, Ward CL, Bresick GF, et al. Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: a randomized clinical trial. Alcohol Alcohol. 2014;49(4):430–438.