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Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms
Author(s) -
Drislane Laura E.,
Waller Rebecca,
Martz Meghan E.,
Bonar Erin E.,
Walton Maureen A.,
Chermack Stephen T.,
Blow Frederic C.
Publication year - 2020
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.14781
Subject(s) - cannabis , anxiety , psychological intervention , medicine , psychiatry , randomized controlled trial , alcohol use disorder , brief intervention , emergency department , clinical psychology , poison control , alcohol , emergency medicine , biochemistry , chemistry , surgery
Background and Aims Despite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapist‐delivered BI (TBI) or computer‐guided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time. Design Latent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment. Setting Hurley Medical Center Emergency Department (ED) in Flint, MI, USA. Participants The sample was 780 drug‐using adults (aged 18–60 years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the Healthi ER You study. Interventions and comparator ED‐delivered TBI and CBIs involved touchscreen‐delivered and audio‐assisted content. The TBI was administered by a Master's‐level therapist, whereas the CBI was self‐administered using a virtual health counselor. EUC included a review of health resources brochures in the ED. Measurements Assessments of alcohol use (10‐item Alcohol Use Disorders Identification Test), cannabis use (past 30‐day frequency) and anxiety symptoms (Brief Symptom Inventory‐18) occurred at baseline and 3‐, 6‐ and 12‐month follow‐up. Findings TBI, relative to EUC, was associated with significant reductions in cannabis use [B = –0.49, standard error (SE) = 0.20, P < 0.05) and anxiety (B = –0.04, SE = 0.02, P < 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (B = –0.60, SE = 0.19, P < 0.01) and patients aged 18–25 years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (B = –0.78, SE = 0.31, P < 0.05). Results for CBI were non‐significant. Conclusions Emergency department‐based therapist‐delivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.