Screening, Brief Intervention and Referral to Treatment for Substance Abuse in Mental Health Treatment Settings

NCT01883791 | Completed DMC

• 2 other identifiers: 1R01DA032733-01A1R01DA032733
• Study Type: interventional
• Target: 1,080
• Locations: 1 country
• Sites: 2

Brief Summary

An estimated 40% of patients in mental health treatment settings engage in hazardous alcohol and/or drug use. One model of intervention that has been shown effective in medical settings to reduce alcohol use and/or promote engagement in addiction treatment is screening, brief intervention, and referral to treatment (SBIRT). Despite the effectiveness of SBIRT for risky alcohol use in medical settings, there has been no research on the effectiveness of SBIRT in mental health treatment settings. Given the proportionately large number of mental health patients who also engage in hazardous substance use, research is needed to find an appropriate and effective substance use intervention for patients in these settings. The proposed study uses a randomized controlled trial to examine the extent to which the World Health Organization's SBIRT model, the ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) and its associated brief behavioral intervention, leads to reductions in substances prevalent in mental health settings: alcohol, cannabis and stimulants (i.e., cocaine and methamphetamine). The study will also examine the effect of SBIRT on improvement in psychiatric symptoms, improved quality of life and for those whose level of substance misuse indicates a need for treatment, initiation and engagement into SUD treatment services. Eligible participants will be mental health patients who report any past year use of cannabis or stimulants or at least one heavy drinking day in the past year. Mental health patients (N=750) who meet eligibility criteria will be enrolled and randomly assigned to either the SBIRT intervention condition or to a health education attention control condition. Participants will be assessed at baseline on substance use, psychiatric symptoms and quality of life. Each participant will be assessed at 3-, 6- and 12- month follow up points for alcohol and drug use, involvement in SUD treatment services, severity of psychiatric symptoms and quality of life. If successful this study will yield valuable new knowledge about the effectiveness of SBIRT in mental health treatment settings and will promote improved well being of mental health patients. Further, the study will provide evidence on the effectiveness of SBIRT for reducing illicit drug use. Results from this research will be used as the basis for broader dissemination and of SBIRT in mental health settings.

Conditions

Substance Use Disorders; Mental Illness

Keywords

substance abuse prevention and treatment; comorbidity; SBIRT

Outcome Measures

Primary Outcomes (1)

• Time Line Follow Back (TLFB)

  The TLFB will be used to determine days of use for alcohol and drugs over the 90-day period prior to the baseline assessment. The interviewer will guide the participant to identify the number of standard drinks consumed each day, starting from the day immediately before the assessment and moving backwards in time. Days on which cannabis and/or stimulants were used will also be queried. Variables calculated from the interview will include: (1) total standard drinks, (2) drinking frequency, (3) heavy-drinking frequency (5+ for men; 4+ for women), (4) maximum quantity of alcohol consumed, (5) number of days using cannabis, (6) number of days using cocaine, (7) number of days using methamphetamine, and (8) days on which any alcohol, cannabis or stimulant was used. This measure is completed at 3, 6 and 12 months post baseline in order to measure change from one timepoint to the next.

  These data will be assessed for each 90-day period preceding the 3-, 6- and 12-month follow ups.

Study Arms (2)

SBIRT

EXPERIMENTAL

The SBIRT condition will include the WHO's Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and its accompanying brief intervention that uses motivational interviewing techniques to provide feedback, emphasize personal responsibility, give advice, provide a menu of options, convey empathy, and promote self-efficacy.

Behavioral: SBIRT

Health Education

OTHER

The control group will receive a Health Education (HE) session, informational brochures and a contact information for addiction treatment sites that we will develop with Ventura County. The session will be administered in an individual format for 30-minutes and will address general health, wellness and lifestyle topics.

Behavioral: Health Education

Interventions

SBIRT BEHAVIORAL

See above Arm description.

Also known as: Screening, Brief Intervention and Referral to Treatment.

SBIRT

Health Education BEHAVIORAL

See Arm Description.

Health Education

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• (1)have affective disorder (Major Depressive Disorder, Dysthymia, Bipolar Disorder) or psychotic disorder (Schizophrenia, Schizoaffective, or Psychotic Disorder Not Otherwise Specified),
• (2) have any use of cannabis or stimulants in the past year or a heavy drinking day (5+/4+ drinks for men/women) in the past year,
• (3) are 18 years or older,
• (4) have a stable living situation (i.e., has not been homeless during the past two years),
• (5) are not under the influence of alcohol and/or drugs at the time of enrollment and
• (6) have not received substance abuse treatment within the past year.

You may not qualify if:

• (1) have received any substance abuse treatment in the past year will be excluded because exposure to addiction treatment may confound the effects of the SBIRT intervention.
• (2) have Opiate and opioid use because we cannot guarantee access to appropriate pharmacotherapies (e.g., suboxone or methadone).

Sponsors & Collaborators

• University of California, Los Angeles: lead
• National Institutes of Health (NIH): collaborator
• National Institute on Drug Abuse (NIDA): collaborator

Study Sites (2)

UCLA Inpatient and Outpatient Psychiatric Units

Los Angeles, California, 90025, United States

Location

Ventura County Behavioral Health

Oxnard, California, 93036, United States

Location

MeSH Terms

Conditions

Substance-Related Disorders; Mental Disorders

Interventions

Mass Screening; Crisis Intervention

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and Procedures; Diagnosis; Health Surveys; Surveys and Questionnaires; Data Collection; Epidemiologic Methods; Investigative Techniques; Diagnostic Services; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Public Health Practice; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Mitch Karno, Ph.D.

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

• Suzette Glasner-Edwards, Ph.D.

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

• Richard Rawson, Ph.D.

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Psychologist

Study Record Dates

• First Submitted: November 30, 2012
• First Posted: June 21, 2013
• Study Start: March 1, 2013
• Primary Completion: June 30, 2017
• Study Completion: June 30, 2018
• Last Updated: November 2, 2018

Record last verified: 2018-10

Locations

US (2)