Development and Testing a Counseling strategy for drug and alcohol misuse in prisons.

Not yet recruiting

Conditions: Mental and behavioral disorders due to psychoactive substance use,

Registration Number: CTRI/2022/01/039182

Lead Sponsor: Indian Council of Medical Research

Brief Summary: **Introduction:**

A systematic review & meta-analysis foundthat the prevalence of drug use in prisons ranges from 10%-60% among men and30%-70% among women. Moreover, many prisoners would have been imprisonedbecause of their drug use (in countries where drug use has been criminalized,e.g., India). The drug-related deaths increased three to eight-fold in thefirst two weeks of discharge,6. Therefore substance use in prison poses asevere risk to public health and society. Indian prisons lack a systemicapproach to dealing with substance use disorders. An otherwise effectiveintervention, the ASSIST-linked enhanced SBIRT, could be tested in theresource-limited prison settings of India. If it is effective, it can addressthe treatment gap and reduce substance use and other substance-related complicationsin the prison population. A study of the predictors of response to the SBIRTshould help optimize the available resources. SBIRTcould also creates a windowof opportunity for the decriminalization of drug use by making treatmentavailable, accessible, acceptable, and affordable to those imprisoned for thepossession of small quantities of drugs.

**Objectives:**

To develop and test the enhanced-SBIRT for riskysubstance use.

To explore the barriers and facilitators of theintervention.

**Methods:**

The study will consist of formative,intervention, and post-intervention phases. The formative stage will havein-depth interviews and focus group discussions. The manually coded transcribeddata will generate the themes and sub-themes for developing the â€œenhancedâ€component of the SBIRT. The intervention phase will be a double-blind,individual-based, parallel-design RCT (n=188 in each arm after powercalculation). Results access may begin at 12 and 24 weeks after intervention.This phase is to determine the feasibility and preliminary efficacy of theintervention. Capability, Opportunity, Motivation-Behaviour change theoreticalframework will be used to understand the processes in the final phase of thepost-intervention process evaluation.

**Expected outcome:**

The newly developed enhanced-SBIRT should befeasible and acceptable to the Indian prison population. It will reduce theseverity, frequency of substance use, and will have a significant reduction inhigh-risk behaviour and overdose risk. The intervention will be tested at thestate and even at the national level.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 376

Inclusion Criteria

ASSIST score in the â€œmoderate riskâ€.
If the participant scores within the moderate-risk range for two or more of the target drugs, the intervention will be focused on the highest-scoring substance or the substance that is of most concern to the participant.
Alcohol, in any case, receive the intervention.
Inmates who will remain in the prison for at least 6 months following intervention; for under-trial prisoners, it will be decided on the basis of the next date of the court hearing.

Exclusion Criteria

Only tobacco use Unable to provide informed consent for cognitive impairment.
Not willing to participate in the intervention and for follow-up assessments.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
2. Feasibility and acceptability of brief intervention for substance use disorders in prison population	Third and Sixth months.
1. To develop the â€œenhancedâ€ component of SBIRT	Third and Sixth months.
3. Reduction in the ASSIST score by more or equal to 7 points in the intervention arm compared to the control arm.	Third and Sixth months.

Secondary Outcome Measures

Name	Time	Method
1. To identify the facilitators and barriers of the uptake of the intervention and to	modify the intervention accordingly.

Trial Locations

Locations (1): Postgraduate Institute of Medical Education and Research
🇮🇳
Chandigarh, CHANDIGARH, India
Postgraduate Institute of Medical Education and Research
🇮🇳Chandigarh, CHANDIGARH, India
Dr Debasish Basu
Principal investigator
9876826618
db_sm2002@yahoo.com