title: Brief intervention for daily marijuana users identified by screening in primary care: A subgroup analysis of the ASPIRE randomized clinical trial.
abstract: The use of brief intervention for decreasing frequent marijuana use holds potential, but its efficacy in primary care is not known.
  
  
  
  
  
  
  
  To assess the impact of 2 brief interventions on marijuana use among daily/or almost daily marijuana users.
  
  
  
  Subgroup analysis of a 3-arm randomized clinical trial of 2 brief counseling interventions compared with no brief intervention on daily marijuana use in a primary care setting (ASPIRE).
  
  
  
  ASPIRE study participants who both reported 21-30 days of marijuana use during the past month and identified marijuana as their drug of most concern.
  
  
  
  (1) brief negotiated interview (BNI), a 10-15-minute structured interview, and (2) an adaptation of motivational interviewing (MOTIV), a 30-45-minute intervention. Control group participants received only a list of substance use treatment resources.
  
  
  
  The primary outcome was number of days of marijuana use in the past 30 days at the 6-month follow-up. Secondary outcomes were (1) number of days of marijuana use at 6-week follow-up and (2) drug problems (Short Inventory of Problems-Drugs, SIP-D) at 6-week and 6-month follow-ups. Differences between intervention groups were analyzed using negative binomial regression models.
  
  
  
  Among the 167 eligible participants, we did not find any significant impact of either of the 2 interventions on past 30 days of marijuana use at 6 months (adjusted incidence rate ratio [aIRR]: 0.95, 95% confidence interval [CI]: 0.75-1.15, P = .82 for BNI vs. control; aIRR: 1.02, 95% CI: 0.85-1.23, P = .82 for MOTIV vs. control). There was no significant impact on drug-related problems at 6-month follow-up (aIRR: 1.12, 95% CI: 0.69-1.82, P = .66 and aIRR: 1.46, 95% CI: 0.89-2.38, P = .27 for BNI vs. control and MOTIV vs. control, respectively). Results were similar at 6 weeks.
  
  
  
  Brief intervention has no apparent impact on marijuana use or drug-related problems among primary care patients with frequent marijuana use identified by screening.
authors.affiliation: a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston Medical Center and Boston University School of Medicine , Boston , Massachusetts , USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fuster
authors.affiliation: a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston Medical Center and Boston University School of Medicine , Boston , Massachusetts , USA.|b Department of Biostatistics , Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.affiliation: c Data Coordinating Center , Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Na
authors.initials: N
authors.lastname: Wang
authors.affiliation: d Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Bernstein
authors.affiliation: e Department of Psychology and Brain Sciences , Boston University , Boston , Massachusetts , USA.
authors.forename: Tibor P
authors.initials: TP
authors.lastname: Palfai
authors.affiliation: a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston Medical Center and Boston University School of Medicine , Boston , Massachusetts , USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Alford
authors.affiliation: a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston Medical Center and Boston University School of Medicine , Boston , Massachusetts , USA.|d Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
authors.affiliation: a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston Medical Center and Boston University School of Medicine , Boston , Massachusetts , USA.|d Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000628:therapy*; D062405:Motivational Interviewing; D011320:Primary Health Care / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Brief intervention; marijuana; primary care; screening