Voluntary Brief Intervention for Multiple Substances Is of Questionable Benefit in Young Adult Men

Evidence exists for the efficacy of brief interventions (BI) following a positive screen for at-risk or harmful drinking. Multi-substance use is the more common pattern in the general young adult population, however. The authors of this effectiveness trial investigated multi-substance* BI in a Swiss cohort of young adult men undergoing army conscription who voluntarily sought BI, without prior screening. Switzerland has a mandatory 2-day army recruitment conscription process for young men at age 19. During this process, conscripts complete a physical, medical, and cognitive assessment of fitness. Between 2008–2009, all conscripts were invited to a counseling session on tobacco, alcohol, and cannabis. Of 4767 conscripts available to participate in the study, 1052 voluntarily sought BI. Participants were randomized to receive assessment and BI (n=362) versus assessment only (control group, n=461). The authors also tested the incremental benefit of a 3-month booster session in the BI group.
 

• Although the BI subjects reported nonsignificant reductions in substance use on 10 of 12 measures at 6 months compared with controls, the only significant between-group difference was for cannabis use (from 45% to 39% in the control group versus 46% to 34% in the BI group [p=0.013]).

• There were no differences in outcomes in subjects who received a booster session at 3 months compared with those who did not.

Comments:

Although this study offered a possible model for a distinct population of young Swiss men who voluntarily sought a multi-substance BI, no differences were seen in alcohol or tobacco use outcomes, only a small decrease was seen in cannabis use, and there was no added benefit of BI booster sessions. Current screening and BI models—either with or without booster sessions—should be implemented to detect and treat substance use only in settings and for substance use patterns where efficacy is proven.

Jeanette M. Tetrault, MD

Reference:

Gmel G, Gaume J, Bertholet N, et al. Effectiveness of a brief integrative multiple substance use intervention among young men with and without booster sessions. J Subst Abuse Treat. August 10, 2012 [Epub ahead of print]. doi: 10.1016/jsat.2012.07.005