Abstract
BACKGROUND: Screening and brief intervention (SBI), effective in community health care, show inconsistent results in correctional settings (CS). We hypothesized that SBI needs adaptation for the incarcerated population. The study aimed to evaluate the effectiveness of extended SBI (X-SBI) for substance misuse in CS. METHODS: A controlled trial was conducted in two federal CSs in India. X-SBI included coping skills training, risk behavior counseling, and acceptance-based stigma reduction, while the control group received screening, advice, and brief psychoeducation. Both groups received three sessions with 188 participants each, with a "moderate risk" of SUD. Measurements included the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), Timeline Follow-up for drug and alcohol use frequency, Overdose Risk Information, HIV risk-taking behavior scales, Self-reporting questionnaire, and Internalized Stigma of Substance Abuse scale. Follow-ups were done at three- and six months post-intervention. RESULTS: All participants were men. No initial differences in ASSIST scores or substance use frequencies were noted. ASSIST scores for all substances were significantly reduced at follow-ups. X-SBI showed better outcomes in reducing ASSIST scores for primary substances and illicit drugs, with small effect sizes (η(2) = .06-.10). Reductions in drug and alcohol use were noted in both groups, with X-SBI showing a greater decrease in illicit drug use at six months. X-SBI had higher transition rates to the "action" stage of motivation and significant declines in overdose and HIV risk behaviors, mental distress, and stigma scores. CONCLUSION: Integrating three-session X-SBI into CS may effectively address substance misuse. TRIAL REGISTRATION: Clinical Trial Registry, India (Reference No. CTRI/2022/01/0391XX).