Long-term Follow-up Study On Screening And Intervention Of Substance Abuse In Community Medical Institutions In Five Provinces And Cities

Objectives:The abuse(addiction)of alcohol,tobacco,benzodiazepines and other illicit addictive substances is a serious public health problem that affects individual health and social stability.Considering the lack of drug abuse intervention services in community medical institutions and the feasibility,feasibility and effectiveness of brief interventions to reduce drug abuse in other countries,we have conducted multi-center clinical practice in community medical institutions in five regions of China.The aim was to compare the effectiveness of the intensive intervention group,the brief intervention group,and the control group in reducing substance abuse(any illicit drug use or prescription drug abuse).Methods:Design: This study was conducted in community health facilities in five provinces of China(Shanghai,Xi’an,Harbin,Xinjiang,Henan).Participants: Participants were outpatients aged 18-75 years and their Alcohol,Smoking,and Substance Involvement Screening Test [ASSIST]screening questionnaire scores were moderately risky.Interventions: The brief intervention group(118 patients)received a brief intervention of 15-20 minutes,and the intensive intervention group(118 patients)received two brief interventions of 15-20 minutes in 1 weeks.The control group(120 patients)had no interventions,all participants received a written list of treatment for drug abuse disorders and mutual resources.The primary efficacy measure was the total ASSIST score at the third month of followup(for smoking behavior,the primary efficacy measure was the ASSISTtobacco score at the third month of follow-up.For drinking behavior,the primary efficacy measure was the third month follow-up.When ASSISTalcohol score).Secondary efficacy measures included changes in motivational scale scores at the third month of follow-up,depression scores,anxiety scores,positive/negative emotional scores,self-esteem scale selfesteem scale scores,addiction knowledge scores,and the Addiction Severity Index(ASI)composite scores.Results:A total of 356 subjects were enrolled in the study,and 319 were actually completed.In the intervention test,37 cases were detached and the detachment rate was 10.4%.The primary efficacy scores of the intensive intervention group,the brief intervention group,and the control group at baseline were ASSIST total scores of 23.16(10.61),22.02(10.94),and 23.12(11.57),respectively,and there was no significant difference between the three groups(P>0.05).After the clinical trial,the total scores of the primary efficacy indicators of the intensive intervention group,the brief intervention group,and the control group at the first month of follow-up were 16.05(7.68)20.89(12.41)and 24.30(11.84),respectively,and the interaction effect was significant(P <0.05);The primary efficacy scores of ASSIST scores at the third month follow-up were 12.27(7.40)19.77(13.22)and 24.23(11.68),respectively,and the interaction effect was significant(P<0.05).From the primary efficacy indicators,this indicates that the intervention effect of the intensive intervention group and the brief intervention group on the addictive substance abuse behavior is significantly better than the control group,and the intervention effect of the intensive intervention group is more significant than the brief intervention group.In addition,the main efficacy index of the intensive intervention group and the brief intervention group-ASSIST score scores decreased significantly at baseline,first month follow-up,and third-month follow-up at three time points,but the ASSIST total of the control group.There is no significant decline in the score trend.Finally,the primary efficacy indicators of the three groups were evaluated from the perspective of smoking behavior and drinking behavior.The ASSIST-tobacco/alcohol scores at the third month of follow-up were also consistent with the above results.Conclusion:(1)The two intervention groups for drug misuse have superior effectiveness to no-treatment controls.;(2)The intervention effect of the intervention group on the use behavior of the addictive substance was more significant than that of the brief intervention group;(3)Brief intervention improves motivation to change states;(4)Brief interventions can improve physical health of addicts;(5)Intensive intervention can reduce negative emotions in addicts.