title: Randomized clinical trial of the effects of screening and brief intervention for illicit drug use: the Life Shift/Shift Gears study.
abstract: BACKGROUND
  Although screening, brief intervention, and referral to treatment (SBIRT) has shown promise for alcohol use, relatively little is known about its effectiveness for adult illicit drug use. This randomized controlled trial assessed the effectiveness of the SBIRT approach for outcomes related to drug use among patients visiting trauma and emergency departments (EDs) at two large, urban hospitals.
  
  
  METHODS
  A total of 700 ED patients who admitted using illegal drugs in the past 30 days were recruited, consented, provided baseline measures of substance use and related problems measured with the Addiction Severity Index-Lite (ASI-Lite), and then randomized to the Life Shift SBIRT intervention or to an attention-placebo control group focusing on driving and traffic safety (Shift Gears). Both groups received a level of motivational intervention matched to their condition and risk level by trained paraprofessional health educators. Separate measurement technicians conducted face-to-face follow-ups at 6 months post-intervention and collected hair samples to confirm reports of abstinence from drug use. The primary outcome measure of the study was past 30-day drug abstinence at 6 months post-intervention, as self-reported on the ASI-Lite.
  
  
  RESULTS
  Of 700 participants, 292 (42%) completed follow-up. There were no significant differences in self-reported abstinence (12.5% vs. 12.0% , p = 0.88) for Life Shift and Shift Gears groups, respectively. When results of hair analyses were applied, the abstinence rate was 7 percent for Life Shift and 2 percent for Shift Gears (p = .074). In an analysis in which results were imputed (n = 694), there was no significant difference in the ASI-Lite drug use composite scores (Life Shift +0.005 vs. Shift Gears +0.017, p = 0.12).
  
  
  CONCLUSIONS
  In this randomized controlled trial, there was no evidence of effectiveness of SBIRT on the primary drug use outcome.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01683227.
authors.affiliation: San Diego State University, School of Social Work, Center for Alcohol and Drug Studies, 5500 Campanile Drive, San Diego, CA HH-203E, USA. swoodruff@mail.sdsu.edu.
authors.forename: Susan I
authors.initials: SI
authors.lastname: Woodruff
authors.forename: John D
authors.initials: JD
authors.lastname: Clapp
authors.forename: Kimberly
authors.initials: K
authors.lastname: Eisenberg
authors.forename: Cameron
authors.initials: C
authors.lastname: McCabe
authors.forename: Melinda
authors.initials: M
authors.lastname: Hohman
authors.forename: Audrey M
authors.initials: AM
authors.lastname: Shillington
authors.forename: C Beth
authors.initials: CB
authors.lastname: Sise
authors.forename: Edward M
authors.initials: EM
authors.lastname: Castillo
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Chan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sise
authors.forename: Joey
authors.initials: J
authors.lastname: Gareri
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation; D002140:California; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006786:Hospitals, Urban; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D062405:Motivational Interviewing; D012017:Referral and Consultation; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs