The identification and management of unhealthy substance use in primary care are public health priorities. Screening, brief intervention, and referral to treatment (SBIRT) has been widely disseminated for this purpose, despite limited evidence of efficacy. Recovery management checkups (RMCs) may consist of personalized feedback, care facilitation, scheduling assistance, and follow-up calls; they are designed to improve substance use treatment engagement, linkage, and retention. This paper provided 3-month results from a randomized controlled trial comparing primary care-based SBIRT with SBIRT+RMC in US Federally Qualified Health Centers (FQHCs).
- Participants were recruited from 4 FQHCs and were included if they had a score of ≥5 on the Alcohol Use Disorders Identification Test (AUDIT), or a score of ≥3 on the Drug Abuse Screening Test (DAST), and were not already engaged in treatment.
- Of the 266 participants, most were male (65%) and Black (81%); the average age was 48. Most participants had alcohol use disorder (68%), followed by cannabis (35%), stimulant (35%), and opioid use disorder (24%).
- Participants who received SBIRT+RMC were significantly more likely than those who received SBIRT alone to access any treatment at 3 months (46 percent versus 20 percent, respectively); they also reported more days of abstinence (41 versus 32 days).
Comments: Substance use disorders are chronic conditions that cannot be sufficiently addressed by a one-time intervention. Most individuals with unhealthy substance use need ongoing treatment and support; recovery management checkups are a promising way of delivering this.
Darius A. Rastegar, MD
Reference: Scott CK, Dennis ML, Grella CE, et al. Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings. Addiction. 2023;118(3):520–532.