Readers may remember that I was one of a number of speakers at an EMCDDA seminar earlier in the year.
They have now published the minute of the event and some of the presentations. The minutes include the following key messages:
- ‘Early intervention’ is a term that should be treated with caution (e.g. in quotation marks) as it does originally not refer to intervening early in drug use trajectories, but early in lifetime and is not necessarily related to substance use.
- More useful in this environment is the term ‘brief interventions”. These interventions have, often with a motivational interviewing element, been applied to a number of settings.
- Most of the literature on BI and MI is about adults, alcohol and primary health care. Implementation and effectiveness research on cannabis, other illicit drugs, young people and other-than-health-care settings is scarce.
- Effectiveness: Brief Interventions and motivational interviewing are effective, at least in primary health care for alcohol. Also the evidence on cannabis use is very promising; as well for computerised interventions (Carey et al., 2009; Khadjesari et al., 2011; Moreira et al., 2009; Rooke et al., 2010). It seems not to matter much who delivers the interventions, in terms of basic professional training, provided they have sufficient dedicated training and motivation.
- Roll-out: Brief interventions with a motivational interviewing are feasible to be applied in primary health care, particularly in National Health System. Experiences in UK and Spain have shown that. There are also promising experiences with young people and in street work settings. Better coordinating and streamlining existing different services (‘bust the silos’) might be an option in austerity times in order to achieve positive outcomes on health, social and substance use behaviours.
- To implement BI in public health systems, it needs to be backed with proper specialist referral systems and training systems for front line professionals: they need to know where to send people with special needs and have sources of support and skills development.