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Efficacy of Brief Interventions for Comorbid Substance Misuse in Patients on Opioid Agonist Treatment: A Systematic Review and Meta-analysis

Efficacy of Brief Interventions for Comorbid Substance Misuse in Patients on Opioid Agonist... Background and Aims Multiple substance use is a common but underrecognized problem in patients on opioid agonist treatment (OAT). Co-occurring substance misuse is associated with poor clinical and psychosocial outcomes. We aimed (a) to determine the effect of screening and brief intervention (SBI) for substance misuse in people on OAT and (b) to qualitatively summarize the implementation of SBI. Methods We performed a systematic review of clinical trials on the efficacy of SBI for alcohol and drug misuse in participants on OAT. We searched 5 electronic databases and included published studies and unpublished trials. We measured the standardized mean difference in substance risk scores before and after intervention. We also estimated the standardized mean difference in alcohol consumption per day before and after intervention. Results We included a total of 8 studies; 5 of these were included in the meta-analysis, and all were reviewed for narrative synthesis. We observed a significant change in the pre-post brief intervention substance risk scores with a medium effect size (Hedges g = 0.752, 95% confidence interval, 0.405–1.099). Sensitivity analyses with different pretest-posttest correlations did not change our result. Modest effects of SBI were found in reducing both alcohol and illicit drug risk scores, and among the population on methadone and buprenorphine treatment. We also observed a significant decrease in alcohol consumption per day 3 months after SBI. Studies showed a limited and incomplete screening for substance misuse and delivery of brief intervention in OAT settings. Conclusions Screening and brief intervention may be a potential treatment for co-occurring substance misuse among patients on OAT. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Addiction Medicine Wolters Kluwer Health

Efficacy of Brief Interventions for Comorbid Substance Misuse in Patients on Opioid Agonist Treatment: A Systematic Review and Meta-analysis

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References (32)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2022 American Society of Addiction Medicine
ISSN
1932-0620
eISSN
1935-3227
DOI
10.1097/adm.0000000000001058
Publisher site
See Article on Publisher Site

Abstract

Background and Aims Multiple substance use is a common but underrecognized problem in patients on opioid agonist treatment (OAT). Co-occurring substance misuse is associated with poor clinical and psychosocial outcomes. We aimed (a) to determine the effect of screening and brief intervention (SBI) for substance misuse in people on OAT and (b) to qualitatively summarize the implementation of SBI. Methods We performed a systematic review of clinical trials on the efficacy of SBI for alcohol and drug misuse in participants on OAT. We searched 5 electronic databases and included published studies and unpublished trials. We measured the standardized mean difference in substance risk scores before and after intervention. We also estimated the standardized mean difference in alcohol consumption per day before and after intervention. Results We included a total of 8 studies; 5 of these were included in the meta-analysis, and all were reviewed for narrative synthesis. We observed a significant change in the pre-post brief intervention substance risk scores with a medium effect size (Hedges g = 0.752, 95% confidence interval, 0.405–1.099). Sensitivity analyses with different pretest-posttest correlations did not change our result. Modest effects of SBI were found in reducing both alcohol and illicit drug risk scores, and among the population on methadone and buprenorphine treatment. We also observed a significant decrease in alcohol consumption per day 3 months after SBI. Studies showed a limited and incomplete screening for substance misuse and delivery of brief intervention in OAT settings. Conclusions Screening and brief intervention may be a potential treatment for co-occurring substance misuse among patients on OAT.

Journal

Journal of Addiction MedicineWolters Kluwer Health

Published: Mar 24, 2023

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