group (from 49.2 percent at baseline to 34.6
percent three years after the first intervention).
The intervention participants also experienced
55 percent fewer nonfatal motor vehicle crashes
and 46 percent fewer arrests.^94 Another study
found that a 30-minute brief intervention was
associated with significantly fewer at-risk
patients* being arrested for driving under the
influence of alcohol during the next three years
(11.3 percent of brief intervention patients had a
DUI arrest vs. 21.9 percent of control group
patients).^95
A systematic review of emergency department-
based screening and brief intervention programs
found that 82 percent of the studies included in
the review demonstrated a positive effect.† 96
Even in non-emergency cases and cases
seemingly unrelated to substance use (e.g.,
general surgery and anesthesia consults),
routinely screening all pre-surgical patients for
risky use and addiction can prevent
complications from surgery, and brief
interventions or referral to treatment can prevent
the presenting condition from worsening.^97
Brief interventions conducted in trauma centers
for patients who engage in risky alcohol use
have been associated with a 47 percent reduction
in re-injuries requiring emergency department or
trauma center admission and a 48 percent
reduction in re-injuries requiring hospital
admission.^98 Brief interventions with follow-up
are more effective than single-contact
interventions:^99 a review comparing multi-
session and single-session brief alcohol
interventions found that those who received
multi-session brief interventions reported a 13 to
34 percent greater reduction in the average
number of drinks per week after six to 12
- Specifically, those who have a BAC ≥ 80 mg/dL or
a score ≥ 8 on the AUDIT screening instrument.
† Ninety percent showed a decrease in alcohol
consumption, 13 percent showed a decrease in
emergency department visits and hospitalizations, 13
percent showed a decrease in negative social
consequences and 13 percent showed an increase in
referrals for follow-up and/or treatment.
months than those receiving single-session brief
interventions.‡ 100Other Drugs ..................................................................................................................
Although the research on screening and brief
interventions for other drug use is quite limited
and therefore data supporting these services is
scarcer than in relation to tobacco and risky
alcohol use,^101 the available research suggests
that screening and brief interventions can reduce
other drug use among patients in primary care
facilities, emergency departments, trauma
centers and other hospital units.^102 In one study
conducted at six health care sites across the
country, patients who screened positive for drug
use (other than tobacco or alcohol) received
screening and brief interventions, brief treatment
or referrals to treatment based on the severity of
their drug use. Six months after receiving these
interventions, the percentage of patients
reporting past month marijuana, cocaine,
methamphetamine, heroin or other drug use--
including the misuse of prescription sedatives
and opioids as well as hallucinogens and
inhalants--decreased significantly.^103 However,
this study did not contain a control condition so
the extent to which substance use would have
decreased without these interventions cannot be
determined. (Figure 4.A)Patients in the study reported significant
increases in health status (from fair to good) and
employment (from 31.3 percent to 36.1 percent)
at the six-month follow-up as well. There also
were significant decreases in the percentage of
patients reporting past-month emotional
problems (from 25.6 percent to 17.6 percent),
arrests (from 12.2 percent to 4.4 percent) and
homelessness (from 11.8 percent to 6.4
percent).^104‡ Ranges rather than single values are cited because
the figures come from a meta-analysis comparing
results from multiple studies.