title: Screening and Brief Interventions for Illicit Drug Use and Alcohol Use in Methadone Maintained Opiate-Dependent Patients: Results of a Pilot Cluster Randomized Controlled Trial Feasibility Study.
abstract: The present study evaluated the effectiveness of a single clinician delivered brief intervention (BI) to reduce problem alcohol use and illicit substance use in an opiate-dependent methadone maintained cohort of patients attending for treatment.
  
  
  
  Four addiction treatment centers were randomly assigned to either treatment as usual (TAU; control group) or BI (intervention group). Clinicians screened patients using the alcohol, smoking, and substance involvement screening test (ASSIST) screening tool at baseline and again at three-month follow up. Fidelity checks were performed to ensure that training was delivered effectively and uniformly across all study sites. Feasibility of administering a BI within daily practice was assessed through intervention fidelity checks, patient satisfaction questionnaires and process evaluation.
  
  
  
  A total of 465 patients were screened (66% of the overall eligible population) with a total of 433 (93%) ASSIST positive cases. Randomization was effective, with no differences in the control versus the intervention arms at baseline for key demographic or clinical indicators including substance us. There was a statistically significant difference between global risk score for the intervention (x = 39.36, sd = 25.91) group and the control group (x = 45.27, SD = 27.52) at 3-month follow-up (t(341) = -2.07, p < .05).
  
  
  
  This trial provides the first evidence that a single clinician delivered BI can result in a reduction in substance use within a methadone maintained opiate-dependent cohort, and this effect is sustained at three month follow up.
authors.affiliation: a Department of Public Health & Primary Care , Trinity College Dublin , Dublin , Ireland.
authors.forename: Catherine D
authors.initials: CD
authors.lastname: Darker
authors.affiliation: b Tara Trust , Edinburgh , Scotland ;
authors.forename: Brion
authors.initials: B
authors.lastname: Sweeney
authors.affiliation: c HSE Addiction Service , Dublin , Ireland.
authors.forename: Eamon
authors.initials: E
authors.lastname: Keenan
authors.affiliation: a Department of Public Health & Primary Care , Trinity College Dublin , Dublin , Ireland.
authors.forename: Lucy
authors.initials: L
authors.lastname: Whiston
authors.affiliation: d Charlemont Clinic , Dublin , Ireland.
authors.forename: Rolande
authors.initials: R
authors.lastname: Anderson
authors.affiliation: a Department of Public Health & Primary Care , Trinity College Dublin , Dublin , Ireland.
authors.forename: Joseph
authors.initials: J
authors.lastname: Barry
mesh_terms: D000428:Alcohol Drinking; D005240:Feasibility Studies; D006801:Humans; D013287:Illicit Drugs; D008691:Methadone; D053610:Opiate Alkaloids; D010865:Pilot Projects; D019966:Substance-Related Disorders
chemical_list: D013287:Illicit Drugs; D053610:Opiate Alkaloids; D008691:Methadone
keywords: Substance abuse; alcohol; illicit drugs; methadone; motivational interviewing; randomized controlled trial