Evidence supporting the efficiency of counseling interventions for controling unhealthy alcohol use has compeled health care professionals to adopt this practice as a way of treating unhealthy drug use. However, its success rate for treating drug abuse is inconsistent. A study conducted at the Boston University School of Public Health suggests that brief intervention sessions lasting between 10 and 75 minutes are rarely effective in treating adults who suffer from unhealthy drug use.

"Prescription drug misuse is particularly complex, with diagnostic confusion between misuse for symptoms (e.g., pain, anxiety), euphoria-seeking, and drug diversion,” lead researcher Dr. Richard Saitz said in a statement. “Brief counseling may simply be inadequate to address these complexities, even as an initial strategy. These results do not support widespread implementation of illicit drug use and prescription drug misuse screening and brief intervention."

Saitz and his colleagues recruited 528 adult primary care patients with a history of unhealthy drug use. Out of the group of study participants, 63 percent reported reported frequent marijuana use, 19 percent said cocaine was their drug of choice, and 17 percent indicated opioid abuse. Patients were assigned to one of three groups including one that received a brief negotiated interview with health educators that lasted 10 to 15 minutes, a second group that underwent an adaptation of motivational interviewing lasting 30 to 45 minutes on top of a 20- to 30-minute booster with masters-level counselors, and a third group that received no intervention.

Findings revealed no significant difference in the number of days of drug use in the past 30 days among patients in the brief negotiated intervention group, motivational interview group, or the control group. There were also no perceivable differences in consequences related to drug use such as risky sexual behavior, intravenous drug use, hospital or emergency room visits due to addiction or mental health, or mutual help group attendance. The research team said that compared to unhealthy alcohol use, people who abuse drugs are less likely to benefit from a brief intervention, considering drugs are illegal, socially unacceptable, and can vary from occasional marijuana use to daily intravenous heroin use.

"Although these studies offer no direct evidence of effectiveness for universal drug screening, brief intervention, and referral to treatment in primary care settings, exploring drug use with patients should remain a priority in primary care. The goal for clinical research is to develop and test new interventions with potential for benefiting patients,” Dr. Ralph Higinson from National Institute on Alcohol Abuse and Alcoholism and Dr. Wilson Compton from the National Institute on Drug Abuse said in an accompanying editorial. “If brief interventions are insufficient, then easily accessible treatment services with long-term follow-up may be needed, as will development of efficient primary care referral approaches to address risky substance use and related physical and mental comorbidities."

Source: Saitz R, et al. JAMA. 2014.