Brief Emergency Department Interventions for Youth Who Use Alcohol and Other Drugs: A Systematic Review

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  • Objective: Brief intervention (BI) is recommended for use with youth who use alcohol and other drugs. Emergency departments (EDs) can provide BIs at a time directly linked to harmful and hazardous use. The objective of this systematic review was to determine the effectiveness of EDbased BIs. Methods: We searched fourteen electronic databases, a clinical trial registry, conference proceedings, and study references. We included randomized controlled trials (RCTs) with youth ≤21 years old. Two reviewers independently selected studies and assessed methodological quality. One reviewer extracted, and a second verified, data. We summarized findings qualitatively. Results: Two trials with low risk of bias, 2 trials with unclear risk of bias, and 5 trials with high risk of bias were included. Trials evaluated targeted BIs for alcohol-positive (n=3) and alcohol/other drug-positive youth (n=1) and universal BIs for youth reporting recent alcohol (n=4) or cannabis use (n=1). Few differences were found in favor of ED-based BIs and variation in outcome measurement and poor study quality precluded firm conclusions for many comparisons. Universal and targeted BIs did not significantly reduce alcohol use more than other care. In one targeted BI trial with high risk of bias, motivational interviewing (MI) that involved parents reduced drinking quantity per occasion and high volume alcohol use compared to MI that was delivered to youth only. Another trial with high risk of bias reported an increase in abstinence and reduction in physical altercations when youth received peer-delivered universal MI for cannabis use. In 2 trials with unclear risk of bias, MI reduced drinking and driving and alcohol-related injuries after the ED visit. Computer-based MI delivered universally in 1 trial with low risk of bias reduced alcohol-related consequences 6 months after the ED visit. Conclusions: Clear benefits of using ED-based BI to reduce alcohol and other drug use and associated injuries or high-risk behaviours remain inconclusive because of variation in assessing outcomes and poor study quality.

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    • Newton AS, Dong K, Mabood N, Ata N, Ali S, Gokiert R, Vandermeer B, Tjosvold L, Hartling L, Wild TC. Brief emergency department interventions for youth who use alcohol and other drugs: a systematic review. Pediatric emergency care. 2013 May 1;29(5):673-84.
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    Pediatric Emergency Care
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