Brief interventions delivered in general medical settings to reduce use and harms

A systematic review with meta-analysis (Tanner-Smith et al., 2021, RCTs = 116, N= 64 439) investigated the effectiveness of brief interventions in patients of any age or severity level recruited in general medical settings. Analyses were conducted separately by brief intervention (BI) target substance: alcohol only or drugs. The overall conclusion was that when delivered in general medical settings, alcohol-targeted brief interventions may produce small beneficial reductions in drinking (equivalent to a reduction in 1 drinking day per month), however there is limited evidence regarding the effects of drug-targeted brief interventions on drug use.

Specific results of the analysis found that:

• drug-targeted BIs yielded significant small improvements in multiple drug/mixed substance use (Hedges' g = 0.08; 95% CI = 0.002, 0.15), but after adjusting for multiple comparisons, they did not produce significant effects on cannabis use (g = 0.06; 95% CI = 0.001, 0.12), alcohol use (g= 0.08; 95% CI = -0.0003, 0.17), or consequences (g = 0.05; 95% CI = 0.01, 0.10)
• drug-targeted BIs yielded larger improvements in multiple drug/mixed substance use when delivered by a general practitioner (g = 0.19; 95% CI = 0.187, 0.193)
• alcohol-targeted BIs yielded small beneficial effects on alcohol use (g = 0.12; 95% CI 0.08, 0.16), but no evidence of an effect on consequences (g = 0.05; 95% CI = -0.04, 0.13). However, alcohol-targeted BIs only had beneficial effects on alcohol use when delivered in general medical settings (g = 0.17; 95% CI = 0.10, 0.24); the findings were inconclusive for those delivered in emergency department/trauma centers (g = 0.05; 95% CI = 0.00, 0.10)