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Cited by 188Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentHIV, Drug Use, Sexual Risk

Brief Intervention for Problem Drug Use in Safety-Net Primary Care Settings: A Randomized Clinical Trial

Open access
Roy-Byrne, Peter, Bumgardner, Kristin, Krupski, Antoinette, Dunn, Chris, Ries, Richard, Donovan, Dennis, West, Imara I., Maynard, Charles +4 more·2014·JAMA
DOI 10.1001/jama.2014.7860PMC PMC4599980
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Abstract

IMPORTANCE: Although brief intervention is effective for reducing problem alcohol use, few data exist on its effectiveness for reducing problem drug use, a common issue in disadvantaged populations seeking care in safety-net medical settings (hospitals and community health clinics serving low-income patients with limited or no insurance). OBJECTIVE: To determine whether brief intervention improves drug use outcomes compared with enhanced care as usual. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial with blinded assessments at baseline and at 3, 6, 9, and 12 months conducted in 7 safety-net primary care clinics in Washington State. Of 1621 eligible patients reporting any problem drug use in the past 90 days, 868 consented and were randomized between April 2009 and September 2012. Follow-up participation was more than 87% at all points. INTERVENTIONS: Participants received a single brief intervention using motivational interviewing, a handout and list of substance abuse resources, and an attempted 10-minute telephone booster within 2 weeks (n = 435) or enhanced care as usual, which included a handout and list of substance abuse resources (n = 433). MAIN OUTCOMES AND MEASURES: The primary outcomes were self-reported days of problem drug use in the past 30 days and Addiction Severity Index-Lite (ASI) Drug Use composite score. Secondary outcomes were admission to substance abuse treatment; ASI composite scores for medical, psychiatric, social, and legal domains; emergency department and inpatient hospital admissions, arrests, mortality, and human immunodeficiency virus risk behavior. RESULTS: Mean days used of the most common problem drug at baseline were 14.40 (SD, 11.29) (brief intervention) and 13.25 (SD, 10.69) (enhanced care as usual); at 3 months postintervention, means were 11.87 (SD, 12.13) (brief intervention) and 9.84 (SD, 10.64) (enhanced care as usual) and not significantly different (difference in differences, β = 0.89 [95% CI, -0.49 to 2.26]). Mean ASI Drug Use composite score at baseline was 0.11 (SD, 0.10) (brief intervention) and 0.11 (SD, 0.10) (enhanced care as usual) and at 3 months was 0.10 (SD, 0.09) (brief intervention) and 0.09 (SD, 0.09) (enhanced care as usual) and not significantly different (difference in differences, β = 0.008 [95% CI, -0.006 to 0.021]). During the 12 months following intervention, no significant treatment differences were found for either variable. No significant differences were found for secondary outcomes. CONCLUSIONS AND RELEVANCE: A one-time brief intervention with attempted telephone booster had no effect on drug use in patients seen in safety-net primary care settings. This finding suggests a need for caution in promoting widespread adoption of this intervention for drug use in primary care. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00877331.

Integrity signals

Registry

Crossref · 10.1001/jama.2014.7860

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 30 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    GEE analyses found no significant treatment difference over 12 months in the ASI Drug Use composite (β = 0.005, 95% CI -0.005 to 0.016).

    “Generalized estimating equation analyses confirmed that there were no significant treatment differences during 12 months postintervention in either days of drug use (odds ratio, 1.20 [95% CI, 0.96 to 1.50]) or the ASI Drug Use composite (β = 0.005 [95% CI, –0.005 to 0.016]).”
    Quote in the paperSubstantial claim
  • Findingown data

    The intervention had no significant effect on any secondary outcome, including admission to chemical dependency treatment.

    “There were no significant intervention effects on any secondary outcomes, including admission to chemical dependency treatment.”
    Quote in the paperSubstantial claim
  • Findingown data

    The difference-in-differences estimate for days of drug use at 3 months was not statistically significant (β = 0.89, 95% CI -0.49 to 2.26).

    “Acute treatment differences based on difference in differences revealed no significant differences in either days of drug use (β = 0.89 [95% CI, –0.49 to 2.26]) or ASI Drug Use composite (β = 0.008 [95% CI, –0.006 to 0.021]).”
    Quote in the paperSubstantial claim
  • Findingown data

    GEE analyses found no significant treatment difference over 12 months in days of drug use (OR 1.20, 95% CI 0.96-1.50).

    “Generalized estimating equation analyses confirmed that there were no significant treatment differences during 12 months postintervention in either days of drug use (odds ratio, 1.20 [95% CI, 0.96 to 1.50]) or the ASI Drug Use composite (β = 0.005 [95% CI, –0.005 to 0.016]).”
    Quote in the paperSubstantial claim
  • Findingown data

    The difference-in-differences estimate for the ASI Drug Use composite at 3 months was not statistically significant (β = 0.008, 95% CI -0.006 to 0.021).

    “Acute treatment differences based on difference in differences revealed no significant differences in either days of drug use (β = 0.89 [95% CI, –0.49 to 2.26]) or ASI Drug Use composite (β = 0.008 [95% CI, –0.006 to 0.021]).”
    Quote in the paperSubstantial claim
  • May combine two claims. 22
  • Classified as probably not a substantial claim. 20
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    Baseline drug use severity, psychiatric comorbidity, and motivation to change did not significantly moderate the intervention effect on primary drug use outcomes.

    “Effect modification of primary drug use outcomes by baseline drug use severity, psychiatric comorbidity, and motivation to change revealed no significant moderation effects (eTable 4 and eTable 5 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Mean days of use of the most common problem drug were 14.40 (SD 11.29) in the brief intervention group and 13.25 (SD 10.69) in enhanced care as usual at baseline, and 11.97 (SD 12.13) and 9.84 (SD 10.64) at 3 months.

    “Mean days used of the most common problem drug at baseline were 14.40 (SD, 11.29) (brief intervention) and 13.25 (SD, 10.69) (enhanced care as usual) and at 3 months postintervention were 11.97 (SD, 12.13) (brief intervention) and 9.84 (SD, 10.64) (enhanced care as usual).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among participants with high baseline drug problem severity, those receiving the brief intervention were more likely to enter specialist drug treatment and to reduce emergency department use than those receiving enhanced care as usual.

    “Participants with high drug problem severity receiving the intervention were more likely to enter specialist drug treatment and more likely to reduce their use of the emergency department (Table 3 and eTable 6 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both groups had modest, similar reductions in drug use frequency during the first 3 months, with no further change thereafter.

    “Both groups showed modest and similar reductions in drug use frequency over the first 3 months with no subsequent change, possibly suggesting a regression to the mean in both groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The treatment means were virtually identical, with minimal change over time and no evidence of an intervention effect.

    “The treatment means in each plot are virtually identical, change over time is minimal, and there is no evidence of an intervention effect.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Adding positive urine screen results to self-reported drug use only slightly increased the proportion classified as using particular drugs.

    “Supplementing self-reported drug use with positive urine screen results only slightly increased the proportion of individuals classified as using particular drugs (eTable 3 in the Supplement).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In the sample, 56% had some comorbid mental illness and 37% had a goal of abstinence from drugs.

    “A majority of participants (56%) had some comorbid mental illness, and a minority (37%) had the goal to try to abstain from drugs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Mean ASI Drug Use composite score was 0.11 (SD 0.10) in both groups at baseline and 0.10 (SD 0.09) and 0.09 (SD 0.09) at 3 months.

    “Mean ASI Drug Use composite score at baseline was 0.11 (SD, 0.10) (brief intervention) and 0.11 (SD, 0.10) (enhanced care as usual) and at 3 months was 0.10 (SD, 0.09) (brief intervention) and 0.09 (SD, 0.09) (enhanced care as usual).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The study sample was severely socioeconomically disadvantaged.

    “Second, the sample was severely socioeconomically disadvantaged.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Drug use in the sample was highly heterogeneous, with different types and patterns of use across DAST-10 severity categories.

    “Drug use was similar between groups (mean, 13.82 [SD, 11.00] days of the most frequently used drug) and was highly heterogeneous, with different types and patterns of use evident according to the severity of drug use measured by validated DAST-10 score categories (eTable 1 and eTable 2 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Among three randomized clinical trials of brief intervention for drug abuse in non-treatment-seeking individuals, two reported positive results and only one found an effect in US patients.

    “Of the 3 randomized clinical trials of brief intervention for drug abuse in non–treatment-seeking individuals,5-8 only 2 were positive,7,8 and only 1 found an effect among US patients.8”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [5] Otto C Crackau B Löhrmann I Brief intervention in general hospital for problematic prescription drug use: 12-month outcome. Drug Alcohol Depend 2009 105 3 221 226 19726140

      Not checked in the free run.

    • cites [6] Zahradnik A Otto C Crackau B Randomized controlled trial of a brief intervention for problematic prescription drug use in non-treatment-seeking patients. Addiction 2009 104 1 109 117 19133895

      Not checked in the free run.

    • cites [7] Bernstein J Bernstein E Tassiopoulos K Heeren T Levenson S Hingson R Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend 2005 77 1 49 59 15607841

      Not checked in the free run.

    • cites [8] Humeniuk R Ali R Babor T A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addiction 2012 107 5 957 966 22126102

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The primary outcome was prespecified on ClinicalTrials.gov.

    “The primary outcome, prespecified on ClinicalTrials.gov, was self-reported days of drug use during the past 30 days.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Follow-up assessments at 3, 6, 9, and 12 months were conducted by research assistants blinded to randomization assignment.

    “All measures except the demographics and DAST-10 were repeated at 3-, 6-, 9-, and 12-month follow-up assessments conducted by research assistants blinded to randomization assignment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Individuals with drug abuse or dependence are disproportionately from lower socioeconomic strata and primarily receive care in public sector hospitals and community health clinics.

    “Recent studies show that a disproportionate number of individuals with drug abuse or dependence are from lower socioeconomic strata12 and primarily receive care in public sector hospitals and community health clinics (ie, safety-net medical settings that serve low-income patients with limited or no insurance).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Compton WM Thomas YF Stinson FS Grant BF Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007 64 5 566 576 17485608

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Participants were randomized 1:1 using permuted blocks stratified by clinic and by drug use severity, comorbid mental illness, and readiness to change.

    “participants were randomized in a 1:1 ratio (Figure) to brief intervention or enhanced care as usual using permuted blocks stratified by clinic and by 3 factors known to affect outcome: drug use severity20 (Drug Abuse Screening Test [DAST-10] score ≥3 [range, 0-10; 10 indicates greatest severity]; the DAST-10 instrument and interpretation guide are available in the eAppendix in the Supplement),”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Follow-up participation exceeded 87% at 3, 6, 9, and 12 months and was similar between groups.

    “Follow-up rates were greater than 87% at all 4 points (3, 6, 9, and 12 months) and were similar in both groups.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    All analyses were intention-to-treat, analyzing all available data by randomization group.

    “All analyses were intention-to-treat, with all available data from participants analyzed by randomization group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Allocation was concealed using sequentially numbered opaque envelopes opened by the research assistant at randomization.

    “allocation was concealed in sequentially numbered opaque envelopes opened by the research assistant at randomization.23”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Doig GS Simpson F Randomization and allocation concealment: a practical guide for researchers. J Crit Care 2005 20 2 187 193 16139163

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Baseline drug use was similar between groups, with a mean of 13.82 days of the most frequently used drug.

    “Drug use was similar between groups (mean, 13.82 [SD, 11.00] days of the most frequently used drug) and was highly heterogeneous, with different types and patterns of use evident according to the severity of drug use measured by validated DAST-10 score categories (eTable 1 and eTable 2 in the Supplement).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The null findings may be due to participant characteristics, intervention delivery, and outcome measurement.

    “Although our negative findings are consistent with prior studies in treatment-seeking patients in the United States,5,6,8 they also may be a product of our participant characteristics as well as the ways in which the intervention was conducted and the outcomes were evaluated.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [5] Otto C Crackau B Löhrmann I Brief intervention in general hospital for problematic prescription drug use: 12-month outcome. Drug Alcohol Depend 2009 105 3 221 226 19726140

      Not checked in the free run.

    • cites [6] Zahradnik A Otto C Crackau B Randomized controlled trial of a brief intervention for problematic prescription drug use in non-treatment-seeking patients. Addiction 2009 104 1 109 117 19133895

      Not checked in the free run.

    • cites [8] Humeniuk R Ali R Babor T A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addiction 2012 107 5 957 966 22126102

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Study design and conductown data

    Among intervention participants, 97% received the brief intervention and 47% received the booster call, so most had only a single contact.

    “Of the 435 participants randomized to the intervention, 423 (97%) received a brief intervention and 203 (47%) received a booster call.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    During follow-up, a small number of participants in both groups received brief interventions outside the study.

    “Over the course of the next year, a small number of participants in both conditions (brief intervention: n = 26; enhanced care as usual: n = 34) received brief interventions outside the study via regular clinical services.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    More frequent intervention contact may increase efficacy, although some studies have not found this.

    “Although more frequent contact may increase efficacy,1 some studies have failed to show this.38”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Kaner EF Beyer F Dickinson HO Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2007 2 CD004148 17443541

      Not checked in the free run.

    • cites [38] D'Onofrio G Fiellin DA Pantalon MV A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med 2012 60 2 181 192 22459448 PMC3811141

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The poverty and mental illness of the sample, and participant compensation, may limit generalizability.

    “These last 2 aspects of our population (poverty and mental illness), along with the fact that patients in this study received compensation, may limit the generalizability of our results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study used a hybrid efficacy-effectiveness design to enhance external validity by employing a brief intervention protocol similar to the Washington State SBIRT study and delivering it through clinic social workers.

    “A hybrid efficacy-effectiveness design was chosen to enhance external validity by using a brief intervention protocol similar to that used in the Substance Abuse and Mental Health Services Administration–funded Washington State SBIRT study16 and having the intervention delivered by social workers already working with patients in these clinics.17”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [16] Krupski A Sears JM Joesch JM Impact of brief interventions and brief treatment on admissions to chemical dependency treatment. Drug Alcohol Depend 2010 110 1-2 126 136 20347234

      Not checked in the free run.

    • cites [17] Carroll KM Rounsaville BJ Bridging the gap: a hybrid model to link efficacy and effectiveness research in substance abuse treatment. Psychiatr Serv 2003 54 3 333 339 12610240 PMC3650626

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Monthly group supervision and feedback on 25% of recorded brief interventions were used to maintain intervention fidelity.

    “Monthly group supervision and ongoing e-mailed feedback from the trainer (25% of recorded brief interventions) were used to maintain intervention fidelity.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The study was a randomized clinical trial with blinded assessments at baseline and 3, 6, 9, and 12 months.

    “A randomized clinical trial with blinded assessments at baseline and at 3, 6, 9, and 12 months conducted in 7 safety-net primary care clinics in Washington State.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The brief intervention averaged 27 minutes, and 86% were audio recorded.

    “The brief intervention averaged 27 minutes, and 86% of interventions were recorded.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    All interventionists met basic motivational interviewing proficiency goals on at least one practice role-play.

    “All interventionists met basic motivational interviewing proficiency training goals on at least 1 practice role-play.26”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Moyers TB Martin T Manuel JK Hendrickson SM Miller WR Assessing competence in the use of motivational interviewing. J Subst Abuse Treat 2005 28 1 19 26 15723728

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The assessment battery was kept brief to minimize unintended intervention effects and maximize completion around a primary care visit.

    “The assessment battery, administered by trained research assistants, was brief to minimize any unintended intervention effects17,28 and to maximize the chance of completing study procedures around a primary care visit.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [17] Carroll KM Rounsaville BJ Bridging the gap: a hybrid model to link efficacy and effectiveness research in substance abuse treatment. Psychiatr Serv 2003 54 3 333 339 12610240 PMC3650626

      Not checked in the free run.

    • cites [28] Kypri K Methodological issues in alcohol screening and brief intervention research. Subst Abus 2007 28 3 31 42 18077301

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Measuring frequency but not quantity of drug use is a limited outcome measure.

    “Fourth, measuring frequency but not quantity of drug use is a limited measure of outcome.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The intervention was not delivered by the participant's primary care physician or by a research-confirmed expert.

    “Second, the participant's primary care physician did not deliver the intervention, nor did a research-confirmed expert.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Comorbid mental illness is associated with poorer substance use outcomes.

    “Third, the sample had a high rate of comorbid mental illness, which is known to be associated with poorer substance use outcomes.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Krupski A Sears JM Joesch JM Self-reported alcohol and drug use six months after brief intervention: do changes in reported use vary by mental-health status? Addict Sci Clin Pract 2012 7 1 24 23186062 PMC3685518

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study lacked data on quantity of alcohol consumed per drinking day, so hazardous alcohol use could not be determined.

    “Many participants also used alcohol, but because we had no data on quantity of alcohol consumed per drinking day, determining degree of hazardous alcohol use was not possible.”
    Quote in the paperNot a substantial claim
34 of 34

  • The paper relies on this without support.

    There is no gold standard for quantifying problem drug use.

    “Currently there is no gold standard for quantifying problem drug use.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting three-month drug-use mean for the intervention group

    Minor

    The abstract reports 11.87 days for the brief-intervention group at three months, while the Results section reports 11.97 days for the same group and time point.

1 of 1

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Authors
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I. I., Maynard, C., Atkins, D. C., Graves, M. C., Joesch, J. M., & Zarkin, G. A.
Affiliations
  • Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
  • University of Washington (US)
  • RTI International (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2014-08-06
Volume
312
Issue
5
Pages
492
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2014.7860
PMC
PMC4599980
OpenAlex
W2022063518
Cited by
188
References
37
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 18 · 2018: 19 · 2017: 41 · 2016: 34 · 2015: 40 · 2014: 6
FWCI
30.48
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Drug Abuse (R01DA026014)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042828)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
brief intervention, problematic substance use, substance use disorders, safety-net primary care, motivational interviewing, Addiction Severity Index, substance abuse treatment admissions, HIV risk behavior, emergency department admission, arrests, mortality, health disparities, Washington State, Oregon, California, Colorado, New Mexico, Arizona, Nevada, Utah, Idaho, Montana
MeSH terms
Adult, Female, Patient Care, Humans, Male, Middle Aged, Patient Education as Topic, Primary Health Care, Severity of Illness Index, Telephone, Treatment Outcome, Substance-Related Disorders, Motivational Interviewing, Safety-net Providers

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